Gout and Nootropics

Important drugs have often originated in some sort of ‘traditional medicine” – witch doctors and such. Even Western medicine, the most baroque and useless of ‘traditional medicines”, has occasionally yielded a useful therapies. But maybe we should look at traditional diseases, too. What if some disorder had a beneficial side effect – say, was some kind of mental stimulant?

Many people have had the impression that gout had such an effect. It seems to have a special fondness for men of consequence. Alexander the Great apparently had it. “So did Ben Jonson, Talleyrand, Martin Luther, John Wesley, Henry Fielding, Edward Gibbon, Thomas Gray, Stendhal, Sir Isaac Newton, Samuel Johnson, the Pitts (father and son), William Congreve, Francis Bacon, William Harvey, Lord Tennyson, Walter Savage Landor, Charles Darwin, General Winfield Scott, Guy de Maupasssant, and John Barrymore.” And Benjamin Franklin. Havelock Ellis, in A Study of British Genius, said “There is … a pathological condition that occurs so often, in such extreme forms, in men of such preeminent intellectual ability, that it is impossible not to regard it as having a real association with such ability.”

Of course they could all be wrong. But maybe someone should take a look…

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42 Responses to Gout and Nootropics

  1. Sandgroper says:

    On the other hand, I know a couple of prominent idiots who also suffer from it.

  2. Should be easy to find the prevalence in Fellows of the Royal Society

  3. MawBTS says:

    Urbach–Wiethe disease causes calcification of the amygdala, often disabling the subject’s ability to feel fear.

    https://en.wikipedia.org/wiki/Urbach%E2%80%93Wiethe_disease

  4. HermanBlume says:

    It’s also possible they were all reasonably wealthy men of good stock who just ate food that was too rich.

    • I suspect that rich food has nothing to do with it. I have a gouty second toe but 150mg Allopurinol completely surpresses symptom. And I am super smart, at least according to an IQ test I took in 8th grade: 157.

  5. Fourth doorman of the apocalypse says:

    Speaking of oddities, I came across this:

    https://en.wikipedia.org/wiki/Ewa_K%C5%82obukowska

    A genetic mosaic of XX/XXY cells? Allegedly with Barr bodies in each cell.

    Well, at least she didn’t have too many Zs in her name.

  6. AppSocRes says:

    I experienced my first attack of gout in my late sixties. A flare-up is very unpleasant and the side effects of treatment aren’t that great either. I’ve since learned that the disease has become more prevalent in the USA than it once was. Diet plays a major role and many of the purine-rich foods associated with gout were once readily available only to the upper classes, although this situation has changed over the past century or so in more developed countries. This may explain, at least i part, both the apparent relationship between gout and achievement in the past and the recent increasing prevalence of gout in developed countries.

    • dearieme says:

      Good God! Do you mean you can get it without the compensation of having had an adult life of imbibing Port?

      • AppSocRes says:

        My doctor joshed with me after a confirmed diagnosis by asking whether I enjoyed my port and oysters. Unfortunately I don’t enjoy either. I paid for my last plate of steamed mussels with a really bad attack though.

        • John Wesley says:

          AppSocRes,
          I’d suggest you look into Celery seed extract. An excellent gout prophylaxis when you wish to enjoy mussels, sardines, or a beer. Chronic supplementation should keep your uric acid levels quite low and those painful symptoms at bay

  7. AllenM says:

    Nothing like hitting close to home, my Father is howling about the increased costs of his https://en.wikipedia.org/wiki/Colchicine due to the Orphan Drug Scam- but then you the taxpayer are footing the bill through his VA coverage.

    I do find it interesting that I have both gout and https://en.wikipedia.org/wiki/Gilbert%27s_syndrome from my central European part of my heritage.

    That is also the part of the family with the language ability to learn multiple language.

  8. David says:

    Do I really need to bring up the distinction between correlation and causation? Apparently…

    • gcochran9 says:

      More likely, I need to explain how you find out new things: it isn’t by jamming every possible observation into the existing conceptual framework without even checking.

    • Bob says:

      That seems to be a theological mantra designed to inhibit people from examining things and generating new hypotheses.

      “Causation” is ultimately a metaphysical concept. There is only direction of entropy as measured by gradients of correlation.

    • William Newman says:

      As per commenter hlynkacg elsewhere, “correlation may not prove causation but it does wiggle its eyebrows while mouthing ‘look over here’.”

  9. Martin L. says:

    Greg, I think HermanBlume nailed it.

    Gout is a disease of excess, similar to diabetes today. The only thing is in the 1700s, only a very select few of financially privileged humans were able to indulge themselves to excess. It is well known that only the upper classes were able to dabble in philosophy, science, politics, etc. so there you go. There were probably lots of smart people who couldn’t contribute to civilization because they were toiling away each day, while tuberculosis slowly ate them alive, in order to not starve or get kicked off their tiny plots of land, who did not have gout and never would get it, who are forever lost to history… you get the idea.

    On the other hand, in 2016, I’d be willing to bet that gout is far more a disease of the lower classes than upper (like diabetes, heart disease, obesity, etc.). How times have changed.

