The Gout Thread

Quote: mcallister3200

Quote: BillHasRetired

.

There's a whole lot more, but just from these facts (yeah, I looked them up), we can state pretty clearly:
1. Genetics cause about 60% of the cases. If this is you, you're boned for life.

3. Lifestyle changes have limited usefulness, unless your gout is caused be non-genetic reasons (about 1 in 8 cases)


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I gotta say the maths on #1 and 3 seem a bit incongruent to me taken together.
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Not really. They can pinpoint malfunctioning genes in about 60%, and diet in about 12%. The other 28%? They can't determine a main cause.

If you're one of the 12% (one in eight) who are sucking down pate three times a day, change that lifestyle, and your system rights itself. If you've got bad genes, then you can lock down your purine intake, but you can't zero it out, and your genes will still be screwing up your UA metabolism. But genetic issues are a continuum, not an on-off switch in every case. So you might have a genetic cause, but a purine-free diet can keep gout at bay.

Maybe I'm missing your argument. Tell me exactly what's wrong with the math.

Quote: Ace2

Quote: rxwine

Quote: Ace2

They went from being active people living off the land/sea to sedentary people eating processed food and, in some cases, drinking too much alcohol

The internets says processed food really didn't come into fashion until 1920s. Seeing as gout sufferers like Bejamin Franklin was long dead by then.

(though I don't doubt it contributes to many ailments)
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Sugar, probably the worst processed food you can eat, existed centuries before 1920
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Sugar, sausage, salt pork...

Quote: Ace2

Think about that for a minute, then read the recently posted Journal of Clinical Rheumatology report that 60% of gout cases are caused by genetics. Does that seem even remotely plausible? Recent historical facts show it's essentially 100% caused by diet and lifestyle. 60% is that Journal’s subjective measurement and interpretation of something, not a “fact”. And biased since this is the kind of “fact” that generates more patients

Let’s say 1 in 10,000 of the ancient native people ever got T2 diabetes or gout. In those cases, probably bad genetics
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(sigh)
There are two problems with your argument.
First, their genetics DID change via intermarriage with other human subgroups. Some of those subgroups have varying levels of bad genetics WRT gout.
Second, the white man's culture, so demonized by all, happens to have modern medicine as an essential part of it. So, those one in 10,000 that usually died early childless in pre-contact Maori civ? They now live quite a bit longer, and along the way, pass their bad genes (your words) onto their children.

So, yes, the Maori today are different from the noble savages of the Middle Ages. What do you propose, though? Take away modern medicine? Remove the modern lifestyle, including such decadent innovations as food preservation and sanitation? I would never arrogate such a decision unto myself.

Quote: Dieter

(snip)
Sugar, sausage, salt pork...
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You forgot alcohol. The four basic food groups.
</snark>

Although I generally agree with Ace2 that healthy living might completely eliminate some evidence of some health conditions, I also note that reproduction is a constant process of variation of individuals. Variation is necessary for the survival of the species, so we all aren't susceptible to the same diseases.

So, it's going too far (imo) to say the same action will have the same result for everyone.

Also, I'd note just from being on this site, we know people can be given the correct information about how to play certain games and what games to avoid, and the casinos still get plenty of business on those games and bad play. Much as I'd note (at least in my experience) a doctor can tell you, you should lose weight or exercise more and only a certain number of people are going to change their ways. So, I don't know that they need to make a concerted effort to sell you an unnecessary drug. They're going to get customers even after they give out the helpful information.

I think the ones that don't inform you of other options are of course unethical. I'm sure some do. Hopefully not many.

I have yet to have a doctor of mine not espouse good diet and exercise (even when some were morbidly obese themselves).

They never say "take medication and you can enjoy poor diet all you want."

So this whole notion that the medical field is trying to create customers is a bit of paranoia imo.

As Bill points out above the medication I take is extremely cheap. Allopurinol is $8 a month, zero co-pays.

Quote: darkoz

So this whole notion that the medical field is trying to create customers is a bit of paranoia imo.

As Bill points out above the medication I take is extremely cheap. Allopurinol is $8 a month, zero co-pays.
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Exactly. The medical/pharmaceutical industry is just a tiny non-profit sector of the US economy. They don’t even advertise on TV, especially since direct marketing to their customers would (I mean should) be illegal like it is in almost every other country. For a customer with gout, diabetes and high blood pressure, the industry will only get $8/month in revenue over the course of his life. Cheaper than Cuba

Quote: Ace2

Quote: darkoz

So this whole notion that the medical field is trying to create customers is a bit of paranoia imo.

