How side effects can also be beneficial
‘Three months later, he realised he no longer needed to take his usual medication’
Over the years, many have written to tell of the inadvertent benefits of medicines prescribed for one ailment that gratifyingly have also alleviated some other quite unrelated condition: the beta-blocker for angina that abolished their migrainous headaches, or the cholesterol-lowering cholestyramine that cured their irritable bowel syndrome. These are profoundly non-trivial observations and, increasingly, a major focus of research as drug companies seek to re-purpose long-established remedies looking for hidden properties that might be turned to therapeutic advantage.
There is no longer-established remedy than the autumn crocus (Colchicum autumnale), which first features in the Ebers Papyrus from Ancient Egypt. Since the first century AD, physicians have been commending it as a specific antidote for the agonisingly painful swelling of the big toe characteristic of gout – that we now know to be due to the accumulation of uric acid crystals in the joints. Come the 19th century, chemists finally isolated the crocus’s active ingredient, colchicine, that remains to this day the most reliably fast-acting treatment, reducing the pain and swelling within 24 hours.
Colchicine does not, as might be supposed, prevent the accumulation of those uric acid crystals but, rather, modifies the inflammatory response of the tissues of the joint to their presence by blocking the activation of certain types of blood cells.
The same activation, it transpires, is implicated in a host of other conditions, notably aphthous mouth ulcers, the relentlessly itchy rash of chronic urticaria and acute pericarditis, inflammation of the outer surface of the heart.
“Colchicine may be the oldest therapeutic substance known to mankind,” notes Dr Anastasia Slobodnick in The American Journal of Medicine, “but has proved to be highly beneficial in these previously frustrating (difficult to treat) conditions.”
Former physicist Dr Tony Hanwell from York has recently reported another. Now just 80, he has, for the past decade, suffered from severe osteoarthritis with at-times incapacitating swollen painful hands, knees and elbows. More recently, he had the further misfortune of an attack of gout for which he was advised to take a low dose of colchicine. Three months later, he realised he was virtually pain-free, no longer needing to take his usual medication and could press the palms together of his previously stiff curved hands. He stopped the colchicine, back came the symptoms, restarted it and they improved once more.
“The benefits continue to accrue,” he writes. Meanwhile, his wife, slightly younger but similarly afflicted, was so impressed she persuaded her doctor to prescribe her it as well, with a similarly felicitous outcome. There is clearly a lot of mileage in this repurposing – further instances would be much appreciated.
Regular episode?
There could be a prosaic explanation for the televisual “déjà view” described by a gentleman convinced he had already seen an episode of Michael Portillo’s travel series that was being shown for the first time. “Might it not be that he is recognising the clips shown at the end of the previous episode, anticipating what to expect next time?” asks a reader.
None the less, several others report the same “déjà view”, watching, variously, episodes of Homeland, Pointless and the BBC drama Collateral.
Some people clearly have a gift for precognition which, for one woman, encompasses books she is sure she has already read and, distressingly for her husband, “I am positive I know what he is going to say next.”
Hard to swallow
This week’s medical query comes courtesy of Mrs OC from Bath, troubled for the past two years with the most puzzling pain in the left ear whenever she swallows food or even just a glass of water. She has had all the usual tests, including endoscopies and CAT scans. “He has discharged me saying that while he appreciates I have this pain, he can find no cause for it.” Might anyone, she wonders, be similarly afflicted?