Gout and MS

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Re: Gout and MS

Postby jimmylegs » Mon Jul 22, 2013 1:54 pm

ah, tmj and gout, interesting. can you requisition - or recommend - bloodwork for this patient?

having a scout around.. first i started with a search for any deficiency in gout, documented in research.
found this:

Hypoxanthine-Guanine Phosphoribosyltransferase Deficiency in Gout
http://annals.org/article.aspx?articleid=682912

so. this enzyme. wondered about its mineral connection. with tmj in the picture, i'd be looking askance at magnesium status. so i searched on Hypoxanthine-Guanine Phosphoribosyltransferase and magnesium, which turned up this study:

Human hypoxanthine guanine phosphoribosyltransferase. The role of magnesium ion in a phosphoribosylpyrophosphate-utilizing enzyme.
http://www.jbc.org/content/256/8/3671.short

very interesting. every day i get more impatient for full text access :D

now, i'm considering that people can get good results using potassium on gout, and I've observed this in person as well (even though there's a gap in the science on the subject, so we seem only have anecdotal reports to go on). thought i'd have a last scour for science but we're not quite there in terms of a proper study. when i specify potassium and gout in an article title, weber seems to be about it, for now. probably worth a review of the writing and citations - although more research is clearly needed:

Potassium Bicarbonate to Ameliorate Gout
http://www.webmedcentral.com/article_view/4217

anyway. given the known interactions between magnesium and potassium, it's starting to look like we have an interesting little biochemical dance going on here.

i like this next article, even though the title is a little odd (to me 'refractory repletion' implies that no matter how low researchers dropped magnesium levels, that potassium status stayed stubbornly replete). just underscoring the mag and potassium connection:

Refractory Potassium Repletion - A Consequence of Magnesium Deficiency
http://archinte.jamanetwork.com/article ... eid=615872

oh and here's this one again, just underscoring the possible magnesium basis for potassium depletion

The production of secondary potassium depletion, sodium retention, nephrocalcinosis and hypercalcaemia by magnesium deficiency
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1196693/

now, on to the tmj connection. can we link up magnesium and tmj, it's certainly plausible. definitely something to at least try to rule out. here's an article i had my eye on recently for someone else

Serum nutrient deficiencies in the patient with complex temporomandibular joint problems
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2446412/
"..Standard blood assays were performed for beta-carotene (vitamin A), folate, serum iron, ferritin, zinc, magnesium, and vitamins B1, B6, B12, and C. Each patient was deficient in at least one of these 10 elements, with an average of 3.3 elements. Some factors that may be responsible for the deficiency state include inadequate nutritional intake, malabsorption, utilization dysfunction, increased requirements, or drug interactions."

nice that it's full text, but lame that it's not a step or two closer to raw data. can't really assess the validity of their stats wrt 'low' 'normal' or 'high' nutrient status. nonetheless, across the board the trend is distinctly toward low values.. esp if we should actually be categorizing half or more of the 'normals' as low. especially re something like magnesium, where the 'normal' range is notoriously faulty.

i could go on about interconnections but it's too complicated, i can only deal with so much info at once in this editor!

very interesting when it comes to the alignment side of things. definitely see the connections btw biochem and tmj. somewhat relevant anecdote: i am currently in physio while awaiting knee reconstruction surgery. last time i arrived at an appointment my therapist confronted me indignantly: 'why are you limping!!' i hadn't really noticed the transition from normal walking to this limp, but explained it 'it feels like my knee gives a bit, and then my hip sort of shifts over as well.." so then it was off to the torture chamber to release my quads, and minutes later i wiped away the tears (kidding, mostly!) and out i walked straight as can be. so, muscular tension can certainly wreak havoc on the function of the joint. i suspect the TMJ is no exception. anyway for me, i'm going to prescribe a nice soak in mag chloride and see if i can get my tissue to soak up a little more mag that way. at least until i can find some more mag citrate (i'm maxed out on mag glycinate.. it gives me side effects :S )

basically in the end it looks reasonable for magnesium levels to be a trouble spot in both TMJ and gout, with secondary links to the potassium aspect of gout. so all in all, if you can get serum magnesium and potassium levels for this patient, i can provide the serum magnesium target, and i'll go track down a serum potassium target too.

