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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Updated: EPA and DHA Fish Oils

EPA and DHA (which stands for Eicosapentaenoic Acid and Docosahexaenoic Acid respectively) belong to the Omega 3 fatty acids. They are oils derived from cold water fish and krill. They are not produced by these fish and krill but rather accumulated by the ingestion of micro-algae.

EPA’s and DHA’s primary role is to protect these fish and krill from cold water temperatures. What defining feature of fatty acids (including EPA and DHA) are their long chain carbon structures with an acidic group at the end.

The term “Omega” means they have a double bond and the 3 number means that that bond is at the 3rd carbon position. They are also called polyunsaturated fatty acids meaning that they have one or more double bonds in their structure between their carbon atoms. This property makes them liquid at room and body temperature.

In contrast saturated fatty acids which are found mainly in animal fats (beef, butter, lard) are solids at room and body temperature which makes them more “sticky”. This property, along with the fact that they are not anti-inflammatory makes them the culprits of cholesterol plaques in our arteries-the cause of heart attacks and strokes. The terms Trans and Cis saturated fatty indicate how some of the chemical bonds are aligned. Trans saturated fatty acids are worse then the Cis fatty acids since the Trans fatty acids align themselves more readily thus forming solids. But let’s go back to DHA and EPA.

DHA comprises 50% of the weight of the membranes covering our brain cells. As our brains are mostly membranes, this is very significant. Mothers produce DHA in their breast milk and higher levels have been associated with better mental development in infants.

DHA is also essential for the development of our eyes and vision. Supplementation with DHA has also been linked to the significant improvement in mental functioning in healthy individuals, especially in the elderly. Low levels have also been found in patients with Alzheimer’s disease. DHA has been shown to slow down the shortening of telomeres, which are markers of cellular aging.

EPA on the other hand is a potent anti-inflammatory and neuro-protective agent. A very significant number of human studies have shown that it is very effective for major depression. This effect was just as strong as that observed with prescription anti-depressive medications although without the accompanying side effects.

Furthermore two well designed clinical trials have shown that EPA significantly eradicated the symptoms of Schizophrenia even to the extent that majority of patients stopped their standard anti-psychotic medications. The length of time to achieve these results was about 3 months of supplementation at a high does of 1000 mg/day.

Further studies were performed with patients with Huntington’s disease, another very serious neuro-degenerative disease. Again EPA has shown statistically significant improvement in these patients especially with their motor (i.e. muscle coordination).

EPA also holds great promise in patients with other neurological conditions such as mood disorders, bi-polar disorder and anxiety.

But this is not the end of the story. EPA is also a potent inhibitor of platelets. Platelets help us with blood clotting when we are injured but they also contribute to the clogging of small blood vessels – as in heart attacks and strokes. Usually platelets are overactive, so inhibiting them helps prevent these dreaded occurrences. EPA also stops the growth of the muscular walls of blood vessels, which prevents their closure. Both platelet clogging and blood vessel narrowing contribute to cardiovascular disease. Finally, EPA is a potent anti-inflammatory agent, and as inflammation is the cause of many debilitating conditions (including cardiovascular disease, diabetes, arthritis and others) EPA helps with their prevention.

The vast majority of us do not get enough EPA and DHA in our diets. But we can fix this by taking a fish or krill oil supplement, or incorporating more cold water fish into our diets. The ideal EPA/DHA supplement should have a high level of both fatty acids in order to benefit from what both have to offer.

However as shown above EPA definitely shows more effectiveness for a number of serious medical conditions in our society-both for treatment as well as for prevention.

Fish oil supplements have come a long way since their introduction. Now you can decide if you want to go with an equal EPA/DHA supplement or a high EPA/low DHA supplement or vice versa. When deciding on which fish oil supplement you should take be driven by your needs.

Overall a high EPA and low DHA supplement is your best choice, unless you are a pregnant or nursing mother, an infant or a child (in this case the higher DHA level is needed for proper brain and eye development). A high EPA level will help protect you from neuro-degenerative diseases, mood disorders and depression. As mentioned above studies also show that EPA is also an excellent treatment modality for these serious conditions. Furthermore EPA will also protect from atherosclerotic plaques responsible for cardio-vascular disease (i.e. heart attacks and strokes). Usually a high EPA supplement also provides some DHA for your brain’s structural needs.

The final note is that when you review the label of your fish oil supplement pay attention to the source of the oil. It should be derived from cold water fish such as salmon, mackerel, sardines, anchovies, halibut or the little creatures called krill.

Take care and remember-prevention is key. See you next time.

