Dr. Roach: Tart cherries are not recommended for acute gout
Dear Dr. Roach: When I first had gout, a friend suggested I eat several dried sour cherries for a few days. I had about a dozen dried sour cherries a day for only three days, and the pain was gone. This also has regularly worked for my wife. Sour cherries work! They also work for some arthritis conditions.
Dear M.M.: I was able to find two papers on gout and sour (Montmorency) cherries. One showed they reduce uric acid levels in healthy volunteers; the other that they cut the likelihood of an acute attack in someone with established gout. I could find no evidence they treat an acute attack. In fact, lowering uric acid levels suddenly can make an acute attack worse, so I can’t recommend tart cherries (or juice, or extract) for acute gout.
Dear Dr. Roach: I am an 89-year-old male who has been taking simvastatin for years to control high cholesterol. Except for the side effect of muscle pain, it is working.
It is my understanding that taking statins long term can create a deficiency of CoQ10. My family doctor, as well as my cardiologist, says not to worry about it and that CoQ10 supplements do not help. Is there any way to measure a possible deficiency in CoQ10, and does taking supplements help?
Dear A.D.M.: CoQ10, a vitamin-like substance, can indeed be depleted by metabolism of most statin drugs, including simvastatin. Most of the published evidence has failed to show a benefit from CoQ10, in doses from 120 mg to 600 mg daily, in divided doses. Despite this, I have had some people with muscle pain on statins try CoQ10 supplements, sometimes with success. This may all be placebo response, but CoQ10 is safe, relatively inexpensive and might be worth a trial. I don’t recommend it as a preventive agent. CoQ10 levels are not generally available.
Two statins, fluvastatin and pravastatin, are metabolized differently, and they are less likely to cause muscle aches than the others.
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