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Speaker 1: You're listening to the Saturday Morning with Jack Team podcast

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Speaker 1: from News Talks AB.

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Speaker 2: Doctor Brian Behe is with us this morning and he

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Speaker 2: is focusing on gout and there's some really interesting new data, Brian.

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Speaker 2: A major international study with more than two and a

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Speaker 2: half million people, led by the University of Otago researchers

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Speaker 2: has found that gout is a chronic illness for which

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Speaker 2: genetics are a major cause. This is a bit of

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Speaker 2: a surprise, right.

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Speaker 3: Well, look, we've always suspected that was the case. You know,

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Speaker 3: traditionally often people have thought of gout as you think

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Speaker 3: of the English King who sort of overweighth drinking port

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Speaker 3: legs venison and has laid up with gout and suffers

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Speaker 3: from gout. So this lifestyle issue has always been this

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Speaker 3: factor that's run around that you can modify gout by

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Speaker 3: reducing or changing your lifestyle or what you do. What

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Speaker 3: this study actually says, and it was a large study

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Speaker 3: with about two and a half million people, has said, well, look,

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Speaker 3: primarily what's going on is your genes caused the problem

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Speaker 3: that causing you to have too much uric acid in

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Speaker 3: your blood. And actually lifestyle changes, although they are important

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Speaker 3: in stopping c gout attacks. They don't lower your uric

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Speaker 3: acid level, so they can't cure the gout. So that's

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Speaker 3: the big, big shift. So moving away from saying lifestyle

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Speaker 3: as reason garcurves and yeah, pretty important.

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Speaker 2: Okay, so let's just go back to basis. Remind us

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Speaker 2: what is gout?

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Speaker 3: Yeah, so gout is when we've got too much of

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Speaker 3: the stuff called uric acid flowing around in our blood streams.

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Speaker 3: The body produces uric acid as part of its metabolism,

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Speaker 3: and we also invest uric acid through certain foods. Now,

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Speaker 3: if you have too much of it, what can actually

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Speaker 3: happen is the uric acid can deposit little salts in joints.

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Speaker 3: So what happens is the uric acid goes into a joint,

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Speaker 3: and typically where we see it is the joint that's

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Speaker 3: at the base of the big toe, and suddenly these

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Speaker 3: crystals form in the joint. The body reacts to that

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Speaker 3: immune response, and sudden you get this very very painful, swollen,

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Speaker 3: red joint that's really really debilitating and it just pops

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Speaker 3: out of the blue. Yeah, and then we have to

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Speaker 3: treat it. So look really really really awful when it occurs,

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Speaker 3: and for anyone who's had gout, they know exactly what

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Speaker 3: I'm talking about. And yeah, a very nasty, nasty condition.

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Speaker 2: When you get it, it sounds like super painful. I

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Speaker 2: know a few people have had it and they just

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Speaker 2: talk of their like it. It's really shocking how painful

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Speaker 2: it actually is. Like even if you just have a

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Speaker 2: tiny bit of cloth, you know, like on a on

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Speaker 2: a joint or something, or like putting on a sock,

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Speaker 2: if you have gout in your big toe is absolutely

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Speaker 2: off agonizing.

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Speaker 3: Yeah, look look at it. And then so people come

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Speaker 3: into the surgery with cute gout attacks and they limp

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Speaker 3: up into the room and they can't put their foot down,

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Speaker 3: and they can't wear a shoe, and they talk about

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Speaker 3: it at night. They can't put sheets on the toe because

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Speaker 3: or the joint because it's just so so painful. So yeah,

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Speaker 3: very very unpleasant and unforgettable. If you have a gout attack,

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Speaker 3: you'll remember it for life.

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Speaker 1: Yeah.

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Speaker 2: Stuff, it's tough. Okay. So for those of us who

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Speaker 2: know that there is a bit of gut in the family,

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Speaker 2: are there lifestyle causes that can trigger it? Like, are

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Speaker 2: there things that I'm going to need to look out for,

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Speaker 2: because I'm going to warn you right now, Brian, ours

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Speaker 2: is a family that likes ice cream, It likes cheese,

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Speaker 2: it likes seafood, it likes all of those all other

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Speaker 2: good things.

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Speaker 3: Look, look, look, it's important to have a healthy lifestyle,

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Speaker 3: so we've got to say that. But up from what

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Speaker 3: the study is saying to us, Look, if you're predisposed

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Speaker 3: to gout because your uric acid is too high, regardless

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Speaker 3: of what you do with your lifestyle, you know, you

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Speaker 3: stop those things and actually give us uric acid. So

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Speaker 3: that's basically red meat things like shellfish, alcohol, sugary drinks,

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Speaker 3: like like our carbonated sugary drinks. They can give us

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Speaker 3: more uric acid and cause the gout to occur. But

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Speaker 3: the fact of the matter is, if you get rid

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Speaker 3: of all those things and stop all those things, if

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Speaker 3: you've got to underline predespicion to out, lower your uric

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Speaker 3: acid to a level that you won't get the gout.

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Speaker 3: So yeah, you can, you can change, you can modify

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Speaker 3: those life those factors which can trigger gout, but they

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Speaker 3: won't reduce your overall uric acid and they won't reduce

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Speaker 3: your risk over time of getting out. So that's the

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Speaker 3: big difference.

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Speaker 2: Why does it affect more men than women.

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Speaker 3: Yeah, look, that's a good question. So really what the

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Speaker 3: study is pointing to it's biological factors. So again it's

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Speaker 3: the genetics men versus women that that tend to produce

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Speaker 3: a higher uric acid and also in some cases kidney

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Speaker 3: disease itself because uric acid has got rid of through

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Speaker 3: the kidneys can actually produce this kidney this condition. The

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Speaker 3: other important, really important thing to note is that Mari

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Speaker 3: and Pacifica peoples have four to six times the rate

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Speaker 3: of gout, So it is particularly prevalent across New Zealand.

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Speaker 3: And because again driven by this genetic sort of predisposition

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Speaker 3: to gout that we see.

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Speaker 2: So what do you do about it?

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Speaker 3: Yes, So look, I mean, look, there's no doubt that

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Speaker 3: if you predispose the gout and you have a big

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Speaker 3: feed of oisters or something, often that's what triggers the

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Speaker 3: out because you put extra uric acid into an underlying

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Speaker 3: high level and it will precipitate the gout. So look,

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Speaker 3: just avoiding certain foods will lessen the frequency of gout attacks,

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Speaker 3: but it won't get rid of the gout. So look,

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Speaker 3: for most people, you need to take medication to lower

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Speaker 3: your uric acid level. That's a medication that's commonly called alipurinol.

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Speaker 3: You need to take it once a day essentially once

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Speaker 3: you're on it, and you need to take it for life.

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Speaker 3: And what alipurinol does very effectively is lower the underlying

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Speaker 3: level of the uric acid and reduces your chances of

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Speaker 3: getting the gout, prevents the gout. So look, at most cases,

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Speaker 3: to be honest, Jack, it comes down to medication.

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Speaker 2: Yeah, okay, hey, thanks for your tom, Brian. We really

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Speaker 2: appreciate it. As ever, we'll put all of Brian's tips

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Speaker 2: and information there on the News Talks You'd be website.

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Speaker 1: For more from Saturday Day Morning with Jack Tame. Listen

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Speaker 1: live to News Talks at b from nine am Saturday,

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