Me Vs Gout

[Chili777]

So I don't know anything about gout and am asking out of curiosity cause I don't have a dog in this fight; if at 6 weeks, the uric acid comes back wrong, that means you still have gout even without flareups? And if that's a yes, does that mean you'll resign yourself to the allopurinol so it doesn't mess you up just without symptoms?

The uric acid level to watch is over 6.0 in women and 7.0 in men. They aren't static and go up and down according to diet, exercise and weight. Obesity is a known factor for gout, as is alcohol, red meat and seafood consumption. If you have relatives in your mother's or father's family with a history of gout, you may be predisposed to it.

Having said that, I never had a reading over 6.4 and I'm a guy, yet it still has been a curse for me. So, like peptides, people are different there in what levels of uric acid cause crystal formation. If you don't have uric acid crystals forming, usually starting in a big toe, then it's certainly something to be aware of, but I don't see a need to take action on it yet, IMHO. It could be that you (or whomever) just had a spike in uric acid levels due to diet prior to the test.

It only becomes an issue when they are consistently high, which may indicate a precursor to crystal formation, because it means the kidneys are not keeping up with clearing the levels of uric acid from the blood.

 

[randompersonrandom]

The uric acid level to watch is over 6.0 in women and 7.0 in men. They aren't static and go up and down according to diet, exercise and weight. Obesity is a known factor for gout, as is alcohol, red meat and seafood consumption. If you have relatives in your mother's or father's family with a history of gout, you may be predisposed to it.

Having said that, I never had a reading over 6.4 and I'm a guy, yet it still has been a curse for me. So, like peptides, people are different there in what levels of uric acid cause crystal formation. If you don't have uric acid crystals forming, usually starting in a big toe, then it's certainly something to be aware of, but I don't see a need to take action on it yet, IMHO. It could be that you (or whomever) just had a spike in uric acid levels due to diet prior to the test.

It only becomes an issue when they are consistently high, which may indicate a precursor to crystal formation, because it means the kidneys are not keeping up with clearing the levels of uric acid from the blood.

Thank you. I see my first husband bitching on Facebook occasionally about gout, and I never thought anything of it because I didn't actually realize that it's dangerous. I will redouble my hoping that he changes his mind about GLP-1's, cause his weight is almost certainly not helping. (I'd cut my tongue out before I'd unsolicited-advice him, but he's my favorite ex-husband and I still want him to BE my ex-husband when we're all old.)

 

[rkbleddyn]

Too much protein?

This brings back a fort of funny memory to me. I think this was back in the really old days, like in the 2000s before 2010. Anyway, everyone at the organization I worked for at the time started doing the keto diet because it was the big trend.

One of my co-workers came in late one day and said he had to go to the hospital the night before because of his toe. I guess the doctor told him he had to get off the diet because it was gout caused by all that protein. He was so happy because he had to get off this diet, even though he was at least 100 lbs overweight.

This was the sort of barbaric stuff people endured before GLP-1s.

 

[lastresort]

Have yall tried cranberry juice??

 

[Jfrick11]

if at 6 weeks, the uric acid comes back wrong, that means you still have gout even without flareups? And if that's a yes, does that mean you'll resign yourself to the allopurinol so it doesn't mess you up just without symptoms?

My read? Probably not. If I'm reading his posts correctly, he seems pretty committed to the idea that peptides might be the answer, despite there not being evidence that they lower uric acid or dissolve urate crystals.

It's hard to call this a six week experiment. He's had gout for 7 years, and his attacks have progressed from once or twice a year to every 6–8 weeks. 😢

At some point, it stops being "I'm giving this a short trial" and becomes a decision to delay proven urate lowering therapy while the underlying disease may continue to progress.

I genuinely hope he proves everyone wrong.

 

[RetCurious]

Obesity is a known factor for gout, as is alcohol, red meat and seafood consumption.

It was the 20 year aged cheese that set me off. I miss it. 😭😆

 

[Chili777]

It was the 20 year aged cheese that set me off. I miss it. 😭😆

My first attack was after drinking a lot of vodka at 32. I still can't drink it without getting a flare, at least when I was drinking.

 

[SVT810E]

he seems pretty committed to the idea that peptides might be the answer, despite there not being evidence that they lower uric acid

https://www.nature.com/articles/s41467-023-44067-4

https://diabetesjournals.org/diabet...LB-A-Novel-Glucagon-Like-Peptide-1-GLP-1R-and

https://diabetesjournals.org/diabet...-Mazdutide-a-Dual-GLP-1R-GCGR-Agonist-Reduces

https://pmc.ncbi.nlm.nih.gov/articles/PMC12477040/

That effect was first noticed in human clinical trials for mazdutide. The mouse studies were a followup to try to figure out why it was lowering uric acid levels. Because Innovent decided to publish papers about it, all of the published research we have so far is from studies on mazdutide which is a weaker glucagon agonist.

While we don’t have data for reta yet (Eli Lilly has collected it but hasn’t mentioned or released it), I know a clinical trial participant who saw a 50% reduction in their uric acid levels on 12mg of reta. My SO started on reta three months ago, is currently taking 6mg, and has seen a 25% reduction so far.

So whether it was a wise decision to avoid standard therapies like allopurinol or not (it wasn’t), OP’s gonna luck out because the peptide he’s taking just so happens to work for this. Dumb luck is still luck.

 

[Jfrick11]

https://www.nature.com/articles/s41467-023-44067-4

https://diabetesjournals.org/diabet...LB-A-Novel-Glucagon-Like-Peptide-1-GLP-1R-and

https://diabetesjournals.org/diabet...-Mazdutide-a-Dual-GLP-1R-GCGR-Agonist-Reduces

https://pmc.ncbi.nlm.nih.gov/articles/PMC12477040/

That effect was first noticed in human clinical trials for mazdutide. The mouse studies were a followup to try to figure out why it was lowering uric acid levels. Because Innovent decided to publish papers about it, all of the published research we have so far is from studies on mazdutide which is a weaker glucagon agonist.

While we don’t have data for reta yet (Eli Lilly has collected it but hasn’t mentioned or released it), I know a clinical trial participant who saw a 50% reduction in their uric acid levels on 12mg of reta. My SO started on reta three months ago, is currently taking 6mg, and has seen a 25% reduction so far.

So whether it was a wise decision to avoid standard therapies like allopurinol or not (it wasn’t), OP’s gonna luck out because the peptide he’s taking just so happens to work for this. Dumb luck is still luck.

Those are interesting papers, and I appreciate you sharing them. I should be more careful about how I phrase things.

I agree they suggest mazdutide may have uric acid lowering effects. But I don't think they answer the clinical question being discussed here.

None of these are gout treatment trials. The human studies were conducted primarily in people with obesity, diabetes, or other metabolic disease, not patients with longstanding recurrent, escalating gout deciding whether to defer allopurinol. Many participants also experienced substantial weight loss and improvements in insulin resistance, both of which are independently associated with lower serum uric acid.

Even the case report (1 patient) included metformin, insulin, diet, exercise, and significant weight loss, and the authors explicitly acknowledge they can't attribute the uric acid reduction to mazdutide alone.

That's why I said there's no evidence that reta reliably treats gout. Lowering uric acid in a metabolic disease population is encouraging, but it's different from demonstrating that a drug can consistently lower uric acid below the crystal saturation threshold, dissolve existing urate deposits, and prevent recurrent flares in people with established gout.

I genuinely hope glp1s end up proving beneficial for gout.... it would be fantastic, my husband has the disease.

I personally just don't think a 45 year old with a seven year history of progressively more frequent flares should delay proven therapy based on maybes. I also know, it's his choice 😉