Descriptions of gout have been found as far back as almost 5,000 years ago, dating back to ancient Egypt. Gout takes place when urate crystals accumulate within your joint. This accumulation results in the intense pain and joint inflammation of a gout attack. The crystals can form when you have heightened levels of uric acid in your blood. The body creates uric acid when it breaks purines down. Purines are substances that are found naturally in the body and also found in certain foods.
This formation of crystals causes sudden, severe episodes of pain, redness, tenderness, swelling, and warmth. Gout symptoms usually occur suddenly and often during the night.
The symptoms of gout include the following:
- Intense pain in the joint – Gout commonly affects the large joint in your big toe. However, it can also occur in the ankles, feet, knees, wrists, and hands. The pain is usually severe within the first 4-12 hours after it starts.
- Discomfort that lingers – After the most intense pain subsides, some discomfort in the joint may remain and last either a few days to a few weeks.
- Redness and inflammation – The joint that is affected may become tender, swollen, red, and warm.
- Range of motion limitations – Decreased mobility in the joint may occur with the progression of gout.
For hundreds of years, gout has been referred to as “the disease of kings” or a disease amongst those of great wealth. The reason for this was due to their overindulgence of alcohol and rich foods. In modern times, it is a common disease amongst the middle-class.
There are many notable people in history and celebrities that suffer from this disease including:
- King Henry VIII – King of England from 1491 – 1547.
- Sir Isaac Newton – A mathematician, physicist, and astronomer.
- Thomas Jefferson – Founding father and president from 1801 – 1809.
- Benjamin Franklin – Founding father, inventor, scientist, and civic activist.
- Charles Darwin – Famous geologist, naturalist, and biologist.
Franklin utilized colchicum extract whilst serving as the Ambassador to France from 1776 to 1785. Franklin also introduced the medicine to his fellow countrymen.
Colchicine has been used for the treatment of gout for more than 2,000 years, dating as far back as ancient Egypt.
To this day, the drug is still prescribed to sufferers of gout. However, colchicine is not prescribed as often as it was in the past. Since there are newer, more effective medications being produced for the treatment of gout in modern times, colchicine has been relegated to the backseat by these modern equivalents.
Origins of Colchicine
Colchicine has been known by many names since its discovery, including colchicon, colchicum, hermodactyl, ephemeron, and surugen.
The use of colchicine for the treatment of gout was mentioned in the classic work of Pedanius Dioscorides, entitled De Materia Medica, between the years 50 and 70 AD. Pedanius Dioscorides was a Greek pharmacologist, botanist, physician, and author who was a medic in the roman army. In the De Materia Medica, a pharmacopoeia of herbs and the medicinal ingredients that can be extracted from them, Dioscorides recounts the uses of colchicum (meadow saffron) seeds in the treatment of gout. Extracts from the seeds were utilized well into the 19th century. Colchicine is an alkaloid and an active constituent in colchicum. It was extracted from the seeds in the year 1820 by French chemists’ Joseph Bienaimé Caventou and Pierre-Joseph Pelletier.
Colchicine is effective and selective in its ability to reduce swelling and pain that is seen with acute gout attacks but not with the other forms of arthritis. It is also utilized in the prevention of attacks in patients that are afflicted with recurrent and frequent episodes of gout.
Uses of Colchicine
Colchicine is primarily prescribed for the treatment of gout because it works by decreasing the build-up of uric acid crystals in the joints. Uric acid crystals in the joint are the result of high uric acid levels in the bloodstream that are eventually deposited into the joint. By reducing the level of uric acid, colchicine also reduces the pain associated with gout attacks and the subsequent swelling.
Besides gout, it can be used to prevent pain in the chest and abdomen that is caused by Mediterranean fever.
This is an inherited disease that leads to increased production of the amyloid A protein, leading to severe pain. Colchicine reduces the production of this protein. Therefore, it can be used in the treatment of this condition.
Because of its pain relieving properties with gout, some people mistakenly take it as a pain reliever for other conditions. However, it is not advisable to use colchicine this way given the potential side-effects that may arise as a result.
Except in cases where colchicine is delivered intravenously, most people will receive the tablets. For severe cases, the doctor will recommend the 0.6mg concentration that should be taken orally. Take 2 tablets at the first sign of a potential attack to receive a 1.2mg dosage and then follow it up with a single tablet an hour later. It is not recommended to take more than a 1.8mg dosage within an hour regardless of the level of pain. For a milder case of gout, the 0.5mg tablets may be preferred because they are a bit less powerful and can help you avoid any side-effects.
It is always best to follow the doctor’s instructions regarding dosage because only they can diagnose a particular individual. They may also offer better insight on whether you should take the medication before or after a meal.
Why Colchicine Is No Longer Often Prescribed
Despite being very effective, colchicine was overshadowed by new medicines which have less side-effects and are generally more effective. Some of the negative side effects of colchicine include diarrhea, nausea, and abdominal cramps. In rare cases, severe side-effects have been noted that led to its fall from favor.
The Bottom Line
Despite modern alternatives to treat gout, colchicine is still used even today for the prevention and treatment of gout attacks. If you are suffering with gout and trying to determine what medication you should use to treat it, consult your doctor first as they can help decide what is best.