What is Gout?
Gout is a very complex form of arthritis. This condition can affect anyone- however, it has been proven that there are more men affected by this than women. Women are likely to experience attacks of gout after going through menopause.
An attack of gout is characterized by sudden and extreme pain, redness, and tenderness around the affected joint. The big toe is the joint that is most commonly affected- and most of the time, it’s just one of them, not both.
You may be awoken in the middle of the night by an attack of gout, in which you may feel like your big toe is on fire. The joint will be hot, swollen, and so tender that even the mild pressure of the bed sheet is too much to bear.
Gout Signs and Symptoms
Typically, the signs and symptoms of gout are acute and come on quite suddenly at night, without any warning at all. The signs and symptoms of an attack of gout include:
- Intense joint pain- In most cases, it is your big toe that will be affected by an attack of gout. However, you can also get attacks in your feet, hands, elbows, wrists, ankles, and even your knees. Most of the time, the pain is most severe within the first 12 to 24 hours after onset.
- Lingering discomfort- Once the initial intense pain has dissipated, you will see that you still have some lasting discomfort for a few days to a few weeks. Later attacks of gout will be more likely to last much longer and affect multiple joints.
- Inflammation and redness- You will notice that the joint that is affected will be tender, red, and swollen.
Any time you experience a sudden, intense attack of pain in your joints, you should call your physician immediately. If you don’t get proper treatment for gout right away, it could lead to joint damage and pain that gets worse.
Additionally, if you have a fever along with a joint that is inflamed and hot, you could have an infection- see your physician immediately for diagnosis and treatment.
What Cause Gout?
When you have too much uric acid in your body, this could cause urate crystals to form and collect in your joints. These crystals result in pain and inflammation in the joints, which is an attack of gout.
Your body produces uric acid when it breaks down purines. Purines are found naturally in your body as well as in foods such as seafood, red meats, organ meats, asparagus, mushrooms, and other foods.
In normal circumstances, the uric acid will end up dissolving in your blood and passing through your kidneys into your urine for elimination. However, in some cases, an individual’s body produces too much uric acid or the kidneys don’t collect and eliminate enough.
When this happens, the levels of uric acid in the body increase, which results in the formation of urate crystals in joints or tissues surrounding the joints, which causes inflammation, pain, and swelling.
Gout Risk Factors
You should be aware that there are some things that can cause or at least contribute to the development of gout. Some of these are within your control- others are not.
Some of the risk factors that are outside of your control include the following:
- Sex: Men are much more likely to develop gout than women are. However, women who are past menopause are much more likely to develop the condition than younger women.
- Family History: Some studies have shown that a family history of gout equals an increased risk for developing the condition.
- Certain other syndromes: Lesch-Nyhan or Kelley-Seegmiller Syndromes can cause high uric acid levels in the blood. This is due to a deficiency of a specific enzyme that regulates levels of uric acid.
Medications that increase uric acid levels:
- Taking niacin or more than 1 or 2 aspirin per day
- Diuretics, which are also known as water pills, and serve to reduce the levels of salt and water in your body
- Chemotherapy to treat cancer
- Cyclosporine, or other immunity suppressing medications. Cyclosporine is typically used after an organ transplant to prevent rejection of the new organ.
Conditions related to body and weight:
Following are some areas that you do have some control over. Sure, in some cases, metabolic problems, which contribute to weight problems could be present, but most of the time, there are things you can do to control these:
- Overweight or obese: it is important that you get to a healthy weight, not just to prevent gout attacks, but also for your overall health.
- Drinking lots of alcohol: everyone likes to have a drink every now and then, but when it’s a daily thing and you’re drinking a lot of alcohol, especially beer, you could be contributing to your problem of gout.
- Consuming lots of foods that are high in purines: foods such as meats and seafoods contain high levels of purines, which break down into uric acid and cause gout.
- Dehydration: it is very important that you get adequate amounts of water. It is vital that you don’t get dehydrated, not just for gout treatment/prevention, but for your overall health as well.
- Low-calorie diets: while losing weight is important, you must be sure that you don’t cut your calories too low. A low- calorie diet can actually contribute to the problem of gout.
Other conditions that have been proven to be related to gout:
There are a few other conditions and disorders/diseases that seem to occur at much higher rates in those who have gout than those who don’t. However, research has been unable to point out a clear-cut relationship between these conditions and gout.
