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Dear Miriam.

Byline: Miriam Stoppard

My husband's started complaining of a very sore big toe joint on his left foot.

It seems to come and go, but when he has it he hobbles around because it's so painful. I say he's just being a big baby and he should lose some weight.

Do you think it's serious?

Dr Miriam says: As well as losing some weight, you might suggest your husband goes easy on rich foods and strong wines like port because it sounds as though he might have gout.

This condition - which runs in families and is 20 times more common in men than women - is due to a fault in protein metabolism which leads to high levels of a waste product (uric acid) in the blood. It's crystals of uric acid in the big toe joint that causes pain and inflammation.

Your doctor can arrange for blood tests to measure your husband's uric acid levels and, if high, he or she may prescribe two drugs.

The first will lower the production of uric acid, and the second will raise uric acid excretion through the kidneys.

During an attack a drug called colchicine will reduce pain and inflammation.
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Title Annotation:Features
Publication:The Mirror (London, England)
Date:Apr 4, 2011
Words:197
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