Dr.Karol, MD

The doctor with alternative solutions

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The Best Supplements for Gout


While in Montreal for a recent trade show, I came across a man suffering from gout. He’s a middle-aged well-built man who appears to be someone who spends a lot of time in the gym, not someone living with gout. But he limped when he walked and he was in pain. When I mentioned my work and interest in natural health he practically begged me to give him advice on how to deal with his pain. So I’m writing this article and sending him the link.

Gout is the build-up in joints of a substance called uric acid. Uric acid is formed as a by-product of purine breakdown. Purines are chemical molecules which make up the backbone of our genetic code, i.e., our DNA. As cells divide and old ones are replaced by new ones, the DNA of old cells is broken down to individual units before being used again to form new DNA. The by-product of this process is uric acid. Most people have no problem with uric acid, but some individuals, (due to genetic predisposition, diet or lifestyle), have a predisposition to having uric acid deposited in the joints. When this happens, the uric acid takes the form of sharply pointed needle-like structures (visible under a microscope). These needles cause excruciating, persistent pain and inflammation — described as the worst pain of all rheumatic conditions. For some unknown reason, this usually occurs in the big toe, but any joint can be affected. The worst thing about this condition, other than the excruciating pain and incapacity, is that the pain is continuous — even at night —and the flare-ups can last for weeks. If not properly treated or prevented, this condition can eventually cause permanent joint damage as well as serious kidney damage.

What are the predisposing factors and how should one’s lifestyle be modified to decrease the chances of gout? Firstly, there is genetic predisposition. Some individuals are just more prone to develop gout. But just because you are predisposed, does not mean that you will get gout. This is because diet and lifestyle play a large role as well. The biggest gout triggers are: fatty red meats, organ meats (like liver), shellfish, herring, anchovies, sardines, mackerel, asparagus, mushrooms, all caffeinated beverages, high fructose corn syrup, sugary soft drinks, fruit juices (because of the high fructose content), sweets and alcohol (especially beer). With respect to alcohol and gout, wine is better than liquor and liquor is better than beer. But all three impact gout.

Other predisposing factors are heart disease, kidney disease, diabetes, high cholesterol & high blood pressure, obesity and lack of exercise (especially cardiovascular exercise).

With respect to natural supplements and diet to prevent and treat gout, the most important are anti-inflammatory compounds, as the pain in gout is due to inflammation. Here are the best examples:

Fish oils high in EPA at a dose of 2000-3000 mg of EPA per day.

Flaxseed oil, added generously in its raw form to salads or in smoothies. You can also take it with a spoon.

Turmeric, Devil’s Claw and Boswelia: These are powerful natural anti-inflammatory gifts of nature. They decrease inflammation by affecting multiple points in the inflammatory cascade. Interestingly, these are the same agents used to treat arthritis and other types of pain.

Bromelain is a plant enzyme found most commonly in pineapples. When taken with food, it works like a digestive enzyme. When taken on an empty stomach, it is a powerful anti-inflammatory agent.

Alfalfa apparently can dissolve the uric acid crystals responsible for gout. I recommend alfalfa sprouts, as sprouts are usually the richest in enzymes, nutrition and medicine.

Milk Thistle for liver support metabolizes the purines and uric acid efficiently as well protecting the liver from ongoing inflammation.

Antioxidants in the form of bioflavonoids reduce inflammation and oxidative damage. My favorite in this category is Bioflavia, which is organic grape skin powder.

Plant proteins, especially fermented ones like my favourite, Genuine Health, are important because most animal proteins (from meats, fish and shellfish) predispose to gout. Supplement with plant proteins so you don’t become protein deficient.

Water: Drink at least 3 liters of fluids (mostly water) per day. This is especially important during gout attacks. The water will help flush out the excess uric acid.

B Complex vitamins efficiently metabolize purines, uric acid, proteins and carbohydrates.

Finally, tart cherries, tart cherry juice and other berries, preferably organic and fresh, are said to work miraculously. The reason for this is their very high level of bioflavonoids and anthocyanins. Both are powerful antioxidants with anti-inflammatory properties.

