If you develop severe big toe pain in the middle of the night, and it is so tender that you can’t even stand the pressure of the sheet on it, you may have GOUT, an increasingly common form of ARTHRITIS.

And you would be in famous company: King Henry Vlll, Isaac Newton, and Benjamin Franklin all had Gout. There is even a famous dialogue between Franklin and his Tormentor.

Gout is caused by a buildup of URIC ACID in the bloodstream. This buildup can be caused by eating too much nucleic-acid-containing foods, like meats, “sweetbreads” and shellfish, and drinking too much alcohol, especially beer.

Reduced Clearance of Uric acid in the kidneys may contribute, and may be responsible for some of the familial tendencies of gout. The uric excess acid in the blood stream gets into joint tissues, most famously the big toe, although ankles, knees and other joints may be involved.

When deposited in joint tissues, the uric acid crystals attract inflammatory cells, which secrete their Interleukins and produce all of the symptoms of painful, red and swollen joints.

Risk factors include Obesity, diabetes, and the usual suite of problems of the METABOLIC SYNDROME. Just look at a picture of Henry Vlll with a mug of beer in one hand, and a leg of mutton in the other, and your big toe will start to hurt.

Dietary regulation is one of the best ways of reducing PURINE AND PYRIMIDINE intake and consequently the metabolic BYPRODUCT, Uric Acid, in the circulation.

There are DRUGS, called uricosurics, which will cause the kidneys to Clear more Uric acid, and other drugs, such as thiazide diuretics, which will reduce clearance and excretion of gout’s causative agent.

Yes, UNHEALTHFUL EATING CAN BE PAINFUL.

–DR. C