Anyone ever have gout?

Originally posted by Number Six [/i]

>>The first time I had gout the doctor prescribed Indocin (I think)

Did your doctor give you the straight dope on possible adverse reactions, including:

"Anemia, anxiety, asthma, behavior disturbances, bloating, blurred vision, breast changes, changes in heart rate, chest pain, coma, congestive heart failure, convulsions, decrease in white blood cells, fever, fluid in lungs, fluid retention, flushing, gas, hair loss, hepatitis, high or low blood pressure, hives, itching, increase in blood sugar, insomnia, kidney failure, labored breathing, light-headedness, loss of appetite, mental confusion, muscle weakness, nosebleed, peptic ulcer, problems in hearing, rash, rectal bleeding, Stevens-Johnson syndrome (skin peeling), stomach or intestinal bleeding, sweating, twitching, unusual redness of skin, vaginal bleeding, weight gain, worsening of epilepsy, yellow eyes and skin."

http://www.picosearch.com/cgi-bin/ts.pl

Thus the possilbe adverse reactions to taking this drug include death (heart failure, Kidney failure, etc.,) among other things. And your doctor appraised you of all this??


>> When I had it again recently I bought Advil over the counter.

Alas, even Advil, a very much less dangerous drug, has, among its "rare" side effects the possibility of a mortal event.

http://www.rxmed.com/b.main/b2.pharmaceutical/b2.1.monographs/CPS- Monographs/CPS- (General%20Monographs-%20A)/ADVIL.html


>>Just out of curiousity, why do you say that drugs by definition are harmful?

Because if they didn't do any harm, they wouldn't be called drugs.
 
Why do you think that if something is called a "drug" is has to cause harm. As I said before, if you mean this in the sense of "everything causes harm and therefore drugs cause harm" then you're strictly correct but making such a point seems meaningless. But if you don't mean it in that context then I don't understand. Why would all drugs, for example, be harmful, but not all food and liquids and environmental exposure and everything else?

A possible side effect doesn't mean a certain side effect. A possible side effect of me typing on this computer is wrist pain or even death by 1 in a trillion odd chemical reaction causing the computer to explode. Can we say the computer is dangerous. Any food you ingest can be choked on and many (maybe all if we're going to be strict) foods are harmful, some not to some people but to others. Can we say food is harmful? How about water? It kills lots of people every year. What is the point you're getting at with all this?

As far as the side effect of drugs go I already knew every drug (and every _thing_) has side effects. An inevitable side effect of life is death. So what? In the end everything is a cost-benefit analysis anyway, not an absolute "X is good, Y is bad" dichotomy.
 
Number Six said:
Why do you think that if something is called a "drug" is has to cause harm. As I said before, if you mean this in the sense of "everything causes harm and therefore drugs cause harm" then you're strictly correct but making such a point seems meaningless. But if you don't mean it in that context then I don't understand. Why would all drugs, for example, be harmful, but not all food and liquids and environmental exposure and everything else?

A possible side effect doesn't mean a certain side effect. A possible side effect of me typing on this computer is wrist pain or even death by 1 in a trillion odd chemical reaction causing the computer to explode. Can we say the computer is dangerous. Any food you ingest can be choked on and many (maybe all if we're going to be strict) foods are harmful, some not to some people but to others. Can we say food is harmful? How about water? It kills lots of people every year. What is the point you're getting at with all this?

As far as the side effect of drugs go I already knew every drug (and every _thing_) has side effects. An inevitable side effect of life is death. So what? In the end everything is a cost-benefit analysis anyway, not an absolute "X is good, Y is bad" dichotomy.
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There are substances that one can ingest that can prevent or cure illness but do no harm. They are called foods. But you did not answer my question. Did your doctor fully appraise you of all possible adverse effects? And if he did, he certainly did not give you any fixed percentages such as "one in a trillion". That's not how the system works. Hard percentages are hardly ever given, even if available. The term 'rare" is a favorite, but no one knows what "rare" means. "Rare" adverse reactions may range from .0001 percent to 25 or 35 or 49 percent. It is the very ambiguity of such words that keep the drugs a-flowing.
 