and obviously, zinc and uric acid levels wouldn't hurt either :) a good starting point anyway.
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Re: Gout and MS

Postby Amir » Tue Jul 23, 2013 2:17 pm

jimmylegs wrote:ah, tmj and gout, interesting. can you requisition - or recommend - bloodwork for this patient?

having a scout around.. first i started with a search for any deficiency in gout, documented in research.
found this:

Hypoxanthine-Guanine Phosphoribosyltransferase Deficiency in Gout
http://annals.org/article.aspx?articleid=682912

so. this enzyme. wondered about its mineral connection. with tmj in the picture, i'd be looking askance at magnesium status. so i searched on Hypoxanthine-Guanine Phosphoribosyltransferase and magnesium, which turned up this study:

Human hypoxanthine guanine phosphoribosyltransferase. The role of magnesium ion in a phosphoribosylpyrophosphate-utilizing enzyme.
http://www.jbc.org/content/256/8/3671.short

very interesting. every day i get more impatient for full text access :D

now, i'm considering that people can get good results using potassium on gout, and I've observed this in person as well (even though there's a gap in the science on the subject, so we seem only have anecdotal reports to go on). thought i'd have a last scour for science but we're not quite there in terms of a proper study. when i specify potassium and gout in an article title, weber seems to be about it, for now. probably worth a review of the writing and citations - although more research is clearly needed:

Potassium Bicarbonate to Ameliorate Gout
http://www.webmedcentral.com/article_view/4217

anyway. given the known interactions between magnesium and potassium, it's starting to look like we have an interesting little biochemical dance going on here.

i like this next article, even though the title is a little odd (to me 'refractory repletion' implies that no matter how low researchers dropped magnesium levels, that potassium status stayed stubbornly replete). just underscoring the mag and potassium connection:

Refractory Potassium Repletion - A Consequence of Magnesium Deficiency
http://archinte.jamanetwork.com/article ... eid=615872

oh and here's this one again, just underscoring the possible magnesium basis for potassium depletion

The production of secondary potassium depletion, sodium retention, nephrocalcinosis and hypercalcaemia by magnesium deficiency
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1196693/

now, on to the tmj connection. can we link up magnesium and tmj, it's certainly plausible. definitely something to at least try to rule out. here's an article i had my eye on recently for someone else

Serum nutrient deficiencies in the patient with complex temporomandibular joint problems
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2446412/
"..Standard blood assays were performed for beta-carotene (vitamin A), folate, serum iron, ferritin, zinc, magnesium, and vitamins B1, B6, B12, and C. Each patient was deficient in at least one of these 10 elements, with an average of 3.3 elements. Some factors that may be responsible for the deficiency state include inadequate nutritional intake, malabsorption, utilization dysfunction, increased requirements, or drug interactions."

nice that it's full text, but lame that it's not a step or two closer to raw data. can't really assess the validity of their stats wrt 'low' 'normal' or 'high' nutrient status. nonetheless, across the board the trend is distinctly toward low values.. esp if we should actually be categorizing half or more of the 'normals' as low. especially re something like magnesium, where the 'normal' range is notoriously faulty.

i could go on about interconnections but it's too complicated, i can only deal with so much info at once in this editor!

very interesting when it comes to the alignment side of things. definitely see the connections btw biochem and tmj. somewhat relevant anecdote: i am currently in physio while awaiting knee reconstruction surgery. last time i arrived at an appointment my therapist confronted me indignantly: 'why are you limping!!' i hadn't really noticed the transition from normal walking to this limp, but explained it 'it feels like my knee gives a bit, and then my hip sort of shifts over as well.." so then it was off to the torture chamber to release my quads, and minutes later i wiped away the tears (kidding, mostly!) and out i walked straight as can be. so, muscular tension can certainly wreak havoc on the function of the joint. i suspect the TMJ is no exception. anyway for me, i'm going to prescribe a nice soak in mag chloride and see if i can get my tissue to soak up a little more mag that way. at least until i can find some more mag citrate (i'm maxed out on mag glycinate.. it gives me side effects :S )

basically in the end it looks reasonable for magnesium levels to be a trouble spot in both TMJ and gout, with secondary links to the potassium aspect of gout. so all in all, if you can get serum magnesium and potassium levels for this patient, i can provide the serum magnesium target, and i'll go track down a serum potassium target too.

and obviously, zinc and uric acid levels wouldn't hurt either :) a good starting point anyway.


