Is there any relation to gout when you have PA? Anyone able to advise?

[AndrewWiseman]

Hi I have PA and about 18 months ago I had terrible problem with gout in my feet- those of you who have had gout know that’s it’s terribly painful!

So a year ago I was diagnosed with PA but now wondering if the two may be linked. As for some reason I have a gout flair up!

Any help or suggestions would be highly appreciated

Thanks guys and gals

[Foggyme Administrator]

Hi AndrewWiseman. There is a link between B12 supplements / injections and gout (though I don't have time to research whether there's a specific causual connection between PA itself, and gout).

One known side effect of B12 injections is that they can precipitate gout in a susceptible individual, so if a gout diagnosis is present, suspected, or perhaps undiagnosed, B12 has to be used with care (enough to control the symptoms of deficiency, but no more). (Gout is common in the toes but can occur in any joint or joints).

Mentioned in patient information leaflets and Mayo Clinic etc. but haven't been able to find much in the research department (just a quick trawl)...but…

Small mention here (but not referenced in research papers at end - unfortunately): Natural Medical Journal vitamin B12 supplements / injections and gout…

'Use cautiously in patients with a history of gout, or elevated uric acid levels, as the correction of megaloblastic anemia with vitamin B12 may precipitate gout in susceptible individuals.'

Link to full article:

naturalmedicinejournal.com/...

There's also a connection between connection diabetes and gout...but can't find research paper right now. An online search will throw up more information, if you're interested.

So, if you're susceptible to gout then it may be that the B12 injections have precipitated a flare up - though there are other factors which may be involved so it's not easy to say for sure.

Interestingly, some of the medications used to treat gout impede the absorption of vitamin B12 - but this shoudn't be an issue for those already on B12d injections.

One of my relatives suffers from gout so I know how very painful it can be. His is now well controlled with medication (can't remember which) so I hope that you manage to find something that works for you.

Good luck 👍

[Gambit62 Administrator in reply to Foggyme]

gout is a form of arthritis associated with high levels of uric acid in general, however, there does also seem to be an association with high homocysteine and reduced kidney function - at least in some patients

ncbi.nlm.nih.gov/pmc/articl...

However, that wouldn't explain the association between megaloblastic anaemia, starting B12 and gout.

most of what I can find on gout and megalobalstic anaemia seems to come from the 1960s but haven't got time to research any further

[Gambit62 Administrator in reply to Foggyme]

ncbi.nlm.nih.gov/pmc/articl...

A very old article - discussion includes effects of folic acid and B12 on production of uric acid. It would appear that B12 increases and folic acid decreases production of uric acid.

In apparent contrast, patients with Addisonian anaemia from vitamin B12 lack are most prone to gout during the initial treatment when increased uric acid production parallels the reticulocyte response, and endogenous uric acid production before is usually normal (Riddle, 1930; Opsahl, 1939).

This difference is paralleled by the experimental ANNALS OF THE RHEUMATIC DISEASES

work of Machlin and others (1952), who found that, whereas folic acid usually lowered the serum uric acid, vitamin B12 acted conversely. They suggested that folic acid inhibited uric acid synthesis, and that vitamin B12 accelerated its formation.

[Foggyme Administrator in reply to Gambit62]

Ah ha...good find Gambit62 . Answers some questions. Thank you 😉😀.

[AndrewWiseman]

Thanks for the Info... yes it’s very painful.... maybe a trip to the doctors maybe required!

[KimberinUS]

hi there,

i have looked and many sites list a connection between b12 use and a gout flare up but i cannot find any research showing why they would be connected.

my step father has gout attacks and while trying to research, several articles mentioned donating blood (to reduce stored iron) and eating cherries. i know he does both of these things and they seem to help him.

i hope your flare is gone but if not, consider a bowl of cherries. suppose to help by following day, not immediately.

[fbirder]

I have high levels of urate in my blood, and I’ve had one attack of gout. That was in July. My GP agreed with my suggestion that it was likely caused by dehydration caused by the stupid weather.

[Gambit62 Administrator in reply to fbirder]

fbirder you might find these articles of interest

ncbi.nlm.nih.gov/pmc/articl...

ncbi.nlm.nih.gov/pmc/articl...

[fbirder in reply to Gambit62]

Thanks, but my hCys levels are very low.