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In A Gout Study, A Low Purine Diet Reduced Uric Acid Levels Better Than Allopurinol
By
John Mepham |
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Do you want a natural remedy for gout? Here's a study that should give you some inspiration, but remember that one study "does not make a summer". In this study uric acid levels fell despite the fact that those taking part did not lose weight.
In this study, (details at the end of this article) the participants did not have gout, but they were certainly at risk for it because they had high uric acid levels – the men 8.5 mg/dL and above; the women 7.5 mg/dL and above. And other risk factors were that they were overweight or obese and had hypertension. The study lasted 36 weeks. 55 patients finished it.
The researchers wanted to learn whether a low purine diet, a low purine diet plus Allopurinol or just Allopurinol, would reduce uric acid levels. And which would do best? So study participants were divided into three groups and placed on one of these three gout treatment options.
THE RULES
High purine foods were defined as those with 100 mg – 1,000 mg of purines per 100 grams of food. The diet was high in carbohydrates, and average calorie amounts varied between 1,670 and 1,854 daily across all groups during the first twelve weeks.
Other natural remedies were not tried alongside the study since they would have skewed results. The main objective of the study was to observe uric acid (UA) changes as a result of purine restriction and compare them with Allopurinol.
Foods high in oxalates were also restricted. These foods can be a risk of kidney stones made from oxalates. Liquids were encouraged. Water is always an obligatory part of gout treatment. In this case 2.5 – 3.5 litres (liters) daily. That is 93 fl.ozs – 127 fl. ozs, or about 12 – 16 glasses daily, which is at the high end of the usual daily recommendations for water only.
Allopurinol dose amounts Those participants who took Allopurinol received at first 150 mg daily. After six weeks, if their uric acid levels remained high, the dosage was increased to 300 mg daily. 150 mg – 300 mg daily is a reasonably typical dose of Allopurinol for people who have gout and no other medical difficulties.
Anti-hypertensive medications Most participants took anti-hypertensive medications during the study. Remember they did suffer hypertension (high blood pressure). Actually most took thiazide diuretics for hypertension. These have a reputation for raising UA levels but the researchers said that in this study these anti -hypertensive drugs did not affect outcomes, probably, they thought, because they were taken in low dosages.
THE RESULTS
After six weeks all three groups reduced uric acid levels. After 12 weeks, in Group 1 (low purine diet only) and Group 2 (low purine diet plus Allopurinol) participants' UA levels rose slightly and those in Group 3 enjoyed an additional fall.
But after 36 weeks the picture changed. Group 1 (diet only) levels fell; in Group 2, (diet plus Allopurinol) they rose for the second time, and in Group 3 (Allopurinol only) there was a rise above the levels achieved after 6 and 12 weeks!
So which group won? If the whole period of the study is considered, all groups enjoyed a fall in UA levels, but in which group did it fall the most?
It was in Group 1, those on the low purine diet. By, an average of –2.09 mg/dL This was a fall of 24% from initial levels.
In Group 2 (diet plus Allopurinol) the UA fall over the whole period was –1.23 mg/dL (–13% from starting levels). The balance of men to women in Groups 1 and 3 was about the same (1 man: 2 women). In Group 2, because group participants were chosen at random, it was reversed (2 men: 1 woman). This may have affected the Group 2 results.
In Group 3 (Allopurinol only) the 36 weeks fall was –1.20 mg/dL (–13.25%).
In the 24 weeks after the monitoring at 12 weeks, UA levels rose in the diet plus Allopurinol and Allopurinol only groups. In the first 6 weeks, Allopurinol plus the diet worked best across all three groups.
FINAL THOUGHTS
There's uncertainty in coming to firm convictions from one study. Successful gout treatment is a question of probabilities. And in this study, patients did not have gout, they had hyperuricemia, hypertension and they were overweight or obese. But here are a few ideas worth considering.
Allopurinol solely (with no other additional treatment except drinking lots of water) may work best in the first 6 – 12 weeks, as it did here. If it doesn't work after 12 weeks it may never work. Allopurinol dosages were increased after 6 weeks among patients for whom Allopurinol was not working, but this seems to have had no effect by the end. On the other hand, Allopurinol has performed better in other studies.
The benefits of a low purine gout diet grow over time. You may need to try it (if it's the sole treatment plus water drinking) for 5-6 months.
Trying a low purine diet plus Allopurinol (a fairly normal treatment) worked the best among these three Groups, during the first six weeks. But the 12 and 36 week measurements recorded increases (the 12 week one a tiny one) in UA levels. Allopurinol dosages were increased after 6 weeks among patients in this group for whom Allopurinol was not working, but this also seems to have had no effect after 36 weeks. So after 12 weeks it may never work.
However, as in all groups, the 36 week figure was down from initial levels.
Did they lose weight on this diet? No. Calorie restriction was not excessive, if at all, bearing in mind that a majority of participants were women, and the diet was high in carbohydrates. If they had lost weight uric acid (UA) levels could have fallen further.
RESEARCHERS' CONCLUSION
The researchers' conclusion was that a low purine diet for gout should be tried first. It also has the advantage of being a cheap gout cure.
NB. The contents of this article contain medical information not medical advice. Please always discuss remedies with your doctor or other health care professional, before implementing any treatment.
Author's Bio
John Mepham has spent much time researching natural remedies for gout. His best tip for treating gout? Get to, and stay at, your ideal weight, whatever the sacrifices may be. Read more about gout remedies at www.best-gout-remedies.com a website with an emphasis on natural gout treatment. If you wish to read this study, which took place in Brazil in 2001 – it's called "Diet and Medication in the Treatment of Hyperuricemia in Hypertensive Patients" – click on this link. http://www.scielo.br/pdf/abc/v76n6/4688.pdf
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