Your doctor will most likely first prescribe NSAIDs like Ibuprofen for the pain of gout. This brings only temporary partial relief and will not solve the underlying problem. NSAIDs also cause stomach ulcers, kidney damage (which is already taxed by the uric acid) and potentially intestinal and stomach bleeding. They also predispose to heart attacks and strokes. If NSAIDs are not enough, doctors recommend steroids (prednisone etc.). These are either injected into the excruciatingly painful and inflamed joint, or are taken orally. In either case, they are highly toxic. They cause hypertension, fluid retention in the body (causing swelling), mood swings (which can be quite serious), and obesity. Also, you cannot stop them abruptly when taken over longer periods of time because this can lead to shock. You must slowly taper your dose. Your doctor may also run some tests to determine if you are over-producing or under-secreting uric acid through your kidneys. For over-production, a drug called Allopurinol is prescribed. It does not work for flare-ups but is rather used to prevent attacks. The problem is that in some cases, it can cause potentially fatal inflammatory skin conditions (Stevens Johnson Syndrome, etc.). It can also cause serious kidney damage as well as inhibition of bone marrow, leading to problems with blood formation. With respect to under-secretion of uric acid, the commonly prescribed drug is Probenecid. It increases uric acid secretion in urine. It is also used for prevention and not for flare-ups. Its potential side effects are headaches, joint pain, swelling, nausea and vomiting. For flare-ups, in addition to NSAIDs, Colchicine is used. It can cause serious stomach upset, bone marrow depression as well as problems with sensory nerves. Although not all patients experience these side effects, many do. By taking them, you risk being one of them. Natural treatments are not only risk-free but the compounds listed above are powerful gifts of nature that benefit our overall health and well-being.

Take care and good luck preventing and treating your gout in a natural, healthy way.

— Dr. Karol M.D





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Every Second Counts: Cardiac Arrest and CPR

Cardiac arrest refers to the total cessation of heart activity, usually caused by a heart attack, i.e., by a narrowing of the arteries that supply blood to the heart due to cholesterol plaques.

I recently posted a link on my Facebook page about new research that was done on patients who underwent cardiac arrest in a hospital setting. The hospital setting is obviously the best place to have a heart attack due to the availability of trained staff and proper resuscitation equipment.

CPR Saves Lives

When a heart attack happens outside of the hospital, the chances of survival drop by 20% with each passing minute without Cardio Pulmonary Resuscitation (CPR). This is why it is so crucial to know the basics of CPR and perform this emergency procedure — even on strangers — while awaiting an ambulance. By the way, calling an ambulance is the first step in the CPR procedure. A lot of people that know and begin CPR forget about this because of all the commotion and the seriousness of the situation. They go into the procedure immediately because they want to save a life, but overlook calling the ambulance.

Performing CPR until an ambulance arrives triples the chances of survival. Here are some other interesting stats:

  • 88% of cardiac arrests occur outside of the hospital.
  • Out of this 88%, only 37% involve CPR from a bystander.
  • The person requiring CPR will most likely be a loved one or a co-worker.

What to Do

The rules are simple: Someone who is lying on the ground not breathing needs CPR. CPR continues to benefit the patient even if it is performed for more than 40 minutes.

The procedure is simple:

  1. Tilt the head back (when the patient is on their back flat on the ground) and lift the chin.
  2. Pinch the nose and give two breaths mouth to mouth.
  3. Then start chest compressions right in the middle of the chest. Do them deep and strong. If you break the ribs, don’t worry. This means that you are performing the procedure correctly. Ribs can be reattached easily after the patient arrives in the hospital.
  4. There are 10 compressions for every two breaths. It is as simple as that.

There are only two exceptions. One is when the patient has vomit in his mouth (e.g., in the case of a heroin overdose). In this case, he or she needs to be turned on the side so the vomit can exit the mouth. If you are not too grossed out, you can help get the vomit out with your hand. Do not perform CPR until the mouth is clear. Another exception is when the person has blood in his mouth. In this case, you risk contracting HIV or another communicable disease. It’s your call. Is it a loved one whom you know does not have HIV, or is it an unknown heroin user?

In my next blog, I will talk about the research that has shown that people experience an out of body experience during cardiac arrest. I meant to talk about that today, but got a little side-tracked by CPR because of my physician training. Once I get started on a life saving procedure, I have to finish it. It’s too important.

And by the way, have a wonderful Thanksgiving.

Dr. Karol

For more sage advice from Dr. Karol and for natural health product recommendations, visit vitarock.com