    So, you’ve demonstrated a relationship and a connection, but not causation.

    • gcochran9 says:

      I don’t know whether success caused gout or whether gout caused success. Neither do you. My guess is that the first – success caused gout – is considerably more likely. But I am absolutely sure that that the second possibility is just that – possible – and if it is the case, potentially very valuable.

      So someone should take a careful look.

      The ability to quickly explain away anything that might be interesting is singularly useless.

      • Martin L. says:

        Greg, I don’t believe that any of what I said invalidated, or attempted to invalidate, the legitimacy of your speculation, and vice versa. I don’t see that we are in disagreement at all.

        Nonetheless, I do agree that success causing gout is far more likely than the reverse. In fact, I thought of yet one more explanation for this relationship. It’s not exactly a secret that your smart/nerdy/brainiac/Aspie types are generally of significantly less fitness than their less-intelligent, higher-T cohorts. There is a reason why the Poindexter computer lab bully targets of your average high school are usually flabby (and why they are invariably shunned by the opposite sex unless they are able to flip their mental endowment into a solid career).

        How many serious professional computer programmers have you known that are in shape? I can personally attest that quite few persons on the autism spectrum, even those who are pretty high-functioning and have few or no concrete health problems, that I have known are physically fit or even of average weight, and I’m quite sure you would agree.

        So, once more, of course you raise an interesting question to kick around, but it’s entirely fair to point out that your hypothesis is not the most likely explanation.

        • j says:

          your smart/nerdy/brainiac/Aspie types are generally of significantly less fitness than their less-intelligent, higher-T cohorts.

          It may comfort you to think so, but it is non-factual. Check it out, visit Google’s campus and then a Salvation Army restaurant.

    • AppSocRes says:

      There are clearly genetic/metabolic pathway factors associated with gout. The lifestyle factors include obesity and the consumption of foods rich in purines. These foods comprise an odd congeries:

      High purine foods: liver, heart, sweetbreads, and other organ meats; game meats and game bird meats; turkey and goose; meat extracts, consomme, gravies; mussels; herring, smelt, sardines in oil , anchovies, fish roe; yeast; beer, port and other alcoholic beverages

      Moderately high in purine foods: red meats; chicken; veal; bacon; salmon; trout; haddock; scallops; fish. generally; legumes: peas, beans, lentils; asparagus; mushrooms; cauliflower.

      Clearly some of these foods were traditionally available only to the well off but others were dietary staples of the lower classes. Lifestyle alone does not explain gout.

      It’s reasonable to at least hypothesize that an inherited tendency to produce excess uric acid or to fail to fully excrete it fully might somehow relate to other metabolic mechanisms that favor success in life. One certainly can’t dismiss this hypothesis out of hand.

      • Lot says:

        Reading your comment really made my mouth water. Well not the heart and sweetbread part, but liver, game, turkey, goose, gravies, mussels, herring, anchovies, roe, beer, port…

        For most of these foods, however, a little goes a long way.

    • c23 says:

      It was well known that gout was a disease of affluence at the time. Ellis must have meant that gout was particularly prevalent among geniuses, not that it occured at rates typical for men of their social class – why else would he even remark on it?

  10. Halvorson says:

    You maybe had this mind when writing the post, but in the The g-Factor Jensen cites a source that shows that academics with higher levels of uric acid produce more papers than their competition.

    “Uric acid, which has a chemical structure similar to caffeine, seems to act as a brain stimulant, and its stimulating effect over the course of the individual’s life span results in more notable achievements than are seen in persons of comparable IQ, social and cultural background, and general life-style, but who have a lower serum urate level. High school students with elevated serum urate levels, for example, obtain higher grades than their IQ-matched peers with an average or below-average serum urate level, and, amusingly, one study found a positive correlation between university professors’ serum urate levels and their publication rates.”

    He also claims asthma and allergies are much more common in those of IQ 130+.

    • gcochran9 says:

      I have read it, but had forgotten that paragraph until you bought it up. Like I said, worth checking out.

      • John Wesley says:

        I, too, was going to mention Jensen studies–but I see I’ve been preempted!

        As it happens, this is an eminently testable hypothesis.
        There currently exists a safe means of pharmacologically increasing uric acid levels: inosine. Supplementation at therapeutic levels (below any gout threshold) are achievable and would allow you to evaluate this nootropic notion for yourself.

        (Though I suspect uric acid is less a true nootropic and more a stimulant.)

        In a clinical trial with MS patients, Inosine doubled uric acid levels (increased from 3.9 to 8.3), stalled progression, and reduced relapse. The only adverse effect was 1/4 of the participants got kidney stones. But this is totally prevented with sufficient water intake. And you could supplement with potassium citrate to be extra careful.

        Treatment of Multiple Sclerosis with Inosine
        http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3189001/

        For the curious and adventurous pharmanauts, a simple n=1 trial awaits.

        I sometimes wonder if the mental clarity I get the day after drinking just the right volume of alcohol is due to temporary elevation of uric acid.

        • j says:

          No need to wonder because it is obvious. Alcohol ends up as uric acid in the blood, causing gout. Alcohol cleans up blood vessels and oxygenates the brain. Gout is the byproduct of a good life.