As Bill points out above the medication I take is extremely cheap. Allopurinol is $8 a month, zero co-pays.
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Exactly. The medical/pharmaceutical industry is just a tiny non-profit sector of the US economy. They don’t even advertise on TV, especially since direct marketing to their customers would (I mean should) be illegal like it is in almost every other country. For a customer with gout, diabetes and high blood pressure, the industry will only get $8/month in revenue over the course of his life. Cheaper than Cuba
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Of course they advertise and need income.

BTW, Last I checked the nutrition industry also advertised on television along with the exercise industry.

I guess the nutrition industry is also trying to kill and enslave everyone.

Quote: BillHasRetired

There are two problems with your argument.

First, their genetics DID change via intermarriage with other human subgroups. Some of those subgroups have varying levels of bad genetics WRT gout.

So, yes, the Maori today are different from the noble savages of the Middle Ages. What do you propose, though? Take away modern medicine? Remove the modern lifestyle, including such decadent innovations as food preservation and sanitation? I would never arrogate such a decision unto myself.
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So, due to a bit of intermarriage with the white man, their genes changed so much that, over just a few generations, their rate of diabetes became several times higher than the white man’s rate ?

If the aforementioned native people had no chronic illnesses until recently, then I propose we should study and copy some of their habits instead of being “Know It Alls”, as you put it. We can learn a lot from them. Medical technology is great, but we should have a more preventative approach with the goal of not getting sick in the first place

All I’ve suggested on this thread is to try a healthy lifestyle. People might be surprised at how many ailments go away naturally, and they might not need some of their medications any longer. This suggestion has been met by stiff resistance, with people insisting that these chronic illnesses are totally genetic, definitely not a consequence of unhealthy lifestyle.

I never recommended ignoring a doctor’s advice. Your comparing my suggestion to the woman refusing a C-section (a few posts ago) is ludicrous

Quote: darkoz

BTW, Last I checked the nutrition industry also advertised on television along with the exercise industry.

I guess the nutrition industry is also trying to kill and enslave everyone.
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I actually agree with you in a way. Some of the advertisements I see for nutritional supplements or fat burning devices are such blatant scams that it’s hard to believe they are legal. “All you need to do is take this pill and wear this fat burning belt”. People actually believe this stuff!

Just to confirm: you think it’s fine for US pharmaceutical companies to do direct advertising, though it’s not allowed in other countries?

Quote: Ace2

Quote: darkoz

BTW, Last I checked the nutrition industry also advertised on television along with the exercise industry.

I guess the nutrition industry is also trying to kill and enslave everyone.
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I actually agree with you in a way. Some of the advertisements I see for nutritional supplements or fat burning devices are such blatant scams that’s it’s hard to believe they are legal. “All you need to do is take this pill and wear this fat burning belt”. People actually believe this stuff!

Just to confirm: you think it’s fine for US pharmaceutical companies to do direct advertising, though it’s not allowed in other countries?
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There are plenty of things both good and bad that other countries have which we don't. No point in comparison. We live where we live

As for advertising, if a drug company is going to spend billions for drug development then they should be able to raise revenue as needed.

Advertising doesn't guarantee people will use a product. But people who need to make choices about their medicine should be aware of what exists. Advertising is one method.

I don't see why the anti-advertising stance.

Quote: BillHasRetired

Quote: Dieter

(snip)
Sugar, sausage, salt pork...
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You forgot alcohol. The four basic food groups.
</snark>
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Good heavens, I did.
Can't understand why; I've been drinking more than usual lately, so it should be on the tip of my tongue.

Quote: Ace2

Quote: darkoz

BTW, Last I checked the nutrition industry also advertised on television along with the exercise industry.

I guess the nutrition industry is also trying to kill and enslave everyone.
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I actually agree with you in a way. Some of the advertisements I see for nutritional supplements or fat burning devices are such blatant scams that it’s hard to believe they are legal. “All you need to do is take this pill and wear this fat burning belt”. People actually believe this stuff!

Just to confirm: you think it’s fine for US pharmaceutical companies to do direct advertising, though it’s not allowed in other countries?
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Would you be happier if drug companies had to put disclaimers like, "Leading a healthy lifestyle may negate the need to use this (medication x)"

I don't have any problem with any maker of any product having to give more useful information than what is normally given to sell the product, but that gets into a broader discussion than gout which is probably not appropriate on the board, given restrictions.

