Just like me, it seems, the LA Times gets letters from its readers about the danger of gout.
It published three letters about gout yesterday, and the depth of ignorance from sufferers, alternative medicine promoters, and qualified medical personnel drives me to despair.

One gout sufferer blames beer. Though alcohol can affect kidney performance in some people, and drinking beer can promote dehydration – a sure cause of gout, to hope that simply stopping drinking beer will stop gout is naive in the extreme. He notes that avoiding dehydration and restricting joints can trigger gout attacks. Both these are true, but avoid the main danger of gout.

Another reader claims respite from gout pain for a year through black cherry concentrate capsules daily, and indomethacin when required. These may well reduce gout pain, but again, they do nothing to avoid the main danger of gout.

The worst story comes from a man who has consulted 4 doctors – 2 of these have had gout and ought to know what they are talking about. But they don’t. He has even been given allopurinol, the best current cure for gout, but it has not worked – presumably because he has not been advised properly how and when to take it.

I was moved to write to them, in the hope that at least a few gout sufferers in Los Angeles might find some permanent relief. I have no idea if they will publish my letter – I’m not even US resident, never mind LA.

Just so you don’t miss out dealing with the danger of gout, here are the key points:

Keep uric acid levels below 6mg/dL.
Allopurinol is best, but if you cannot tolerate it ask about other uricosuric treatments, or new uric acid lowering therapies, like febuxostat or uricase derivatives
Get treated!
Many gout patients do not get uric acid lowering treatment. Those that do are not monitored to ensure the dose is correct – a complete waste of time and money.
Expect pain
Reducing uric acid often causes temporary gout pain until all existing crystals are dissolved. Your doctor should prescribe appropriate pain relief, like colchicine, ibuprofen or other NSAIDs
Consider alternatives
You might lower uric acid through dieting, if your got is not too severe. It is vital to monitor uric acid levels frequently. Do not rely on pain to tell you if you are getting better. The pain caused by new uric acid crystals is the same as pain caused by old uric acid crystals dissolving.
Consult a rheumatologist
I’ve mentioned The American College of Rheumatology listing of rheumatologists on many occasions. Use it.

Do not waste your money on anything unless you understand these basic facts about gout. There are many things that will help you, but only lowering uric acid below 6mg/dL will avoid the long-term danger of gout from uric acid crystals.

Danger Of GoutIf you do not treat uric acid crystals they will increase, often slowly, over many years, and with no real pain symptoms. Then the true danger of gout reveals itself – crippling joint damage and skin-bursting tophi.

These are some of the most important points about gout. As part of my better gout treatment campaign, which I launched in my last newsletter, I am developing key points about gout into a gout patients charter. Please help me focus on the issues that are important to you by completing my gout survey.