Many thanks for this fascinating reply. I have read through the links. The patient has had full blood essays for some years. I have asked him to get hold of them

As per your suggestion we are going to check K, Mg Zn and Uric acid at monthly intervals while he is having TMJ treatment.

At the moment things are going well. We wait in breathless anticipation to see what happens!
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Re: Gout and MS

Postby jimmylegs » Tue Jul 23, 2013 3:07 pm

great to hear about the monthly testing planned! i'll be very interested to see the results, and those obtained via past tests as well if I can :)

so, monitoring established. excellent.

a little more context would be very useful.. is there any chance we could get a detailed three day food/fluids/supplements/meds diary from your patient? could be enlightening.

following from that, would be useful to have a discussion re dietary mods to optimize potassium, mag, zinc, uric acid, etc. have you mentioned anything along those lines with your client?

if these ideas have any legs with the patient, we could follow up by suggesting beneficial diet changes, providing daily nutrient intake targets, and info on nutrient-dense healthy sources, etc.

I share your anticipation of this intervention, I hope you will be able to either post or message me test results as they come in!
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Re: Gout and MS

Postby Amir » Wed Jul 24, 2013 12:26 am

jimmylegs wrote:great to hear about the monthly testing planned! i'll be very interested to see the results, and those obtained via past tests as well if I can :)

so, monitoring established. excellent.

a little more context would be very useful.. is there any chance we could get a detailed three day food/fluids/supplements/meds diary from your patient? could be enlightening.

following from that, would be useful to have a discussion re dietary mods to optimize potassium, mag, zinc, uric acid, etc. have you mentioned anything along those lines with your client?

if these ideas have any legs with the patient, we could follow up by suggesting beneficial diet changes, providing daily nutrient intake targets, and info on nutrient-dense healthy sources, etc.

I share your anticipation of this intervention, I hope you will be able to either post or message me test results as they come in!

I have already asked the patient to keep a daily diary of intakes. Because of years of suffering he has already modified all his foods etc. The medicine never had any effect He stopped taking that recently.

He has sought my help to see if there is any totally different answer and hence our desire not to do any more supplementation for 3 months to see if TMJ correction indeed helps. The results after 2 weeks of treatment look very promising but like I said, in an earlier post, 3 months from the start of the treatment would be a reasonable time frame to suggest that indeed there appears to be a connection and treatment is impacting gout - or vice versa.

Failure at that time would indeed call for all you suggest in your profound and selfless research.

The more important observation is that the patient has a PERMANENT serious jaw asymmetry. He however suffers every 2 months or so for about 3 weeks with horrendous pain. This is why I called his gout a RR Gout condition. If a connection can be discovered it points to the fact the other RR conditions like MS possibly may have the same basis - a permanently asymmetric jaw but RR symptoms just as many patients on TIMS are increasingly reporting that their symptoms have a TMJ/Atlas/hip connection.

This has also been borne out by the numerous patients I have under treatment.

With a presentation of Gout it is very easy to measure uric acid, K, Mg, Zn levels to get an indicator of changing disease with a change in some minerals and Uric acid without extra supplementation. If the levels return to normal with TMJ correction these may impact the production of 'Hypoxanthine-Guanine Phosphoribosyltransferase' which has been found to be deficient in Gout as you discovered in an earlier posting which is perhaps an additional investigation which, if possible, should be undertaken.
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Re: Gout and MS

Postby jimmylegs » Wed Jul 24, 2013 6:23 am

i'm very curious about the nature of the dietary approach and serum levels achieved to date. there may well be some clear steps to take, apart from supplementation. perhaps once you have spent some time working on tmj alignment. i'll still be here in 3 months, as far as I know!