Yeah, that broader discussion should go to DT.
This, at least, is vaguely of concern to a number of gamblers; I'm sure I meet people with gout gambling at casinos; I rarely meet pharmaceutical companies at casinos.

Quote: Ace2

Quote: BillHasRetired

3. Lifestyle changes have limited usefulness
I

That’s exactly what the medical/pharma industry wants everyone to believe…If you’re an obese T2 diabetic with gout, that’s all due to poor genetics. There’s nothing you can do about it except take their drugs to keep you alive
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I already posted a couple of links of the medical establishment point blank saying that proper diet and exercise can go a long way to mitigate the effects of type 2 diabetes, so your claims here are completely false.

Mods, how long are you going to let Ace2 get away with his borderline conspiracy theory nonsense in this thread??

Quote: TigerWu

Mods, how long are you going to let Ace2 get away with his borderline conspiracy theory nonsense in this thread??
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Not sure.
Doesn't seem to be over the line for rule 12 or rule 19. Yet.

Quote: Ace2

(snip)
So, due to a bit of intermarriage with the white man, their genes changed so much that, over just a few generations, their rate of diabetes became several times higher than the white man’s rate ?
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This is not what I said at all. In your original argument, you alleged that "Just over a century ago, before substantial contact with white men, all chronic diseases, like diabetes, were nearly nonexistent.(...)Their genetics didn’t change." That last statement is false, in my opinion. The Treaty of Waitangi, between the British-owned New Zealand Trading Company, and several chiefs of Maori tribes was signed in 1840, 182 years ago. Most demographers divide generations as occurring every 30 years, so that's six generations ago. That's plenty of time for genetic errors to spread in a population.

Let me ask you a related question: What percentage of Maori can cite pure-bloodedness, and NO trace of European heritage in their ancestors? Their genetics have changed. I make no other assertion about disease potential.

As for the Maori experience, perhaps they are not so unique. From the pre-pandemic CDC:
Percentage of US Adults 18 or Older With Diagnosed Diabetes, by Race and Ethnicity, 2018–2019
Race and Ethnicity Percentage
American Indian or Alaska Native 14.5
Asian, non-Hispanic 9.5
Black, non-Hispanic 12.1
Hispanic, overall 11.8
White, non-Hispanic 7.4

I make ZERO statements about genetics here. I can see where societal influences can explain some of the disparity, such as how different demographic groups view the medical profession. There are others, but demography is definitely not part of my skill set, so I'll leave this be.

Quote: Ace2

(snip)
If the aforementioned native people had no chronic illnesses until recently, then I propose we should study and copy some of their habits instead of being “Know It Alls”, as you put it. We can learn a lot from them. Medical technology is great, but we should have a more preventative approach with the goal of not getting sick in the first place
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I characterized one person, the selfish mother, as a know-it-all. Stop lying about what I said.

Study Maori, their genetics, lifestyle, diet, yes. Copy, no. Why? Because their genetic stock is quite divergent from the Western. Maori come from, quite literally, half a world away. Damn near everything is different about them. Small item: most of their diet pre-contact was fish and tropical flora and fauna. Do you think the United States can wholesale adopt that lifestyle? Our fisheries are barely sustainable now.

I agree that prevention is far better than cure, but for a lot of people, they've just got a bad hand, genetics-wise.

Quote: Ace2

(snip)
All I’ve suggested on this thread is to try a healthy lifestyle. People might be surprised at how many ailments go away naturally, and they might not need some of their medications any longer. This suggestion has been met by stiff resistance, with people insisting that these chronic illnesses are totally genetic, definitely not a consequence of unhealthy lifestyle.
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You've done a lot more than that.
— You've asserted that "Gout, like diabetes, is mostly the result of being unhealthy, out of shape, eating processed foods (often sugary)"
— You've mocked people who diverge from your viewpoint: "Where did you hear this nonsense? Probably from an American doctor that got you on another drug for life. Do you also believe diabetes isn’t reversible?" and "They say American doctors don’t create cures…they create customers. You seem like an excellent repeat customer for them and the pharma industry."
— You've implicitly recommended against doctor's advice: "Taking a prescription doesn’t make you healthier, it just masks your symptoms and probably makes you sicker over time." and "I didn’t say medical professionals are liars, I said only you can take charge of your own health. They won’t do anything until you’re already sick, then put you on drugs for life, keeping you alive for a while but not cured or healthy. It’s a very lucrative business for them and big pharma"

In reviewing this thread, I fail to see anywhere where anyone said that obesity, diabetes, and gout were "totally genetic". At most, I've said that genetics predisposes people to diabetes and gout, and quoted a study that found that 60% of gout cases were primarily the result of genetics, that that is far from 'total'.