It is possible that there are certain risk factors that are shared between gout and these conditions, such as obesity, triglyceride levels, and hypertension. Following are the conditions that appear to be connected:
- High Blood Pressure
- Lead Poisoning
- Heart Disease
- Hardening of the arteries
- Joint injury
- Kidney Disease
- Rapid weight loss due to change in diet and/or medications
- Acute infection/illness
- Conditions such as: psoriasis, hemolytic anemia, tumors or multiple myeloma
Reasons to Contact Your Physician
If you experience any of the following symptoms, you should immediately get in contact with your physician to ensure proper and prompt diagnosis and treatment.
- Quick onset of severe pain in a single, specific joint
- Swelling, inflammation and tenderness in the joints, and skin that appears to be red
You should be aware that even after the initial pain of your gout attack has dissipated, you should still continue to visit your physician and obtain treatment.
It is possible that the buildup of uric acid that caused the initial attack could still be causing irritation to your joints and could eventually result in very serious and irreversible damage to your joints and surrounding tissues. Your physician will be able to prescribe some medications that will help to prevent and even reverse the buildup of uric acid in your blood.
There is a variety of tests and examinations that your physician may use to diagnose and to work out treatment options for your gout. After all, the absolute best way to treat a condition is to figure out what is causing it and to treat that cause. Following are some of the methods your physician may wish to use:
- Joint Fluid Analysis, known as arthrocentesis. This will reveal whether there are uric acid crystals present in the joint. This particular procedure is the only certain way to diagnose gout.
- Complete medical history and physical examination
- Blood test to measure the levels of uric acid. Your physician will likely use this test if he/she is unable to safely take fluid from the joint that is affected.
- Urinalysis to measure the levels of uric acid in the urine.
In later stages of gout, x-rays of the hands and feet can be useful to diagnose, but these are not typically used in the earlier stages. Often, pain causes individuals to visit their physician and seek treatment before any long-term changes will be visible on an x-ray. However, on the other hand, x-rays can be quite useful to rule out other possible causes of arthritis.
If you have been exposed to lead through your hobbies or in your job, your physician will most likely have you evaluated for lead poisoning.
Options for Gout Treatment
You should know that the main goals of any gout treatment are to make sure that fast pain relief is provided and future attacks of gout are prevented. Additionally, gout treatment seeks to prevent other long-term complications, such as joint damage and destruction or even kidney damage.
Gout treatment includes medications as well as some things you can do yourself at home in order to prevent gout attacks in the future. Of course, the specific course of treatment your physician chooses will depend entirely on whether you are having an attack or you’re trying to manage chronic gout, or if you’re trying to prevent future attacks of gout.
Acute Attack Treatments
If your physician is treating you for an acute attack of gout, he/she will recommend the following:
- Rest for the joints that are affected
- Ice packs to reduce swelling
- Short-term medications at the first signs of an attack
- NSAIDs (nonsteroidal anti-inflammatory drugs)
- Oral corticosteroids
- Corticosteroid injection
Managing Gout and Preventing Attacks in the Future
If you have had signs and symptoms of gout off and on for years without seeking treatment, it could become chronic, and could possibly affect more than one joint at a time. In order to treat chronic gout, you should do the following:
- Take medications to control pain
- Follow any other directions/recommendations from your physician such as using a gout diet to decrease the amount of uric acid in your body
Specific steps to prevent attacks in the future
- Discuss with your physician all of the medications you’re currently taking- both prescription and OTC. Some of these could be causing an increase in the levels of uric acid in your blood.
- Make sure to keep your weight under control
- Get plenty of exercise
- Limit the amount of meat, alcohol, and seafood you’re consuming
- Medications to reduce the levels of uric acid in the blood
- If prescribed by your physician, take medications such as Colchicine, Xanthine Oxidase Inhibitors, Uricosuric Agents, or Pegloticase, as these have been proven effective at treating chronic gout
- Tophi, which are chalky nodules that result from uric acid crystals, can be treated by taking a medication called Xanthine Oxidase Inhibitors, or through surgery if they are large and causing deformities or other problems.
Gout and Diet
Gout is a very painful form of arthritis and has been connected with diet for a long period of time- especially those who overindulge in things such as seafood, meat, and alcohol.
Therefore, in the past, gout treatment included extreme dietary restrictions, which were very hard to stick to. With medical advancements, new medications have been developed which reduce the need for such a strict diet to control and prevent attacks of gout.
However, there are still some dietary recommendations, but these look much more like a healthy plan for eating, which is recommended for nearly everyone. This diet can help you to manage your gout as well as promote a healthy weight and help to prevent many other chronic diseases and disorders.
Purpose of the Gout Diet
When you have high levels of uric acid in your blood, urate crystals form and accumulate around specific joints. Your body naturally produces this chemical in the process of breaking down purines.