I should note that my own history of almost lifelong problems with tmj arose from trauma and no doubt stress as well, both of which are known to deplete magnesium. I wouldn't characterize my former problem as serious or debilitating, more annoying, and limiting in a relatively insignificant way. I am pleased to report that I don't have these issues any longer. I have been working on magnesium and other nutrients for years now.. it's a very long slow process.

i'll be interested indeed to see the results of your experiment with tmj alignment therapy and gout. I hope in the meantime you and your patient might be comfortable sending some more detail on the interventions attempted thus far.
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Re: Gout and MS

Postby Amir » Wed Jul 24, 2013 7:03 am

jimmylegs wrote:i'm very curious about the nature of the dietary approach and serum levels achieved to date. there may well be some clear steps to take, apart from supplementation. perhaps once you have spent some time working on tmj alignment. i'll still be here in 3 months, as far as I know!

I should note that my own history of almost lifelong problems with tmj arose from trauma and no doubt stress as well, both of which are known to deplete magnesium. I wouldn't characterize my former problem as serious or debilitating, more annoying, and limiting in a relatively insignificant way. I am pleased to report that I don't have these issues any longer. I have been working on magnesium and other nutrients for years now.. it's a very long slow process.

i'll be interested indeed to see the results of your experiment with tmj alignment therapy and gout. I hope in the meantime you and your patient might be comfortable sending some more detail on the interventions attempted thus far.


We shall surely keep this thread alive. He has just gone on a 10 day holiday free of pain but perhaps the pain was in remission any way. We have to wait a couple of months.
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Re: Gout and MS

Postby Amir » Wed Oct 02, 2013 3:59 am

jimmylegs wrote:i'm very curious about the nature of the dietary approach and serum levels achieved to date. there may well be some clear steps to take, apart from supplementation. perhaps once you have spent some time working on tmj alignment. i'll still be here in 3 months, as far as I know!

I should note that my own history of almost lifelong problems with tmj arose from trauma and no doubt stress as well, both of which are known to deplete magnesium. I wouldn't characterize my former problem as serious or debilitating, more annoying, and limiting in a relatively insignificant way. I am pleased to report that I don't have these issues any longer. I have been working on magnesium and other nutrients for years now.. it's a very long slow process.

i'll be interested indeed to see the results of your experiment with tmj alignment therapy and gout. I hope in the meantime you and your patient might be comfortable sending some more detail on the interventions attempted thus far.


As promised I have an interim report on my patient:
Patient has been off his medication for 3 months.
His attack was due more than a month ago but has not materialised. He looks and feels enormously healthy. His gait has improved massively and now appears normal.

His TMJ treatment is about 20% done.

We were able to do Uric acid levels at fortnightly intervals.

These have declined from 0.672 to 0.597 (Normal range 0.155 - 0.428 mmol/L)
I hasten to add that these are the first signs of a decline in 6 years.

His test done last week for:
Magnesium 0.92 ( 0.7 - 1.0 mmol/L)

Potassium 4.0 (3.5 - 5.0 mmol/L)
which are pretty normal.

In future we are also going to monitor Potassium and Magnesium levels as you suggested.

Thank you for your amazing contributions. I shall update again if we achieve normal range in the coming months.
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Re: Gout and MS

Postby jackD » Sat Feb 08, 2014 9:40 am

May not need to get get GOUT to get benefits. See below extract and new drug...

jackD


Neurochem Int. 2014 Jan;64:64-72. doi: 10.1016/j.neuint.2013.11.007. Epub 2013 Nov 22.

Ulinastatin attenuates experimental autoimmune encephalomyelitis by enhancing anti-inflammatory responses.

Feng M1, Shu Y2, Yang Y2, Zheng X3, Li R2, Wang Y2, Dai Y2, Qiu W2, Lu Z2, Hu X4.

Abstract

Multiple sclerosis (MS) is a common inflammatory and demyelinating neurological disease. Experimental autoimmune encephalomyelitis (EAE), an animal model of MS, has been widely used to test MS treatment methods.

