Tag Archives: gout

Got Gout? Put Down that Coffee and Cola

As if suffering from gout isn’t bad enough, new research presented this week at American College of Rheumatology’s annual scientific meeting in Atlanta adds insult to injury.

Researchers led by Dr. Tuhina Neogi of Boston University reviewed data from their study of more than 600 adults with gout. Although previous studies have suggested that long-term caffeine use might relieve gout pain, short-term caffeine used might bring it on.

courtesy of flickr user doug88888 (creative commons)

 In this study, people who drank more coffee, tea, or soda, were significantly more likely to have a gout attack, even after controlling for all the other drinks they had. More specifically, 3-4 caffeinated drinks within the 24 hours prior to a gout attack was associated with a 40 to 80 percent risk of recurrent gout.

And there’s more bad news for gout patients, but this is just for women. Another Boston University research team led by Dr. Hyon Choi presented 22 years’ worth of data from the Nurses’ Health Study showing that women who drank more than two fructose-rich beverages daily (such as orange juice and Atlanta’s lifeblood, Coke) were more than twice as likely to develop gout as those who drank less than one of these beverages per month.

The good news? Diet soda was not associated with any increased risk for gout. Phew! But what about the caffeine? Ok, here’s the deal: Women with gout should stock up on caffeine-free diet soda, at least until the next study comes out. And if I look hard enough, there might be a study about the benefits of chocolate for people with arthritis around here somewhere . . .

–Heidi Splete (@hsplete on twitter)


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Filed under Family Medicine, IMNG, Rheumatology

The Medicine Cabinet of Dr. Caligari


In the 1920 horror film “The Cabinet of Dr. Caligari,” the mysterious Dr. Caligari arrives at a carnival with a cabinet whose contents ultimately cause mayhem, madness, and murder.

In our modern-day editorial offices, a series of display cabinets has suddenly arrived in a side corridor—cases whose colorful contents once had much the same effects as the cinematic Dr. Caligari’s cabinet.

Photo by Terry Rudd

The mysterious cabinets contain antique bottles of medicinal magic, including these pre-modern marvels:

  • Who needed biologics when you had Yohn’s Rheumatic Elixir, “An Infallible Cure for Rheumatism, Lumbago and Gout”?
  • The 18th Amendment probably went down easier with Dr. Fenner’s Golden Relief, containing “Alcohol 65%, Ether 22 minims, Chloroform 5 minims, Capsicum, Turpentine, Ammonia,” and several other Prohibition-relieving compounds.
  • Chemoprevention was as simple as a spoonful of Dirigo Bitters and Blood Purifier: “A Preventive of Cancer.”
  • And finally, Parke-Davis & Co. discovered what Ponce de Leon futilely scoured Florida to find: “Life-Everlasting,” featuring the apparently immortality-inducing agent Gnaphalium polycephalum.

These historical artifacts actually belong to our corporate cousins who cover the pharmaceutical industry. But on some level, they belong to us all, a bottled legacy of medicine’s sometimes perilous evolution.

The medicine cabinets offer a rare glimpse back into the Valley of the Shadow of Death and Snake Oil. They’re reminders that we haven’t been climbing the mountain of medicinal progress as long as we might think.

In a time when a routine case of acute otitis media practically autogenerates an amoxicillin script, it’s easy to forget that many of our parents lived their childhoods in the deep shadows of a pre-antibiotic Dark Age. It’s hard to remember that the politically disparaged words “government regulation” once weren’t even in the pharmaceutical vocabulary, with painful results for millions. It wasn’t so long ago that our well-meaning physician ancestors chipped away at disease with the pharmaceutical equivalent of stone tools.

At best, those cabinets’ antique contents did little for their users. At worst, they were products from the closing moments of a millennia-long medical era that spawned the phrase “The cure is worse than the disease.”

Medical practice and the drugs upon which it relies have escaped their Dark Ages. From the antibiotic I’m giving my AOM-afflicted 7-year-old to the antiretroviral revolution in HIV treatment, scientifically tested and government-approved pharmaceuticals have helped create a world of health and longevity inconceivable a century ago.

Certainly, its snake-oil ancestors’ mortal sins don’t excuse the shortcomings of today’s pharmaceutical industry. Or those of the industry’s sometimes fallible regulators. But while we work ourselves into a righteous dudgeon over the influence of pharmaceutical industry funding or clinical trial obfuscation, or point fingers over imperfections in federal government oversight, we might want to take a moment to look back down the medicinal trail.

And remember how far we’ve come from the madness of those Caligari-esque medicine cabinets.

—Terry Rudd


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Filed under Drug And Device Safety, Endocrinology, Diabetes, and Metabolism, Family Medicine, Gastroenterology, Health Policy, IMNG, Infectious Diseases, Internal Medicine, Pediatrics