Myth no 1:- Eating vegetables such as tomatoes, lettuce as well as consumption of dal can cause you to develop gout.
Actually though purines in these vegetables and dals can be converted into uric acid, research has shown that this generally does not happen inside the human body. In fact the american college of rheumatology, and arthritis foundation (USA) handouts regarding diet in gout clearly state that patients can have all vegetables as well dals as the only purines which are to blame for gout are animal purines. So enjoy those veggies without guilt.
Myth no 2:- Gout can cause pain all over the body
Gout is a very painful arthritic condition. It can cause pain in several joints and sometimes causes pain in areas outside the joint called bursae as well. However gout generally causes severe pain and swelling and redness in a single joint which lasts for one to two weeks . Since uric can be elevated in many people without gout (see Myth number 3) many patients who have pain due to other reasons when tested for uric acid are found to have high uric acid. Their pain is totally unrelated to the "normal elevated uric acid" (see Myth number 3) but unfortunately the uric acid gets blamed for their pain.
Myth no 3:- A high uric acid causes pain
High uric acid IN THE BLOOD is found in many people. However it is only when this uric acid exceeds a certain level (generally 6.5mg/dl) does the uric acid sort of spill out from the blood into the joints. Now uric acid when it first spills into the joints does not cause any problems. In fact scientist estimate that the uric acid has to be elevated and continue to spill into the joints and keep accumulating in the joints FOR ATLEAST 10 to 20 years to ultimately cause pain and swelling in the joints. Uric acid goes up AFTER puberty in MEN and AFTER MENOPAUSE in women. Thus most men develop gout in their late 30s (puberty = 16 years + 20 years) and in their late 70s in women ( menopause = 45 + 20 years ). During these 20 years when uric acid is accumulating silently without causing problems if you test the blood you may get a high uric acid in many people who do not have any problem. This is called asymptomatic hyperuicemia or "normal elevated uric acid". During this time you can have other problems causing pain which can be falsely blamed on uric acid.
Myth no 4:- Once my uric acid has come down I can stop the treatment for gout.
High uric acid in the BLOOD spills over and accumulates in the joint and causes gout as explained in myth number 3. Thus to treat gout and make sure you are cured of gout (see myth number 5) we need to treat the uric acid which has accumulated in the JOINT and not the uric acid in the blood. Thus a low uric acid in the blood does not tell us the level of the uric acid in the joints and may be a false reassurance. Hence patients should continue to take medications for their gout even when their blood uric acid is normal. They should trust their rheumatologist who will be scientifically estimate the uric acid in their joint better and them to guide them regarding how long and at what dose they need to take their medications.
Myth no 5:- Gout is not curable
This is the worst myth of all. I have had many patients who are scared to start medications since they feel that they will be on the medications life long once they start. However gout if treated properly it is a potentially curable disease. However since patients do not start medications and continue taking medications for a few years they have to live with decades of intermittent painful gout. In addition what is not known is gout can also increase your risk of developing heart disease and kidney failure. Thus even if you are superman and can bear the pain that gout brings, you will not be able to bear heart attack or kidney failure. So you should take treatment and cure gout. You owe that much to your body.