Purines naturally occur in your body, but you can also get them from consuming specific foods. A diet for gout will help to control the production and encourage the elimination of uric acid from your body which could work to prevent attacks of gout, or at least reduce the severity of these attacks.
You should be aware that this diet isn’t necessarily to treat gout- you should still take medications or follow other treatment plans recommended by your physician in addition to this diet. Being overweight or obese is one of the risk factors for gout, and this diet can help you to lose weight and therefore reduce your risks for an attack of gout.
Details of a Gout Diet
There really isn’t a specific diet that will prevent or treat gout. You will need to do some research and experimentation to find out what the best eating plan is for you.
A diet meant to reduce your risk for developing an attack of gout involves reducing your consumption of those foods that have high levels of purines, such as animal products. By reducing the amount of purines you consume, you will help to regulate and control the levels of uric acid in your body.
Additionally, a gout diet limits consumption of alcohol- especially beer- which has high levels of purines and has been proven to have a connection to attacks of gout. If you’re overweight or obese, this diet will help you to lose weight.
One word of caution, make sure that you’re not fasting or consuming a diet that is very low in calories because that can actually trigger an attack of gout. Make sure that you’re drinking plenty of water to flush out the uric acid from your body.
You should also use caution to avoid going on the high-protein weight loss diets, as these can also cause your body to produce too much uric acid. When your body produces too much uric acid, it is known as hyperuricemia.
Some tips for a gout diet include:
Limit your consumption of meats, fish, and poultry
You should be aware that animal proteins are very high in purines. In order to control, treat, and prevent your attacks of gout, you should at least limit, if not avoid completely, these foods that are high in purines such as herring, mackerel, anchovies, herring, and more.
Red meats, such as pork, lamb, and beef, as well as fatty fishes and seafood such as lobster, tuna, scallops, and shrimp have all been connected to an increase in attacks of gout. If you must consume these foods, since they all contain purines, you should limit your consumption of these to four to six ounces per day.
Reduce consumption of fatty foods
Something you should know is that saturated fat actually lowers your body’s natural ability to eliminate uric acid. Choosing plant-based proteins, such as legumes and beans or choosing low-fat or even fat-free dairy products will actually help to reduce the amount of saturated fats in your diet.
Diets that are high in fat result in overweight or obese individuals, which is one of the contributing factors to gout.
Limit/Avoid consumption of alcohol
You should know that alcohol can cause interference with the body’s natural elimination of uric acid. Beer has been linked to attacks of gout. So, if you’re experiencing an attack of gout, you should avoid drinking alcohol all together.
However, if you’re not in the middle of an attack, it is perfectly fine if you wish to drink 1 to 2 five-ounce servings per day of wine, as your risk is not likely to increase with wine.
Limit/Avoid foods containing high-fructose corn syrup
Fructose is the only carbohydrate that has been proven to increase levels of uric acid in the body. Therefore, it’s best to completely avoid foods and beverages that have been sweetened with high-fructose corn syrup, especially juices and soft drinks. However, juices that are 100% fruit juice don’t seem to cause an increase in uric acid production levels.
Consume more complex carbohydrates
You should choose more fruits, veggies, and whole grains and fewer refined carbohydrates such as cakes, candy, and white bread. This is not just a great tip for individuals who are at risk for developing gout- this is a great recommendation for everyone for overall health.
Choose dairy products that are low-fat or fat-free
Some studies have suggested that a diet that includes low-fat dairy products can help reduce an individual’s risk of gout. Again, this is a great recommendation not only for individuals at risk for gout, but for everyone.
Make sure to drink plenty of water
Fluids can help to encourage the elimination of uric acid from your body. You should aim to get a minimum of 8 glasses, or 64 ounces of water per day. Additionally, it is interesting to note that drinking four to six cups of coffee seems to lower the risk of gout in men.
List of Foods that Should Be Avoided:
- Game Meats
- Organ Meats (kidneys, sweetbreads, liver, and brains)
- Meats (beef, pork, bacon, and lamb)
- Any meats in large amounts
- Sardines, scallops, mackerel, herring, and anchovies
List of Foods Acceptable in Moderate Amounts
The following foods do contain purines. However, they may not have high enough levels to affect your risk of developing gout:
- Fish and some seafood (besides those that are in the previous list)
- Oatmeal, wheat germ, and wheat bran
Foods that are Safe
The following foods are low in purines and are safe for inclusion in a gout diet.
