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Gout in earlobe ?

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althene

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Gout in earlobe ?
Posted: 04-18-08 07:15am

Hi all,
I have had gout ever since I was 11 years old, with excruciating pain in my big toes. It was only after two years that I was diagnosed with it though. Anyway, I treated it with parsley extracts and not having red meat, and it never appeared until I was around 19.
And then, at the age of 19, I started getting an unbelievable pain in my right ear, so much that I cant even touch it. It feels like the earlobe is being fried. It is only on the lobe and never inside. Still, eight years later, I still have that pain, and the doctor associated it with gout, though the treatment that worked before doesnt seem to work anymore.
The pain often comes when there is a drop in temperature and stays even when the temperature is back to normal. It is always in the right ear, and now, it feels like it has a bit swollen shape. I checked recently and found that it could be Raynaud's Phenomenon, but then, does that mean that gout and the latter are related? Or is it just another form of gout? Or am I just having a bizarre gout attack?
Help me if anyone can.
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halfcow

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Posted: 04-18-08 10:40am

The only helpful thing I can say is that I have heard of another doctor who also said gout can occur in the ear. I don't quite understand it, because I did not think there were any joints in the ear, but at least this might confirm that your doctor is not crazy. Have you tried any type of ointment like Ben-Gay or Blue Emu? There are versions of these products that claim to help with arthritis pain. I have tried them on my ankles, but with mixed results. Sometimes they seem to relieve a little of the pain, then other times not. Confused Anyway, if you've tried everthing else, it may be worth a shot.
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stanl

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Location: San Francisco, CA USA

Posted: 04-18-08 12:26pm

It could be tophi, which are MSU crystals that have formed on the earlobe. Sometimes you can see these crystal deposits, sometimes they are under the skin. Generally tophi are painless, but not always.

If you google "tophi gout" you'll get tons of information on it on the web. Here is a link to one: http://adam.about.com/rep orts/Gout.htm
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gallego1968

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Posted: 04-18-08 13:55pm

I always thought that these crystals only formed in the lowest part of the body.
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halfcow

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Posted: 04-24-08 13:50pm

That is not entirely true, about the crystals forming only in the lower body. It is true that gout usually begins in the feet for most people, but over time it can also begin to affect other locations. I have personally had it in my knuckle and I have a friend who had it in his wrist. My doctor confirmed mine was gout (not just arthritis).
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althene

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Joined: 18 Apr 2008
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Posted: 05-02-08 08:50am

I have done some research lately and have found out that the gout attacks that I have had in my big toes and now in my right earlobe might not be the full-grown gout, but its earlier stage, hyperuricemia, because there has never been any swelling. When there is no swelling, it is said that the uric acid is not yet at a significant level in the body, but only to a level that makes gout highly likely.
The remedies, home-stuff, that I have found are sodium bicarbonate each time I have an attack, and relaxation, because I have tried, and it works: having a nap while having an attack causes the latter to go away.
What I dont know yet is how can uric acid travel in the body and is it true that it causes pain only where it accumulates at a dangerous level? If so, what makes it travel in the first place? In my case, it's been in toes for years, and now in my right ear?!
Whether it is hyperuricemia or gout is no longer relevant from the pain point of view, but only on how efficient a proper diet will be.
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halfcow

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Joined: 23 Jan 2008
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Posted: 05-02-08 13:43pm

Althene, good question about "how" gout travels throughout the body. I have never really considered how, nor have I asked my doctor. However, my elementary understanding of it is that it is absorbed through your digestive system (like anything else) and gets into your bloodstream. It is not the uric acid, itself, that causes pain. But, rather it is the build-up of excess uric acid that forms little crystals in your joints. Well, the doctors call them "crystals," but it makes more sense to think of them as tiny shards of glass. Since they're in the bloodstream, they can accumulate anywhere.
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painfree

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Posted: 05-03-08 13:31pm

Uric acid is the by-product of the metabolic processes of the cells in the body. In other words, it's a waste product from their processing of nutrients and oxygen to sustain life. And when cells undergo catabolism ,i.e., start to die, they generate even more uric acid. The cells dispose of the uric acid into the blood stream, which carries it throughout the body. About 2/3 of it is processed by the kidneys to be excreted in the urine, and the other 1/3 is broken down by the action of naturally occurring intestinal bacteria.

Uric acid is carried through the blood as a supersaturated solution, which means it can be precipitated from solution in the form of solid crystals of monosodium urate (MSU) when something happens to trigger that event. The trigger for such an event can be that the cells start to generate uric acid at a rate faster than the kidneys can dispose of, or the kidney activity slows down so that it can't dispose of it fast enough, or the blood becomes too acidic for other reasons. When MSU crystals form, they are usually deposited in connective tissues in the body, which is present in joints, in the ear lobe, and many other places. The reaction of the body's immune system to MSU through chemical sensing of its presence is to initiate defense mechanisms because it interprets the MSU as an indication of excess uric acid in the blood which may be caused by dying cells, which the immune system attempts to prevent from spreading. The immune system's chemical response to MSU in a joint leads to the intense pain of gout. The fact that MSU crystals have a needle-like shape has nothing to do with the pain they cause. It is all chemistry.

Hypoxia (lack of sufficient oxygen in the body) is an event which can lead to the precipitation of MSU by two effects. First, it leads to cell catabolism, so that they generate excess uric acid. Second, it makes the blood more acidic, so that MSU is more likely to precipitate. One medical journal publication reports that hypoxia caused by moving to a much higher elevation results in a notably higher incidence of gout. Another very common cause of hypoxia is sleep apnea - the repeated cessation of breathing during sleep for many seconds at a time. That's how sleep apnea can be a very immediate cause of a gout attack. Unfortunately, the vast majority of people who undergo sleep apnea have never been diagnosed with it, and don't know that they have it. Even more unfortunate is that most doctors don't pay enough attention to the possibility of sleep apnea in their patients, and don't know enough to screen their gout patients for it. My primary care physician has been doing that screening for several years, and has found that a very high percentage of his gout patients have sleep apnea that was previously undiagnosed. Anyone with gout should be screened for sleep apnea. Untreated sleep apnea can lead to many other serious, even life-threatening, conditions, as well as continued gout attacks.
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