Colchicine – for gout

Hello friend,

Time has slipped by, hasn’t it …. since the last blog? Time, life …… reminds me of something that leadership teacher Dr. John Maxwell says – you cannot manage your time, you can only manage your life. Here we go ….. to the better management of life …..

As our knowledge of medical science and lifestyle increases, we live longer. As we live longer, there’s no point in living unhealthy lives, is there? A healthy lifestyle is what we intend. We watch our diet, take the right medication when necessary and live healthy, happy lives … right?

Which brings us to the management and treatment of a condition that can be painful. Gout. What is gout? High levels of uric acid in the blood along with acidic blood pH cause deposits of uric acid crystals in the cartilage of joints. This leads to painful, burning acute pain, arthritic symptoms, and with time, chronic gout including the formation of nodules called tophi that show through the skin.

Uric acid is normally present in everyone’s blood. Where does an excess of uric acid come from? Some folk may be genetically prone to it, due to aberrations in purine-pyrimidine metabolism. Purines and pyrimidines are part of amino acids (proteins are formed of amino acids), DNA, RNA, energy production in the body …. a lot of body biochemistry. Specifically, uric acid is created from the breakdown of purines. Gout is more likely in more affluent societies due to high dietary intake of proteins, fats and alcohol. “Poor man’s gout” also exists, because of ingestion of an excess of malt liquor combined with bad nutrition. Gout can also be caused from kidney failure and from lead poisoning. In the U.S., gout occurs in about 0.3 per cent of the population.

Treatment of gout. In the first century A.D., they used the extract of plants belonging to the colchicum genus to treat gout. In 1820, the active ingredient from that extract, an alkaloid named colchicine was extracted from colchicum extract  by a couple of French scientists. Research on this alkaloid showed that it inhibits deposition of uric acid crystals by inhibiting glucose oxidation to lactic acid. This is key in the treatment and prophylaxis of gout. Colchicine also prevents the mobility of white blood cells called neutrophils. This prevents inflammation. The drug is used for acute flare-ups as well as for chronic symptoms and prophylaxis between acute events.

Colchicine is used to treat familial Mediterranean fever, a genetically transmitted inflammatory disease affecting groups of people originating from areas around the Mediterranean sea.  It is also used to treat amyloidosis, a deposition of abnormal amyloid proteins in different organs, as well as to treat scleroderma, a chronic autoimmune disease where the skin or other organs harden. It can be used as preliminary treatment of pericarditis, an inflammation of the fibrous membrane around the heart.

This drug is now being investigated for anti-cancer properties. Colchicine prevents polymerization of microtubules by binding to tubulin, and thus acts as a mitotic poison (mitosis is an essential step in cell division and growth), specifically preventing the growth of cancer cells which have a greater rate of mitosis as compared to normal cells.

Molecular modifications of colchicine are being researched to develop a treatment for cancer. Why the molecular modifications? To increase the therapeutic index – higher effectiveness, lower toxicity.

Speaking of toxicity and therapeutic index, colchicine has a low therapeutic index. High toxicity. Neutropenia (reduction in blood neutrophils), gastrointestinal upset, bone marrow damage and anemia. Acute toxicity include fever, stomach upset and kidney failure.

High levels of uric acid is the primary risk factor for gout. Specifically, it’s not protein, it is a diet high in purines like meat and seafood, that lead to increased levels of uric acid. Meat and seafood consist of muscle, which has mitochondria, which has high quantities of DNA and RNA – that is the source of high purines. High amounts of vegetable protein or dairy protein, not being high in purines, do not lead to increased uric acid. A diet high in sugary soft drinks, because of high fructose corn syrup, leads to high uric acid. Drinking even one beer a day (not other alcoholic drinks) leads to elevated uric acid levels too.

Yup … like I said before … let’s eat and drink intelligently, use medicine when necessary … and live healthy.

Until next time, please do take good care of yourself and your health.

Dr. Ajit Damodaran

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One Response to “Colchicine – for gout”

  1. Behandlung von Gicht Says:

    Gout arthritis unquestionably is a nasty condition, my partner is suffering from it for a number of years now. It is increasingly nerve-racking to me, watching a beloved family member experience pain attacks all too often. Sticking to an appropriate diet routine for prevention and making use of proper treatment is in my opinion vital. Personally, I would advise any one who is presently noticing initial warning signs of joint pain to by all means be alarmed. Better check with a medical professional as soon as you can and adjust your diet program to prevent the outbreak of the disease. It is definitely no fun, thats for sure. Try to find healthy therapy options and stay away from foods with a lot of purine, alcoholic beverages and the like for prevention!

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