I have never said reversing an unhealthy lifestyle would not help mitigate these conditions. Indeed, I pointed out that 12% of gout cases have been found to be primarily the cause of bad diet. What I (and perhaps others) bridle about is the assertion that a healthy lifestyle will cure these diseases. T2 diabetes is a condition where the pancreas is unable to supply enough insulin to regulate a body's glucose level. Gout is an inflammatory arthritis caused by deposition of monosodium urate crystals in synovial fluid and joints. There are many reasons for these conditions to occur. Diet is merely one factor. Errors of metabolism caused by genetics cannot be cured with today's medicine.

Quote: Ace2

(snip)
I never recommended ignoring a doctor’s advice. Your comparing my suggestion to the woman refusing a C-section (a few posts ago) is ludicrous
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Yes you have. See above. You have argued over and over how their main motivation was to hook us on 'drugs for life'. You might not have said 'ignore what they say and do what I say', but by reducing the medical profession to nothing but dope-dealing shills for Big Pharma, you've ridiculed their advice.

In effect, you're doing the same thing that happens in some demographics, where the afflicted are encouraged to view Western medicine with suspicion. Then by going without life-extending treatment for killers like diabetes and heart disease, they die prematurely, and Something Must Be Wrong.

The selfish mother refusing a C-Section because She Knew All is all part of the same continuum. Her story was true, and extreme. Fortunately, your story (which I accept arguendo), isn't quite so drastic, but both stories share a suspicion of modern medicine, an unshakable belief in your own rectitude, and dark feelings about modern society.

Me, I know my limits. I will generally accede that most doctors know what they are doing. But I read drug package inserts thoroughly, particularly the pharmacology, and have more than once requested alternatives when the pharma suggested seemed too far out there. Trust, but verify. I go by George Carlin (who I did have the pleasure of meeting): "Somewhere in the world, there is the world's worst doctor, and someone has an appointment with them tomorrow."

Good luck, Ace2. Glad to hear you've got your gout under control. Me? Never had it. It doesn't run in my family.

The funny thing is of all industries that advertise, it seems to me the medical industry is the only one held to truthfulness in advertising

I mean it's become a running joke right. Take XYZ medication if you suffer from this condition. Iconic images of people hair blowing wonderfully in the breeze while a narrator suddenly says:

"Call your emergency room immediately if you suffer from any of these conditions known to be caused by this medication" and then they spout off soooo many things from ingrown hair follicles to heart attack, stroke and brain aneurysm that one starts to wonder

I mean no other industry does that to my knowledge.

"McDonald's, where we serve you your way. Big Macs are known to have fatty tissue and unhealthy ingredients including some that are secret. Call a medical professional if you begin choking on food as it can be a cause of choking if ingested too fast. Heartburn and nausea has occurred. Seek help immediately if you begin to notice abnormal weight gain or hives."

Just waiting for "spontaneous decapitation" to show up as a side effect.
Oddly, there is something called "internal decapitation" which has a 30% survival rate, and is basically a dislocation of the base of the skull and the first cervical vertebra. Weird.

Well, there you go again, Ace2. Wrong info and basic assertions are what you do very well. BTW, where is Michael Bluejay with all his links to info and his non-stop criticisms for partially correct posts. Crickets. Being consistent with posts can be difficult at times.

Mr.BilHasRetired I love reading your posts; they have increased my vocabulary and my knowledge hopefully, some of it will rub off among other forum members. Thank you.

tuttigym

Quote: tuttigym

(snip)
Mr.BilHasRetired I love reading your posts; they have increased my vocabulary and my knowledge hopefully, some of it will rub off among other forum members. Thank you.

tuttigym
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Thank you, Tuttugym.

I should note, however, that as an author of technical science fiction, I try to word things precisely, and that sometimes means choosing an uncommon word when the connotations more precisely constrain its meaning and intent. Many people, with some cause, take offense at that and accuse me of showing off. I have been plagued on occasion with subliterate superiors who took revenge on me when they thought I was mocking them (I wasn't). Now, of course, I can truly mock them in my books, and I do not hold back.