Ulinastatin
(UTI), a drug used to treat acute inflammatory disorders, has been tested in animal models of autoimmune inflammatory diseases, such as ulcerative colitis and crescentic glomerulonephritis.

We recently found that UTI has a neuroprotective effect on EAE by reducing oligodendrocyte apoptosis and demyelination.

The anti-inflammatory effects of UTI on EAE/MS, however, have never been investigated. We have therefore evaluated the anti-inflammatory effects of UTI in EAE and explored the mechanisms underlying this effect. EAE was induced in mice with and without UTI treatment. Inflammation and demyelination of spinal cords were evaluated by staining with hematoxylin and eosin and with Luxol fast blue, respectively. Inflammatory markers in serum were analyzed by the Luminex method, and spinal cords were evaluated by immunofluorescence and Western blotting.

UTI significantly lowered the clinical and pathological scores and the serum concentrations of the inflammatory cytokines interleukin (IL)-1β, IL-6, and matrix metal protease-9 (MMP-9).

UTI also reduced the expression of tumor necrosis factor-alpha (TNF-α)/nuclear factor kappaB (NF-κB)/inducible nitric oxide synthase (iNOS) proteins and decreased CD11b(+) cells in spinal cord lesions.

UTI may protect against EAE in mice by suppressing inflammatory responses. We think that UTI might be a potential therapeutic agent for MS.

Copyright © 2013. Published by Elsevier Ltd

http://en.wikipedia.org/wiki/Ulinastatin

Below is an partial extract from above link....

Ulinastatin (or urinary trypsin inhibitor, UTI) is a glycoprotein which acts as a trypsin inhibitor. It can be derived from urine or it can be synthetically produced. It may be effective in treatment of acute pancreatitis, chronic pancreatitis, toxic shock, Stevens–Johnson syndrome, burn patients, severe sepsis and toxic epidermal necrolysis (TEN). Currently, the drug is being used in Japan, brand name is Miraclid. The drug is also available in Korea, China and India. In India,it is marketed by Bharat Serums and vaccines Ltd by the brand name U-Tryp for severe sepsis.http://u-tryp.com/.

The drug is also known by the name of Bikunin and Urinastatin.

Studies in Japan have documented reduction in the incidence of ERCP-induced pancreatitis with the use of ulinastatin. In one study, the incidence of hyperenzymemia and pancreatitis was significantly lower in the ulinastatin group than in the placebo group.[1] Ulinastatin reduced the levels of serum and drain amylase and the incidence of postoperative pancreatitis following pancreaticoduodenectomy in another study.[2] In a study conducted in India for pancreatitis concluded that, 22-day all-cause mortality in subjects with severe pancreatitis receiving ulinastatin was lower than those receiving placebo (2.8% vs 18.8%; p=0.048), resulting in a 16% absolute reduction in the risk of death and a relative reduction of 85%. Results also indicate that in this population, one life would be saved for every 6.25 subjects treated with ulinastatin. New organ dysfunction was seen in 12 subjects with severe pancreatitis on ulinastatin and 29 on placebo (p=0.0026) thus, ulinastatin reduced the rate of this complication. It also observed that the median hospital stay till discharge in survivors was shorter in the ulinastatin group, but this difference was not statistically significant.[3]

Mechanism of Action

Ulinastatin is an acid-resistant protease inhibitor found in human urine.
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Re: Gout and MS

Postby jimmylegs » Sat Feb 08, 2014 10:15 am

@jack - you don't aim for gout! hehe! you aim for healthy uric acid levels (indicating functioning urea cycle). the sweet spot between ms and outright gout.

addressing low normal zinc status can make a contribution where IL-1β and IL-6 are concerned. wise to look at the possible effects of an essential nutrient often low in ms patients.

from oct 2013: natural-approach-f27/topic18559-960.html#p217103
Zinc in Human Health: Effect of Zinc on Immune Cells (2008)
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2277319/
"In HL-60 cells (promyelocytic leukemia cell line), zinc enhances the up-regulation of A20 mRNA, which, via TRAF pathway, decreases NF-κB activation, leading to decreased gene expression and generation of tumor necrosis factor-α (TNF-α), IL-1β, and IL-8." "A few investigators have reported that inflammatory cytokines such as TNF-α (tumor necrosis factor-α) and IL-1β, generated by activated monocytes-macrophages, also are known to produce increased amounts of ROS (23,24). Increases in these cytokines are associated with decreased zinc status in patients.