- Green veggies and tomatoes
- Breads/Cereals that aren’t whole-grain
- Fruits/Fruit juices
- Coffee, Tea, Sodas
- Peanut butter and nuts
- Cheese, Eggs, Butter, and Buttermilk
Some dairy products, such as low-fat/nonfat milk or low-fat yogurt may possibly serve to decrease your risk of developing gout.
If you have experienced an attack of gout in the past or your physician has diagnosed you with high levels of uric acid in your blood, it might help to make some changes to your current diet- especially reducing your consumption of alcohol, meat, and seafood.
Some studies suggest that making changes in your diet can actually lower your risk for developing attacks of gout in the future. Physicians recommend that individuals who are overweight or obese lose some weight and try to maintain a healthy weight by getting adequate exercise and regulating their fat and calorie consumption.
Sample Gout Diet Menu
Following is an example of what you may see in a typical gout diet.
- Coffee/100% fruit juice
- Whole-wheat toast with trans-free margarine
- Unsweetened, whole-grain cereal, skim/low-fat milk/fresh fruit
- Skim/Low-fat milk
- Fresh fruit (pear, apple, or orange)
- Veggie soup/side salad/carrot or celery sticks
- 2-3 ounces of lean meat, fish, or poultry on whole-wheat with a low-fat spread, lettuce, and tomato
- Water/tea/non-alcoholic beverage
- Fresh fruit (melon or berries)
- Green salad with tomatoes and a low-fat dressing
- Baked potato topped with low-fat sour cream
- Steamed veggies
- 2-3 ounces of baked/roasted chicken
As long as you choose healthy options, you can add snacks in between meals- as long as you are at a healthy weight and you stay within your caloric limit. Some healthy options include fruits, veggies, whole grains, and occasional nuts.
Results of a Gout Diet
Implementing a gout diet into your life can help you to reduce the amount of uric acid your body produces, and encourage elimination of the uric acid. Of course, you’re not likely to be able to lower the concentration of uric acid in your blood enough to be able to treat and control your gout without using medication, but it can help to decrease the number of attacks you experience and limit their severity.
Making sure to carefully follow a gout diet and to limit your caloric intake- especially if you add in some moderate exercise every day into the mix- can improve your overall health by helping you to reach and then maintain a healthy weight.
Risks of a Gout Diet
You should know that a gout diet really isn’t very different from the healthy eating recommendations of the Dietary Guidelines for Americans. Therefore, the risks of this gout diet are very few- if any at all.
Diet and Medications to Control Gout
As mentioned earlier, it is true that a gout diet can be quite effective at treating gout and possibly preventing future gout attacks. However, the diet by itself is not enough. In fact, studies have shown that even a very strict gout diet will really only reduce levels of uric acid by about 1 milligram/dL.
Some people believe that gout is caused by diet. In the distant past, it was referred to as the “disease of kings” because it was thought that it was a result of eating lots of rich foods. However, medical advancements have come along and proven that gout is actually not caused entirely by eating rich foods.
It is true that the foods that are high in purines can trigger an attack of gout, but they are not the cause. Around ten percent of people who are suffering from gout because of the fact that uric acid levels build up because their body naturally produces too much of it. In the other ninety percent of individuals suffering from gout, it is because their kidneys do not properly eliminate the uric acid.
In order to reduce your risk of a gout attack, you must decrease the levels of uric acid in your blood, and keep them low. It’s best to try to reduce your levels of uric acid to around 6 milligrams/dL in order to effectively manage your gout over the long term.
Other Ways to Treat Gout
Diet is not the only way to treat your gout. There are also several things you can do on your own to reduce your risk for gout. These are natural methods- and again, are not meant to be standalone. These are meant to be used in conjunction with your gout diet and any medication treatments that your physician prescribes.
Natural Ways to Treat Gout
Though it is true that gout is very painful, as you have seen, it is very treatable using proper medications. However, you should be aware that there are some natural things you can do for yourself at home in order to reduce your risk for another attack of gout.
First of all, in order to relieve the signs and symptoms of gout, you’re going to have to make some changes to your eating habits. Stop consuming food items such as processed foods, refined sugars, and grains. These are all things that contribute to overall inflammation in your body. Additionally, you’re much better off without these foods anyway. You want a diet that is rich in fruits, veggies, and other natural foods.
Next, get yourself some black cherry juice and make sure to drink some every single day. Black cherry juice has been proven to reduce levels of uric acid levels in the blood. You can find this as a concentrate- drink it straight.
Go to the health food store or the vitamin aisle of your favorite store and get yourself some digestive enzymes. Make sure that you take these with every meal as well as in between meals. These enzymes will help to break down the particles of food and therefore discourage overall inflammation in the body. Start off with these enzymes slowly and work your way up.