As for Ace2, the greatest thing I object to is his mischaracterization of my positions, implying I said something I did not. Beyond that behavior, there's nothing wrong with leading a healthy lifestyle, something i am striving for myself. I don't think it will 'cure' anything, nor will it do more than soften any 'western' conditions I might have.

But this is America (from this keyboard's POV), and he is free to state what he believes. Just as we are also free to state our beliefs. The grand 'marketplace of ideas'. Our greatest strength.

...Might also mention, as far as reversing diseases in general, one also can have damaged organ systems while body was under abuse making it more difficult to obtain normal health.

Of course, that is an argument to at least keep pursuing healthy living whether you succeed completely or not.

Got no problems advocating for that, myself.
I did long-distance running in high school and college. Then life got in the way. Doctors, ever since, have been surprised at my low heart rate (44bpm in college, less than my age now at 62). It's a lasting legacy of that long-ago training regimen. That said, running is not for everyone.

Fat people have fat pets.

It ain't genes.

Quote: Gundy

Fat people have fat pets.

It ain't genes.
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Fat people have fat jeans.

It's matter of waist size.

EDIT:. I should point out that obesity runs in my family. Both my parents weighed over 400 pounds at my age.

I currently weigh half that and while I understand I am considered overweight, having grown up with two morbidly obese parents, my viewpoint on obesity and weighing 200 pounds is a bit different than other people's.

If you find enough identical twin studies where the twins lived apart, you can find a lot of useful information as far as lifestyle influence vs genetics.

Quote: BillHasRetired

Got no problems advocating for that, myself.
I did long-distance running in high school and college. Then life got in the way. Doctors, ever since, have been surprised at my low heart rate (44bpm in college, less than my age now at 62). It's a lasting legacy of that long-ago training regimen. That said, running is not for everyone.
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I am a T2 diabetic and starting swimming at age 59. Swam Masters' age group until I was 72. Workouts were 3,000 meters a day 5 days a week. That constant training kept my T2 in check dramatically. Had to stop because of arthritis in my left shoulder. My heart rate during that time was in the low 40's, and today it is at about 56. Have you considered Masters' age group now in T & F? You are still young. The competition is quite fierce and the times of competitors in all the age groups are eye opening.

tuttigym

Quote: Gundy

Fat people have fat pets.

It ain't genes.
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Fat people have fat friends.

It ain't genes.

Quote: UP84

Quote: Gundy

Fat people have fat pets.

It ain't genes.
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Fat people have fat friends.

It ain't genes.
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It used to annoy me to no end that fat women often had thin, hot girlfriends. Of course that was some 40 years ago.

So, if unhealthy conditions aren't genes, how does this explain the large number of people who have diabetes and gout, but are healthy, active, and have normal weight? Because I know a number of those.

Perhaps it's a combination of behavior and genetics, as I said way back in this thread.

Quote: BillHasRetired

Quote: UP84

Quote: Gundy

Fat people have fat pets.

It ain't genes.
link to original post

Fat people have fat friends.

It ain't genes.
link to original post

It used to annoy me to no end that fat women often had thin, hot girlfriends. Of course that was some 40 years ago.

So, if unhealthy conditions aren't genes, how does this explain the large number of people who have diabetes and gout, but are healthy, active, and have normal weight? Because I know a number of those.

Perhaps it's a combination of behavior and genetics, as I said way back in this thread.
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Yes people get confused between the following statements.

"I have diabetes and Gout so I keep a healthy lifestyle to keep it at Bay"

"I keep a healthy lifestyle so that I don't get diabetes and Gout"

Quote: tuttigym

It is remarkable with all the intelligence associated with this forum that no one has introduced genetics into the discussion. While lifestyle is a major factor, genetics plays a huge role in are health outcomes.

tuttigym
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I was the first to introduce "genetics" to this discussion. Another area which needs to be discussed is individual body chemistry which goes hand in hand with genetics. Body chemistry allows for immunities and susceptibilities for strengths and weaknesses to our environments. For example, there are tens of millions of people who will not catch covid, even with co-morbidities, without any help of vaccines while others, who are seemingly healthy and live a "healthy lifestyle," contract the disease and die. There are too many exceptions to continue to post generalities and even unscientific opinions.

tuttigym