Volume 1, Issue 47, 12/10/2009
Which North American herbs or natural medicines are known to be inhibitors of xanthine oxidase and possibly useful for the treatment of hyperuricemia or gout?
Gout has not only been a medical problem for centuries, but is increasing in prevalence across the world.(1-3) This increase in prevalence may be due to people living longer, changes in dietary patterns that have led to increases in obesity and/or development of metabolic syndrome.(1,4) While not all patients who have hyperuricemia are symptomatic, it is well known that the concentration of serum uric acid directly correlates with the development of gout. Due to the history of gout and its worldwide prevalence, many people have used herbs to self-medicate against gout. In addition, there is some data to suggest that hyperuricemia could be a risk factor for ischemic heart disease.(5,6) As such, it is plausible that some patients and even some clinicians could try to treat asymptomatic hyperuricemia for the purposes of decreasing the risk for coronary artery disease. The mainstay of treatment for decreasing serum uric acid concentrations in traditional medical practice has been with inhibitors of xanthine oxidase (XO), such as allopurinol (Zyloprim®; Aloprim®) and febuxostat (Uloric®).(7,8)
Despite the availability of these agents, there are a large number of herbal and natural medicines that claim to be useful in the treatment of gout. Given the rise in the use of herbal and natural medicines, it would be important for clinicians to be able to recognize...
The full answer to this issue contains a table summarizing all of the North American herbs and their pharmacokinetic characteristics in the inhibition of xanthine oxidase.
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