Try tart cherry supplements to decrease gout flare-ups
Q: I have a history of gout, which has permanently affected the big toe joint of my right foot. Theoretically, I should not be a gout victim: I weigh 140 pounds, eat a healthy vegan diet and exercise regularly. In my most recent few attacks my uric acid level was measured at 6. What suggestions can you offer?
A: A uric acid level of 6 is considered problematic for people with gout attacks. You may need a prescription medicine to get it into an acceptable range.
Another option may sound a little silly, but it has scientific support. Consider tart cherry supplements, either as juice or extract in capsules. A systematic review of six trials found that people taking tart cherry juice or extract had fewer gout flare-ups and lower uric acid (Evidence-Based Complementary and Alternative Medicine, Dec. 4, 2019). A randomized controlled trial confirmed the effect on uric acid and found that capsules are more powerful than juice (Plant Foods for Human Nutrition, Jan. 27, 2021).
Q: I take six to eight Tylenol Extra Strength tablets a day plus one Tylenol PM at night. Will there any side effects from this?
A: Each Tylenol Extra Strength pill contains 500 mg of acetaminophen. Tylenol PM also has 500 mg of acetaminophen. Together, you could be swallowing as much as 4,500 mg of acetaminophen daily.
The makers of Tylenol now state: “To help encourage
the safe use of acetaminophen, the makers of TYLENOL have lowered the maximum daily dose for single-ingredient Extra Strength TYLENOL (acetaminophen) products sold in the U.S. from eight pills per day (4,000 mg) to six pills per day (3,000 mg). The dosing interval has also changed from two pills every four to six hours to two pills every six hours.”
Because you have been exceeding the maximum dose for some time, we would encourage you to have your doctor check both liver and kidney function. Too much acetaminophen can be toxic to these organs.
Q: When I came down with COVID-19, I lost my senses of smell and taste. I have recovered from the virus, but after nine weeks, my senses of smell and taste have not returned. I can taste salt, sweet and spiciness, but I cannot distinguish the flavor from the food or drink that generates those flavors.
I have read that 600 mg daily of alpha lipoic acid (ALA) might help restore smell and taste. Do you have any insights on the ability of ALA to restore these senses?
A: The loss of taste and/ or smell are early symptoms of infection with the coronavirus and may linger after recovery. A report in the Journal of Laryngology and Otology (August 2020) notes that in some studies “around 25% of patients evaluated 30 days after the clinical onset of COVID-19 have severe chemosensitive disorders.” These researchers found that while most people get better within a month, 7.2% of post-COVID patients may still complain of loss of taste and smell two months later.
One small study found that “alpha lipoic acid may be helpful in patients with olfactory loss after upper respiratory tract infection” (Laryngoscope, November 2002). We have not found any studies of ALA for post-COVID sensory deficits. The 600 mg dose you mention has also been used to treat peripheral neuropathy (International Journal of Endocrinology, Jan. 26, 2012).