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By Stephenie Karony

Wednesday, August 16, 2000

Fend off gout by
drinking lots of water

Question: My husband has gout. What exactly is gout and what causes it?

Answer: Years ago, gout was thought of as a disease of the rich. The typical victim was overweight, drank too much alcohol and ate too much rich food. In reality, most anyone can get gout if the conditions are right.

Food is a factor in that certain foods can exacerbate gout, but food won't cause it.

Gout is the result of crystals deposited in the joints. These crystals build up because of an abnormally high level of uric acid in the individual's blood. If the kidneys can't eliminate enough uric acid, it accumulates in the blood and forms crystals, which then settle in the joints. These same crystals can also settle in the kidneys, which is one cause of kidney stones.

Uric acid is a breakdown product of proteins called purines.

Some people inherit a deficiency that makes it difficult to metabolize purines. Such individuals are prone to gout. Also, some medications for the treatment of hypertension can interfere with the metabolism of purines.

Foods containing purines can precipitate an attack of gout in people who are unable to properly digest them. Foods that are rich in purines include red meat, mussels and sardines, cheese, mushrooms, spinach and red wine.

If you have gout, or suspect that you do, see your doctor.

Restrict foods containing purines and avoid alcohol altogether. Also drink plenty of water. Water helps to dilute and excrete uric acid in the urine.

The more water you drink, the easier it is to eliminate uric acid.

Q: I'm a 72 year old woman. On my last visit to my doctor, she told me my blood work showed I have a vitamin B12 deficiency. I eat a well-rounded diet, and I can't understand how this happened. Can you shed some light on the subject?

A: As we age, it becomes more difficult for our bodies to absorb vitamin B12. This makes seniors prone to a B12 deficiency. It's estimated that between 10 and 15 percent of older Americans have low blood levels of vitamin B12. A B12 deficiency can lead to anemia, dementia and low blood pressure. The good news is that if you catch a B12 deficiency in its early stages, it is reversible.

B12 plays a role in several important functions in our body.

It aids in the formation of normal red blood cells. It helps keep our brain cells healthy, our memory strong, and our thinking clear, and B12 enhances our ability to concentrate. In addition to all this, recently it has been discovered that B12 helps to maintain good bone health by preventing bones from losing their calcium and thereby becoming brittle.

A vitamin B12 deficiency also has a negative effect on our moods. Individuals with B12 deficiencies often experience severe mood swings, which can lead to psychiatric problems.

So why do people develop B12 deficiencies? A B12 deficiency can occur for a number of reasons. The number one cause is a dietary deficiency. Vitamin B12 is found only in foods of animal origin, such as dairy products and meat. Older people sometimes don't eat enough of these foods.

Treatment for vitamin B12 deficiency is simple and affordable, but early detection is critical. It can be as easy as taking a B12 supplement for the rest of your life, or it may require monthly B12 injections from a doctor. If you suspect you have a B12 deficiency, see a doctor and ask to be tested for blood levels of vitamin B12.

Health Events

Stephenie Karony is a certified health
and fitness instructor, a personal trainer and the author of
"Body Shaping with Free Weights." Send questions to her at
P.O. Box 262, Wailuku Hi. Her column appears on Wednesdays.

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