Rafael Bautista was first diagnosed with gout at the age of 18. According to the U.S. National Health and Nutrition Examination Survey, gout has increased in recent decades and affects nearly 8.3 million Americans or about four percent of the adult population.
“Gout is the most common inflammatory arthritis among men,” said Dr. Peter Simkin, an emeritus professor in the Division of Rheumatology at the University of Washington Medicine. “The prevalence of gout has nearly doubled over the last several decades because of lifestyle changes, increasing diabetes, obesity and hypertension.”
Gout results from having high levels of uric acid in the body. The normal level of uric acid in the blood is 6.8 ml/dl and anything above that puts people at risk for gout.
Bautista, who is now 30, learned he had gout after a basketball injury had not healed after months.
“In the beginning, I had flare-ups in my ankle and now I have it in every joint, my shoulders, my knees,” Bautista said. “When a flare up begins, it will start swelling and the joint will be tender and if I can’t get rid of the uric acid, it will bug me. Every time I walk, there’s a pain. Every time I move, there’s a pain. It’s like shards of glass.”
Bautista said that having gout at such a young age has affected his life because he is aware of people’s reaction.
“In the very early stages when I had gout, it messed with me psychologically to be 20 and walking around with a cane,” Bautista said. “When other people see you with a cane, they ask you what happened and everybody looks at you like you’re helpless.”
Dr. Gregory Gardner, a professor in the Department of Medicine’s Division of Rheumatology said that one of the reasons that gout is becoming more common is because of the “supersize” generation. The emphasis on eating too much sugary food such as soda drinks and foods with high fructose corn syrup can increase the risk for gout.
About 9 out of 10 affected individuals with gout are men over the age of 40.
Gardner said that some risk factors include being a male, family history and certain medications like diuretics. Other risk factors include diets high in red meats, beer, shellfish and other purine-rich foods.
According to the Primer on the Rheumatic Diseases textbook, men are most likely to develop gout in their 40s and 50s; only between three to six percent of gout patients have it onset before age 25. Eighty percent of those patients who have early onset gout have a family history.
“It’s uncommon that he is under 20 to have gout and it probably has to do with his family history and his ethnic background,” Gardner said.
Gardner said that Pacific Islanders had a greater risk of developing gout because their kidneys handle uric acids differently.
“Their kidneys can’t get rid of the uric acid in an efficient manner and when they come to the U.S. with all these purine-rich foods, their uric acid shoots up and they can’t get rid of it,” Gardner said.
Bautista said both his grandparents from his mom and dad’s side are from the Philippines and have gout although none of his immediate family members have it.
Bautista said one of the most difficult parts of having gout is being constantly aware of his eating habits.
“For example, I really enjoy “pho” [Vietnamese noodle soup] but I have to take out most of the meat, bean sprouts and the flank out because it is not good for me. So in that one bowl of pho, I have to lessen everything,” Bautista said. “I don’t do that all the time but I really have to break every food down and look at what’s bad for me.”
Gardner said the number one way to treat gout is to modify diet, use medications and maintain a healthy weight. The second way is to use medications to lower uric acid.
Bautista said it is difficult for him to stay on the medications.
“It sucks at that age because I can’t work for a certain number of days [when I have a gout attack] and you also need a steady prescription to get the medication. When you switch jobs you can’t [get that medication],” Bautista said.
Bautista said it was frustrating because although his condition is on file, he has to pay $80 for an appointment and hundreds of dollars to get his blood drawn in order to get his medication prescribed again.
For this reason, he has started to use medical cannabis in order to alleviate the pain.
Bautista got his license in 2005. Under Washington’s Medical Use of Cannabis Act; there are 11 qualifying conditions such as cancer, glaucoma and other terminal and debilitating medical conditions.
A physician has to diagnose patients with one of the qualifying conditions and attest that the patient may benefit from the use of medical cannabis.
Gardner said it’s not common for someone with gout to use medical cannabis and it’s not a standard treatment for gout but it is used to treat pain.
Dr. Sunil Aggarwal, a house staff physician at New York University Medical Center, who specializes in rehabilitation medicine, said he has seen a wide range of symptoms that could be alleviated using cannabis.
“It has a wide range of already known and future promising range of applications to treat many difficult conditions and it can be produced cheaply and locally so as a doctor, that’s very exciting to me,” Aggarwal said.
Aggarwal said that very little research has been done regarding the use of cannabis for gout. However, he said cannabis has been used for thousands of years in numerous cultures like India, China and the Middle East as a pain medication. Even the world’s oldest pharmacopeia in China, which dates back to 2700 B.C., references the use of cannabis as a treatment for gout.
“We do know that cannabis has pain-relieving and anti-inflammatory properties that even at the cellular and molecular level, it would be very reasonable to substantiate that someone finds therapeutic benefit both in acute gouty attacks and chronic gout symptoms,” Aggarwal said.
Dawn Darington, the founder and CEO of the Choice Wellness Center, a dispensary in Seattle that serves patients as young as six years old to 84 years old for illnesses from pain control to Crohn’s disease, said that cannabis is a natural and organic pain-reliever.
“It’s inexpensive, it’s natural, it’s very effective and throughout history there have been zero deaths from cannabis,” Darington said. “So even if someone is a heavy cannabis user, they are not going to die as they would with alcohol or pharmaceuticals.”
She said people need to understand that medical and recreational use is not the same.
“The whole point of the medical marijuana act is that it helps patients and recreational use is an entirely different conversation,” Darington said. “I have trouble understanding why anyone could argue with that.”
Bautista said he has a personal project for the new year to maintain a proper diet and take the medication in order to better control his gout.
“Next year, I’ll start a heavy duty diet. It’s either chicken or fish and a lot of veggies; no fast food, no sauce foods — meaning no ranch or teriyaki. It’s going to be a real plain year for me but if I really look at it, it’s been 30 years of trying a lot of different foods so eating simple won’t be difficult,” said Bautista.
For more on how marijuana affects the API community, visit:
Legal Marijuana Needs Accountability in Vulnerable Communities
Marijuana Industry: Asian Pacific Islander Business Owners, Users Keep an Eye Out
Co-ops: APIs Work to Break the Stigma of Medical Marijuana
Vietnamese Marijuana Growers Through the Eyes of their Defense Attorney
