Women do get Gout

DEAR DR. DONOHUE: I am a 63-year-old woman, and I have gout. I can't believe it. I thought only men got it. How did I get it? Do I have to take medicine for it for the rest of my life? How does the medicine work? -- A.D.

ANSWER: You got gout like everyone else gets it -- from a rise in blood uric acid. Uric acid is a byproduct of all the chemical processes that take place in body cells. When blood uric-acid level rises, it can diffuse into joints. Inside the joint, uric acid crystallizes, and those crystals irritate and inflame the joint. The involved joint swells, turns red, becomes hot and is exceedingly painful. In a first gout attack, the big toe is the joint affected the majority of the time. However, any joint can be a target -- chiefly the midfoot, the ankles, the knees, the wrists or the fingers.

Before menopause, few women come down with gout because estrogen promotes uric-acid excretion. By age 60, the number of women with gout equals the number of men, and by age 80, more women suffer from it than do men.

Uric-acid levels rise either because the kidneys fail to get rid of it as they should or because the body overproduces it. Nine times out of 10, the fault lies with the kidneys' inability to excrete it normally.

There are two classes of gout medicine. One class handles the acute attack. Anti-inflammatory medicines like Indocin are often chosen when a joint becomes painfully swollen with uric-acid crystals. Colchicine, a time-honored gout medicine, is still used, but because it can cause some unpleasant side effects, it is often held in reserve.

The second class of gout medicines are ones used to prevent recurrent attacks. Two common ones are Benemid, which promotes uric-acid excretion, and Zyloprim, which reduces its production.

Lifelong therapy is instituted if a person has recurring and frequent gout attacks.

The gout booklet explains this illness in depth. To obtain a copy, write to: Dr. Donohue -- No. 302, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./6.75 Can. with the recipient's printed name and address. Please allow four weeks for delivery.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.