Why is it that foods can prevent or cure illness but do no harm whereas drugs can't? Why should the name of something determine whether it can harm you? That implies that if the FDA classifies a certain food as a drug it becomes harmful even though it is the same substance as before is was classified as a drug, which doesn't make any sense.

Whether it's food or drug or anything else you ingest into your body, whether it has an effect on you depends on...whether it has an effect on you! It doesn't depend on whether it's called a "drug" or a "food" or grows on a bush in North America or in a root in Africa or is synthesized in a lab in China. Right? Or am I missing something? If something has a differential effect simply because of it's name or how it comes into existence then I'd love to know why. Substances are substances and "drug" or "food" or whatever are just names we apply to them.

As far as the drug I took, as I recall, the doc didn't say anything about adverse effects except to say to not take it with liquor and to take it with food and that the pill bottle itself listed some possible adverse effects. But I was somewhat familiar with the drug to begin with (although I didn't know it was used to treat gout...then again I didn't even know what gout was until I got it).

As far as rates of adverse events goes, they most definitely do keep track of those, bot pre-drug approval and post-drug approval. It's impossible to say what the chances are for any single person but there are estimates for the population as a whole for just about every drug and every adverse event you can think of. When they do drug trials they have to track and report every single adverse event. It could be that the adverse event is due to the drug or it could be that the adverse event is coincidental and would have occured even without the drug. Believe it or even not, people eating only food and not using drugs have adverse events.
 
Rouser2 said:
There are substances that one can ingest that can prevent or cure illness but do no harm. They are called foods.
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Foods can most certainly do harm. For example, the very condition we're talking about here (gout) is strongly associated with certain foods as has been amply discussed. Some foods cause serious or even fatal allergic reactions in some people.

So, medicinal substances have the potential to cause adverse effects, at least to some people. Foods also have the potential to cause adverse effects, at least to some people. Remind me of the difference, again?

Rolfe.
 
I'm sitting here thinking, "Alcohol", which is a drug as well as a food. Rouser, what's your stance on alcohol?

What about caffeine--coffee, tea, Pepsi?

Tobacco? Nicotine?

How are you defining "drug", IOW? As any refined substance that gets put into a pill? What about nutriceuticals, herbal teas?
 
Originally posted by Number Six [/i]

>>Why is it that foods can prevent or cure illness but do no harm whereas drugs can't? Why should the name of something determine whether it can harm you?

The name doesn't do the determining; the substance does. If it's harmful, it's called a drug. Just try to go to the PDR or Medline or any other drug source and try to find even one drug that has no adverse effects.

>>As far as the drug I took, as I recall, the doc didn't say anything about adverse effects except to say to not take it with liquor and to take it with food and that the pill bottle itself listed some possible adverse effects. But I was somewhat familiar with the drug to begin with (although I didn't know it was used to treat gout...then again I didn't even know what gout was until I got it).

You survived the meds (at least for now). But if there had been some serious adverse reaction, your doctor could simply say, "well hey, I told him to read the label."

But all this misses an important point. Drugs seldom "cure" anything. What they mainly do is get rid of or hide symptoms. You and I both have had episodes with gout. What this can mean, among other thngs, is that we had been doing something wrong with our life style -- eating habits and exercise or lack thereof. To take a drug to get rid of the pain does not address the facts concering lifestyle. In the future, serious kidney problems may develop. Seems to me a much better, healthier idea to correct the lifestyle than to mask the symptoms with drugs.

>>As far as rates of adverse events goes, they most definitely do keep track of those, bot pre-drug approval and post-drug approval.

You won't hardly find any such specific percentages listed in PDR of the like for any adverse drug event.
 
Originally posted by Goshawk [/i]


I'm sitting here thinking, "Alcohol", which is a drug as well as a food. Rouser, what's your stance on alcohol?
What about caffeine--coffee, tea, Pepsi?
Tobacco? Nicotine?

All drugs. And they all kill

>>How are you defining "drug", IOW? As any refined substance that gets put into a pill? What about nutriceuticals, herbal teas?


Herbal teas? Depends on the herb. Green tea, definitely a food, with a touch of caffein (drug) included.
 