Zinc-suppressed inflammatory cytokines by induction of A20-mediated inhibition of nuclear factor-κB (2011)
http://www.sciencedirect.com/science/ar ... 071000287X
"We confirmed that zinc-induced A20 contributes to downregulation of TNF-α and IL-1β by antisense and short interfering RNA A20 studies."

Zinc in Human Health: Effect of Zinc on Immune Cells (2008)
Zinc decreases C-reactive protein, lipid peroxidation, and inflammatory cytokines in elderly subjects: a potential implication of zinc as an atheroprotective agent (2010)
http://ajcn.nutrition.org/content/91/6/1634.short
"After 6 mo of supplementation, the intake of zinc, compared with intake of placebo, increased the concentrations of plasma zinc and decreased the concentrations of plasma high-sensitivity C-reactive protein (hsCRP), interleukin (IL)-6, macrophage chemoattractant protein 1 (MCP-1), vascular cell adhesion molecule 1 (VCAM-1), secretory phospholipase A2, and malondialdehyde and hydroxyalkenals (MDA+HAE) in elderly subjects. "


@amir - any updates on magnesium and potassium? mag should be at least 1.1 and potassium could likely stand to be closer to 5 (depending on serum sodium levels and sspr)

good potassium status is protective against gout as well :)
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Re: Gout and MS

Postby Amir » Sat Feb 08, 2014 11:41 am


@amir - any updates on magnesium and potassium? mag should be at least 1.1 and potassium could likely stand to be closer to 5 (depending on serum sodium levels and sspr)
good potassium status is protective against gout as well :)


Thank you for inquiring. I take your point about magnesium and Potassium but my patient appears to be doing extremely well.
It has been 7 months since his last Gout attack. He has also indulged in foods and alcohol which formerly brought on an attack but it has not caused him any grief.
We are now doing the uric acid tests less frequently and hopefully the next time the reading will be normal.

Unfortunately I have not come across any other Gout patients so I cannot tell if it will work on other patients. Anyone in the UK suffering from gout can have a free consultation!
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Re: Gout and MS

Postby jimmylegs » Sat Feb 08, 2014 11:46 am

heya - glad he's doing better :) what were the dietary changes you had mentioned above, that your patient implemented?
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Re: Gout and MS

Postby Amir » Sat Feb 08, 2014 11:50 am

jackD wrote:May not need to get get GOUT to get benefits. See below extract and new drug...

jackD


I am intrigued. How does this new drug cure gout!
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Re: Gout and MS

Postby Amir » Sat Feb 08, 2014 11:59 am

jimmylegs wrote:heya - glad he's doing better :) what were the dietary changes you had mentioned above, that your patient implemented?

While he was unwell he refrained from meat and alcohol. He appears to be able to eat and drink anything now.
He is still careful not to overindulge in these.
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Re: Gout and MS

Postby jerrygallow » Sat Feb 08, 2014 12:12 pm

All those people who think they have gout and ms need to take a serious look at Lyme disease. Many docs don't understand Lyme and they stigmatize each other for diagnosing it because quacks say everything is Lyme. Plus there are no good tests for it. After a while the blood work looks normal. One study sent known samples to the labs and half the time the labs reported negative results though all samples were positive. Gout and ms almost never occur together while joint pain is a classic Lyme symptom
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Re: Gout and MS

Postby jackD » Sat Feb 08, 2014 12:27 pm

Amir wrote:
jackD wrote:May not need to get get GOUT to get benefits. See below extract and new drug...

jackD


I am intrigued. How does this new drug cure gout!


There are some real NUTS who want to increase their Uric Acid levels to cure their MS to levels that will give them GOUT.

This substance Ulinastatin found in urine may provide the benefit from urine without the risk of Gout.

I hope this helps but who knows. I could just end up with a wet leg!!

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