  11. Paul Conroy says:

    I stumbled on just such an association last week!

    I have terrible allergies, even though I grew up on a farm, drank “raw” (aka unpasteurized) milk till my late teens.

    I just did a batch of allergy tests 2 weeks ago, of 70 environmental allergies, I was allergic to 69 – except for one type of grass. I did a blood test for food allergies, and am allergic to:
    1. Shellfish
    2. Hazelnuts
    3. Soy
    4. Apples, peaches and cherry

    I also have Samter’s Triad, which is allergy to Aspirin, Nasal Polyps and GERD

    But seemingly allergies are associated with Neurogenesis in the Hippocampus!!!
    http://www.ncbi.nlm.nih.gov/m/pubmed/27445696/

    Then last week I stumbled on this:

  12. The Z Blog says:

    Blacks appear to have an increased risk of gout: http://www.ncbi.nlm.nih.gov/pubmed/24335384

  13. RJJCDA says:

    I am a former Mensan, and have Gout. And I may be a genius, or a fool. So I will be waiting in anticipation for validation of either.

  14. spottedtoad says:

    I have wondered if changes in indoor and atmospheric carbon dioxide concentrations could affect gout and other conditions related to physiological pH.

  15. dux.ie says:

    Gout might correlate to IQ but hard to explain. Another collateral product might be easier. Gout is usually blamed on eating too much red meat, etc, where another by-product is cholesterol. An Indian study had correlated blood cholesterol level with IQ,

    http://www.jcdr.net/article_abstract.asp?id=119

    Cholesterol is the main constituent of myelin of the brain glial cells and the fatty layer is responsible for the higher propagation speed of nerve impulses.

    https://en.wikipedia.org/wiki/Myelin#Composition

    The Jews are reported to have 7 times greater hypercholesterolemia level than the Caucasian,

    http://onlinelibrary.wiley.com/doi/10.1002/ajmg.1320340418/abstract

    And “Einstein’s brain had more glial cells relative to neurons in all areas studied, but only in the left inferior parietal area was the difference statistically significant.”

    https://en.wikipedia.org/wiki/Albert_Einstein%27s_brain#Glial_cells

  16. English Professor says:

    There is a potential problem with the historical examples of people with gout. We think of gout as a specific disease, but at least into the 18th century, “gout” was the common term for arthritis. Any joint disease was likely to be called gout. (There is no entry for “gout” in Robert James’s Medicinal Dictionary [1743-1745], but the article on “Arthritis” generally refers to the disease as different kinds of gout.)

    Also, the Romans had two different words for joint disease, “chiragra” and “podagra,” both of which are commonly translated as “gout.” (The first is usually called “gout of the hands” and the second, “gout of the legs and feet.”) I recall reading a description of a man whose hands were supposedly gnarled with gout. It was a classic description of someone with crippling arthritis. (It was in a satire–perhaps Horace or Juvenal–and the point was that his hands were so crippled that he couldn’t throw dice any more, so he hired a young man to throw dice for him.) I would not be surprised to hear that Ben Jonson had gout, given his excessive habits (he also had delirium tremens and was once so drunk that he said he saw tartars and turks fighting around his big toe). But for the other figures, unless you have clear evidence that they had gouty feet, it’s possible that they just had arthritis.

  17. Cplusk says:

    Einstein, Newton, Darwin and Kepler were also born prematurely which is interesting.

  18. Eugeneswin says:

    Citing about a dozen studies showing some benefits, and substantial burdens, of uric acid and gout, see Richard J. Johnson M.D.’s 2012 book, The Fat Switch, P.182-3.

  19. JayMan says:

    A clue to whether gout is causal to success or the other way around is whether it’s correlated with IQ today. If access to excess protein (or some other dietary or lifestyle factor available to the affluent of the past) was the issue, it’s doubtful it would still be so in the present day.

  20. dux.ie says:

    http://link.springer.com/article/10.1134/S2079086414030086

    “Uric acid and central nervous system functioning (a literature review)”

    “””It should be noted that the results of the majority of
    studies indicate the potential effect of hyperuricemia
    on the motivation for activities rather than the degree
    of intelligence development. The former in many
    respects is crucial for the realization of individual abilities
    (Efroimson, 2002). In this aspect—as a “stimulant” of
    activity—hyperuricemia draws our attention.

    This can be confirmed by the data obtained by Kasl
    et al. (1966) of a higher level of uric acid in the blood
    of those male students who, despite their low perfor
    mance in school, strived to continue their education in
    college; the level of uricemia in them correlated with
    the duration of learning. The correlation between the
    level of uric acid in the blood and IQ was nonsignificant (in this case),
    unlike the correlation between uricemia and
    school rating, as well as the desire to achieve

    inconsistence between IQ and a high school rating (Kasl
    et al., 1970). In addition, the commitment to achieve
    was stronger in those volunteers who were the first
    children in the family, although the relationship of
    purine metabolism with the birth order was not con
    firmed (Wallage et al., 1967).”””

  21. David Epstein says:

    There is a hereditary component in gout. It follows that one might suspect an adaptive polymorphism. Nothing proven of course

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