Originally posted by Rolfe [/i]


Foods can most certainly do harm. For example, the very condition we're talking about here (gout) is strongly associated with certain foods as has been amply discussed. Some foods cause serious or even fatal allergic reactions in some people.


True enough. But generally speaking, a food is a food. If any food is taken to excess, it may be harmful.
 
Rouser2 said:
The name doesn't do the determining; the substance does. If it's harmful, it's called a drug. Just try to go to the PDR or Medline or any other drug source and try to find even one drug that has no adverse effects.[/B]
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That is in agreement with what I was stating earlier that everything that exists is harmful by the strictest defintion. Fine, I accept that. By the way the regulatory process works they have to investigate everything to death and then list all possible adverse events. If *any* food were classified as a drug then it would go through the same process and it too would have adverse events associated with it. The fact that Indocin has adverse effects listed and broccoli does not is not because broccoli can't cause adverse events but rather because it's not required that adverse events from broccoli be compiled or listed.

Rouser2 said:
You survived the meds (at least for now). But if there had been some serious adverse reaction, your doctor could simply say, "well hey, I told him to read the label.".[/B]
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All survival is temporary, is it not? I think there was a lot better chance I'd get hit by a car crossing the road because I walked so slowly with gout than there was that taking a few Indocin over a 24 hour period would cause my death.

Rouser2 said:
But all this misses an important point. Drugs seldom "cure" anything. What they mainly do is get rid of or hide symptoms. You and I both have had episodes with gout. What this can mean, among other thngs, is that we had been doing something wrong with our life style -- eating habits and exercise or lack thereof. To take a drug to get rid of the pain does not address the facts concering lifestyle. In the future, serious kidney problems may develop. Seems to me a much better, healthier idea to correct the lifestyle than to mask the symptoms with drugs.[/B]
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When you get a disease or illness it doesn't necessarily mean you've done something wrong. Everything breaks down and dies, no matter what.

If you're arguing that people should eat right and exercise then just say that and you won't get much argument from people. But note that "eating right" and "exercise" are words with things associated with them. Running 100 miles a day is exercise but but it's bad for most people. Walking 10 feet a day is exercise but it's bad for most people. Walking 3 miles a day is exercise and whlie it's good for most people it's bad for some people. "Exercise" isn't good for people, rather certain things are good for people (in general...not necessarily for every person) and we call those things "exercise." Similarly, "eating right" is good but not because it's "eating right" but rather because eating certain foods are generally good (again, not for everyone though) and we call such a diet "eating right."

I'm not quibbling over words just to be a pain in the butt but rather to emphasize that *things* (exercise, food, whatever kind of substance or activity) affect people in different ways. Just because something grows on a bush or is synthetically created in a lab doesn't automatically mean it's effect on a person is positive or negative.

Rouser2 said:
You won't hardly find any such specific percentages listed in PDR of the like for any adverse drug event. [/B]
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I can't speak for the PDR because I'm not very familiar with it but I know the FDA collects adverse events data on everything it tests. That's part of the point of testing.
 
Originally posted by Number Six [/i]

>>
I can't speak for the PDR because I'm not very familiar with it but I know the FDA collects adverse events data on everything it tests. That's part of the point of testing.


It's is sources such as PDR where doctors get their information on drug reactions. There are seldom any percentages listed for any drug and if you think the FDA is a trusted source for screening drugs, then you just haven't been paying attention to the news of late. If you think that drugs is the answer to your gout problem, then that is your decision. Good luck.
 
Rouser2 said:
Originally posted by Number Six [/i]

>>
I can't speak for the PDR because I'm not very familiar with it but I know the FDA collects adverse events data on everything it tests. That's part of the point of testing.


It's is sources such as PDR where doctors get their information on drug reactions. There are seldom any percentages listed for any drug and if you think the FDA is a trusted source for screening drugs, then you just haven't been paying attention to the news of late. If you think that drugs is the answer to your gout problem, then that is your decision. Good luck.
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I think that while the FDA has issues, the fact that it's a government agency constantly under scrutiny from a thousand different sources makes it a much better source of information than an anonymous person on the Internet, especially one who insists certain positions are valid while refusing to provide reasoning for them.