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

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You are what you eat: Kids & Multivitamins

In the absence of a strict, healthy eating regime from the very beginning, many children resort to junk food, processed foods, foods laden with animal fats, processed sugars, sugar-packed candy & processed drinks, artificial coloring and other garbage. They will especially resort to such diets when their authority figures are not watching. This can begin as early as Grade 1, when they start experiencing more freedom.

Such undisciplined gorging paves the way to obesity, diabetes, heart disease, inflammatory pain conditions, indigestion and —later in life— hypertension and strokes.

Nutrition begins at home

The best way to teach proper eating habits is to not allow the above listed “foods” in the home environment, and to lead by example. If these “foods” are eliminated and not allowed at home, their consumption will drop by up to 80%, because children won’t have time to access them elsewhere. They may have an opportunity at lunch or right after school when no one is watching, but not all day long. With such an approach, the worst-case scenario is a nutritious breakfast, (such as organic eggs, fresh tomatoes, a glass of organic milk, and a small piece of multigrain bread with organic jam), and a healthy dinner. Let’s also remember that the diet plans in most schools lack proper nutritional value. Their meals are usually very simple in composition and they are vitamin and mineral deficient.

The Biology of Food

Even when an effort is made at home, kids still may not get enough nutrients. Kids are growing (even beyond the age of 18) and they need more nutrients, vitamins and essential minerals in order for their biology to advance, promoting optimal physical development, mental development, mental balance as well as sufficient energy levels. These essential nutrients also detoxify their bodies of environmental pollutants as well as from the nasty stuff they eat when we are not watching. When these nutrients become deficient, they can lead to mood swings, depression, inattention, aggressive behavior, lack of energy, decreased learning & memory and a general feeling of lethargy.

Supplements: Going Beyond the Pantry

There is a simple way to prevent this. Have them take one large size multivitamin/multimineral tablet each day with a meal. Supplement with an additional fish oil capsule for mental health and optimal learning. Fish oil with omega-3 fatty acids have also been shown to help prevent the development of Attention Deficit Hyperactivity Disorder (ADHD). This disorder is very common — although also commonly over diagnosed— in children.

And please remember: Try to make them eat at home more often and less often away from home. This will minimize their consumption of junk foods. Make the home meals nutritious with lots of protein, greens, vegetables and healthy oils such as olive oil and flaxseed oil. Also, try to keep it low in carbohydrates. This includes breads, dough, chips, French fries, and pop. Good luck! (No cynicism intended.) If you take my words as a gospel, your kids will thank you when they grow up.

Until next time,
Dr. Karol

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Radical Remedies: Hemp Hearts





Last Saturday on the radio at the Natural Health Show (Saturday 11am ET AM740 and Sunday 5pm PT AM980) I discussed the topic of Hemp Hearts as a super food. I find this topic dear to my heart as I have been involved in healthy body building most of my life and healthy plant based protein sources are essential for the practice of this sport.

This topic is of strong interest at the present in the athletic and the health supplement world because of two reasons. First, traditional animal based (including dairy) protein sources usually contain unhealthy fats and cholesterol. When broken down they acidify the body. This slows down muscle growth, breaks down bones (by dissolving the calcium) and creates an inflammatory state all over the body. The combination of bad fats, lack of fiber and excess acidity can cause a myriad of chronic and serious medical conditions. Furthermore, animal protein sources contain very little, if any, nutrients in the form of vitamins and minerals.

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Radical Remedies: Amazing Garlic





Stress, fast food, lack of exercise, over-eating, drinking alcohol and smoking to relieve the stress, sitting at home, in your car and at the office,  back to eating, and so forth. It’s a perpetual cycle that has lead to the obesity/diabetes/hypertension epidemic in our society. The consequences: heart attacks, strokes, insulin injections, kidney transplants, loss of vision, impotence… what a happy start to my blog entry!

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Radical Remedies: Omega 3 Fatty Acids And Prostate Cancer





Radical Remedies: Omega 3 Fatty Acids And Prostate Cancer

They’re still talking about it in the natural health industry: the recent controversy of ingesting Omega 3 fatty acids (found in fish oil) and the supposedly increased risk of prostate cancer. This one really is shocking, especially when considering the fact that countries that have a history of high consumption of fish like Japan and the Mediterranean countries have always had the lowest occurrence of prostate cancer.  Whereas North American countries that have low fish consumption and high consumption of fast and processed foods have the highest rate of this cancer. But let’s take a closer look at the study that produced these controversial results.


The study design was basically taking 834 men who were already diagnosed with prostate cancer and comparing their Omega 3 fatty acid levels in blood to 1393 randomly selected men without prostate cancer. The conclusion was that the men with prostate cancer had statistically significantly higher levels of Omega 3 fatty acids.

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