Ask the Doctor: Gout, diabetic medication and medical cannabis

Dr. Rob Riley joins us each week from the South Bend Clinic. Here are his responses from May 14.

Justin: Gout seems to be more and more common. Would you agree with that statement and, if so, do you feel it is caused by the overabundance of processed foods?

Gout IS becoming more common. The incidence has about doubled in the last 20 years. Gout is a joint problem that occurs when uric acid, which we all have, forms little crystals inside joints causing pain and inflammation. Some risk factors for gout we can’t control. Being male and over the age of 40 are risk factors, for example. Genetics have a lot to do with it, too. But other important risk factors are obesity, high alcohol intake, and consuming high amounts of certain foods like meat—particularly organ meats like liver. I’m not aware of any direct connection between gout and processed foods, though some would argue that processed foods have contributed to our increasing rate of obesity. We do have medications to treat gout and even to prevent it in those who have already had attacks, but, like many things in medicine, prevention with lifestyle changes like weight loss and dietary changes is safest and best.

Roberta: If you take diabetic medication, should you be taking something to protect your kidneys as well?

Diabetes is a major risk factor for kidney disease and the high sugar levels seem to be a major cause contributing to that. So medications that help to keep the sugar levels under control should actually help to reduce the risk of kidney problems in people with diabetes. It becomes really important to try to reduce other risk factors for kidney disease in these people too. Keeping the blood pressure under control, reducing weight in those who are obese, and stopping smoking are important measures. ACE-inhibitors are a class of medications often used to control blood pressure that also help to preserve kidney function for those at risk so we use these medications frequently in people with diabetes. This is a big problem so doctors monitor kidney function closely in their patients with diabetes.

Anonymous: Can medical cannabis suppress psoriasis?

We had a similar question a couple of weeks ago regarding CBD oil and the answer here is pretty similar. Until recently, marijuana was illegal in all 50 states so it’s been difficult for scientists to do studies regarding possible medical benefits of cannabis. In the absence of good science, we’re left with lots of unproven claims. If you go on the Internet, it’s easy to find people claiming cannabis is the cure for just about everything. The scientific community is quite skeptical of most of these claims but it will probably be several years before the science catches up. In the meantime, I’m not aware of any good science supporting the use of cannabis for the treatment of psoriasis and I usually advise my patients against using any substance in which the benefits and risks have not yet been adequately studied.