And despite writing many long posts in this thread in an effort to clarify things, I never said or implied that drugs were the answer to my gout problem, and yet you copped out at the end and pretended that that was my position. Nice.
 
Rouser2 said:
Herbal teas? Depends on the herb.
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Basically every herbal tea out there has a chemical substance in it that will affect you one way or another. That's why historically people have used them, because they affect your body. Ginger, chamomile, licorice root--they all have chemicals in them that could count as "drugs".

Now, of course, the ones that are not on the Controlled Substances Schedules are the ones whose chemical effects on your body are either so slight as to be unnoticeable, or else those effects are considered "not harmful". These are the ones that the FDA lists as "Generally Recognized As Safe", or GRAS.

But, notice, that the FDA has to pass a judgement on them: Ginger and chamomile and licorice had to submit a body of evidence to show they were safe because, historically, people had always considered them to have physical effects on the human body.

Some of them, like ginger and chamomile, are currently listed as "food additives". There's a list of them here. Are these drugs, or not?

Drugs are also things that are toxic, and there are things on the EAFUS list that are toxic in large amounts: sassafras is on there, but it's a carcinogen. Is it a drug?

Asarum canadense (wild ginger) is on there, but may be toxic. Is it a drug?

So, which herbal teas would you exempt from the "drug" category? And why?

I would challenge you to name a currently available herbal tea that is chemically completely inert. Such a substance would be, basically, "water".

Even the Celestial Seasonings "caffeine-free" Red Zinger teas have licorice root in them. Which although "GRAS" by the FDA, still can have definite physical effects.

http://www.drugdigest.org/DD/DVH/HerbsSideEffects/0,3925,4037|Glycyrrhiza+glabra,00.html
http://www.kroger.com/HN_Herb/Licorice.htm
http://www.pdrhealth.com/drug_info/nmdrugprofiles/herbaldrugs/101700.shtml
http://www.umm.edu/altmed/ConsHerbs/Interactions/Licoricech.html

So, there are lists of "drug interactions" with Licorice: is licorice a drug?


Green tea, definitely a food, with a touch of caffein (drug) included.
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Chocolate has caffeine in it. Are you saying chocolate is a drug?


Many foods contain an amino acid called tryptophan. Tryptophan, due to complex biochemical processes in the brain, has the end result of making you sleepy. In the 1980s, they began marketing tryptophan supplements as sleep aids (the FDA banned it during the 1990s when people started having dangerous reactions to it).

Question: Is tryptophan a drug?

Turkey is especially high in tryptophan.. Is turkey a drug?
 
Goshawk is correct. I took a supplement that has licorice root and when at the hospital the admitting Doc was a nephrologist...just by accident. I told her my prescriptions and my OTC supplement. She stated that "Real" licorice root is indeed a drug and can have an impact on kidney function. Had the admitting been a GP MD or an intern , I wouldn't have known. How's that for serendipity?

As far as gout lay off the booze and red meat. Purines only come from animal protein and form monosodium urate crystals in the joints , kinda like ground glass.
Lotsa water , veggies, you can enjoy a steak once in a while and ****MY OPINION***** Do Not take Allopurinal (Zyloprim) altho hailed as a prophylactic, everyone I know ( all males in family have gout and my MD also ) who took it develops worse symptoms of the disease. Especially if you take it during or just before an attack.
Indocin is a cool drug , but diet and exercise ( like in many chronic diseases ) is crucial.
 
What is the difference between red meat and non-red meat? Is it inhereent in what kind of meat it is or does it have something to do with how the animal was killed or the food was prepared?

Some of the sites I read say stay away from meat and others just say meat. The only meat I ever eat is beef, pork/ham, turkey and chicken and I think only beef is considered "red" in that group. I don't even know what other meat would be considered red meat. In the list of meats I was reading to stay away from it had stuff like liver and brains and all this stuff that I never eat and barely even know exist as foods.
 
Is "gout" making a comeback lately?

Up until a year ago, I had never met anyone who had told me they had gout.

In the past year, I have met five people in my office who all suffer from it, and three of them just discovered they had it.

Maybe I should work somewhere else...

