痛風症(2)

Peter Cheung & Others

16 August 2013

Peter Cheung：

Kay, As I read more about gout disease, some puzzling questions came up. Why it attacks the big toe more often? Why happens at night? Why more men after 40 and postmenupausal women have gout disease? We all have uric acid in our blood. There are people who have high uric acid and have no gout attack! There is probably other factor besides high uric acid that trigger gout attack. Purine is a component of DNA and RNA (not protein as some web info suggests). Xanthine is one type of purine. Allopurinol is a drug that inhibits the enzyme xanthine dehydrogenase/oxidase that converts xanthine to uric acid. When there low blood flow and oxygen and energy flow is low, xanthenes dehydrogenase will go up to compensate. When oxygen level returns to normal, xanthine dehydrogenase is changed to xanthine oxidase which converts more xanthine to uric acid and causes injury. The injury will activate inflammation response which results in redness and pain. This will happen anywhere in our body. The red big toe is a red flag to tell us to take action! Otherwise other problems may come. Gout disease has been associated with many other diseases in the same person or family. Sue 's info should be valued seriously.

Sue：

Re your comment: "When there low blood flow and oxygen and energy flow is low, xanthine dehydrogenase will go up to compensate. When oxygen level returns to normal, xanthine dehydrogenase is changed to xanthine oxidase which converts more xanthine to uric acid and causes injury." Does this means if one can keep a normal/healthy oxygen, energy and blood flow, the risk of getting injured can be reduced?So if one can exercise regularly that promotes normal/healthy energy, oxygen and blood flow level it is another way to help? Thanks.

Bob Choi：

The low blood/oxygen issue might help explain why the big toe is effected most and why at night: The big toe being a body extremity is often low in blood flow to start with(and it bumps into things all the time which only accentuates the pain!) At night during sleep many men suffer from some degree of Apnea which creates a low level of blood oxygen in the body. Why it affects men over 40? Well, most men stop exercising after 40. Look around and you know this is true. So everything makes sense!

-To be continued-