As for it running in the family, one of the people here says that every one of her brothers and sisters has it, as well as both of her parents. Whether this indicates a genetic factor, or their diet as a family is the key, I don't know (They are a pretty traditional Filipino family - whatever that says of their diet).
 
Number Six said:
What is the difference between red meat and non-red meat? Is it inhereent in what kind of meat it is or does it have something to do with how the animal was killed or the food was prepared?

Some of the sites I read say stay away from meat and others just say meat. The only meat I ever eat is beef, pork/ham, turkey and chicken and I think only beef is considered "red" in that group. I don't even know what other meat would be considered red meat. In the list of meats I was reading to stay away from it had stuff like liver and brains and all this stuff that I never eat and barely even know exist as foods.
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Red meat has more purines then light meat. I.E a chicken breast is less probable to cause an attack then a 12 Oz. T-Bone. Believe it or not the worst attack I ever had was from a grilled tuna steak!.
I forgot to mention something , someone said that fasting is good . That's a double edged sword. When you fast the body will feed upon itself meaning muscle tissue first ( the bane of many a dieter) , which is a source of purines.. so............

There is no magic pill, modify Your diet. I useta be a 3 meat meals a day guy. I have learned to love black beans and rice and eggplant parmigiana. As with any chronic disease , the outcome is determined by modifying behavior. I haven't had an attack in years!

Live long and prosper.
 
Originally posted by Number Six [/i]

>>I think that while the FDA has issues, the fact that it's a government agency constantly under scrutiny from a thousand different sources makes it a much better source of information than an anonymous person on the Internet, especially one who insists certain positions are valid while refusing to provide reasoning for them.


The fact that the FDA is a government agency, exempt from the rigors of scrutiny that the market place would place on a private agency makes its judgements all the more dubious. As to "certain positions" that a certain anonymous person may have, this anonymous person has provided ample proof that drugs are dangerous, and gout drugs, especially and specifically are dangerous and provided respectable links to document the claim.
 
Originally posted by Goshawk [/i]


>>Is turkey a drug?

No. I don't think you will find turkey listed in the PDR. As to all of your other exmples, if you are saying there may be some grey areas as to what is a food and what is a drug, yeah there probably are some grey areas. But if you can't find it in the PDR, then it's probably safe to not call it a drug. So what's the point?
 
Is "drug" a word actually used in a technical sense by medics in the USA? For anything other than drugs of abuse I mean?

I ask because it's not a word I would use myself at all. We had quite some fun with Kumar about whether or not insulin is a drug. He said it wasn't because it's a normal constituent of the body, and insulin treatment was replacement therapy. Well of course insulin treatment is HRT, but is it by that definition not a "drug"?

Is an antibiotic a drug? Is prednisolone a drug? Should the word drug only be confined to narcotics? Really, I don't know. It's just semantics, and because of the lack of clarity I simply avoid the word completely when I need to be precise in a technical context. I note the usual UK medical form is to use the term "medicine". Which has its own problems of course, I have difficulty with oestrogen being described as a "medicine", but that's what they do.

Much of this conversation seems to be about semantics. If you define "drug" as everything which has a product licence to be marketed with therapeutic claims then you have maybe clarified your terms. However, you have thus excluded items with marked physiological effects which are being marketed with implied or indirect therapeutic claims, but which have no licences. Thus confining the sometimes pejorative term "drug" to things which are properly tested for safety and efficacy, while letting untested items off that particular hook.

The fact is that products which are properly tested for safety will inevitably come up with some adverse effects, even if only rare occurrences at abnormally high doses. Consider dihydrogen monoxide. So people like Rouser, who want to rubbish the entire medical profession, can look these products up and quote reams of alarming-sounding potential consequences for things we all take routinely without any problems at all. While at the same time, those things which are promoted without this data being available can be touted as having no adverse effects, simply because no testing has been done, or even if it has, there's no requirement that the results be made publicly available.

So, drug = everthing that has been tested so we can read a list of adverse reactions
food = everything that hasn't been tested so we can fondly imagine has no adverse reactions
therefore food = good and drug = bad.

It's easy when you know how.

Humpty Dumpty.
 
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