Consider using essential oils such as grapefruit, hyssop, or even cypress. These are considered to be anti-inflammatory oils. There are also several others that reduce inflammation. Do some research on this form of treatment. You will choose an oil and then add two to three drops of it to two teaspoons of a carrier oil. Good carrier oils include olive or vegetable oils. Never go overboard with the oils- more is not better when it comes to these. Additionally, you will always want to use a carrier oil, as using the oil by itself could result in more harm than good. Massage the oil mixture onto the area that is painful and inflamed.
Another great do-it-yourself remedy to keep in your medicine cabinet is castor oil. This works well to pull out inflammation in the joints- especially when you make a compress with it. First, wet a cotton cloth. Then, add some castor oil on it. Place the wet cloth on the affected area, then place a dry cloth on top of that. Finally, place a heating pad set to the highest setting you can stand on top of the dry cloth. Then, sit back and relax for about twenty minutes. You can repeat this process every few hours- more often, if necessary.
Most often, gout affects the joint of the big toe. To relive a gout flare-up in your foot, you can do a foot bath. Get yourself a pan and add some warm water to it. Then, add in one cup of Epsom salts and one to two drops of your favorite anti-inflammatory essential oil. On the other hand, if gout is affecting another part of your body, you can take a full body bath using the same recipe.
Things to Keep in Mind
As mentioned previously, if you’re experiencing an attack of gout, avoid eating red meats, seafood, organ meats, or even legumes. If you’re experiencing frequent attacks of gout, eliminate these foods from your diet all together.
If your attack of gout is accompanied by a fever or you are experiencing other symptoms, you should immediately see your physician. This could indicate that you have an infection or possibly a much more serious condition.
Always remember that while it is best to have prescription medications, you don’t always have to have these. Once you get your gout and uric acid levels under control, there are plenty of things you can do at home in order to prevent a recurrence of gout in the future.
Other Alternative Treatments for Gout
In addition to changes in your diet and lifestyle, as well as the medication and natural treatments for gout, there are some alternative treatments that have been proven to be effective.
Herbal Treatments for Gout
Unless your physician or research recommends a specific dosage of an herb, you should take it as directed on the label. Since many times, the herbal treatments all provide very similar- if not the same- benefits, it’s not necessary that you take all of them. For example, if you want to reduce inflammation using an herb, you can choose one of the following- you don’t have to take all of them- to treat that one particular symptom.
Bilberry extract has powerful antioxidant compounds, which help to relieve inflammation. Celery seed also contains compounds to help relieve and prevent inflammation. A tincture made from iporruru serves to relive acute inflammation. Sarsaparilla works to reduce the frequency of attacks of gout. You should take 3,000 milligrams of sarsaparilla three times per day. Cranberry extract works to maintain the health of your kidneys.
You should drink 1 to 2 glasses of one hundred percent cranberry juice per day or take 300 to 400 milligrams of a cranberry supplement. The juice should not contain any high-fructose corn syrup. Cat’s claw is very effective at stimulating your immune system and is also a very effective anti-inflammatory. You should take 20 milligrams per day of this powerful herb. Turmeric is another very effective and powerful anti-inflammatory. You should take 300 milligrams of turmeric three times per day, for a total of 900 milligrams daily.
Bromelain has been proven to dissolve the uric acid crystals and is also known for its effectiveness at treating swelling and inflammation. You should take 500 milligrams of this three times per day in between your meal times. You should be aware that if you have an allergy to pineapple, using this herbal supplement can result in a rash. One of the most powerful and effective herbal pain relievers is devil’s claw.
You should take 2,000 milligrams of this herb three times per day, but do not take it for longer than three weeks. If you have a heart condition, you should avoid taking this herb. Quercetin prevents uric acid from forming. If it doesn’t form- it can’t build up and cause urate crystals. You should take 250 milligrams of this three times per day in between mealtimes. However, if you are using prescription medications such as Sandimmune, Procardia, or Neoral you should not use this herbal supplement.
Nutritional Supplements for Treating Gout
In order to address any vitamin and/or mineral deficiencies in your diet, you should take a multivitamin. Omega-3 fatty acids are well known for their anti-inflammatory abilities. Take one to two fish oil capsules or one tablespoon of oil per day. If you are using prescription blood-thinners, you should discuss the use of Omega-3 fatty acid supplements with your physician.
Inositol hexophosphonate, or IP-6 is a nutritional supplement that is very beneficial for the health of your kidneys. You should take one to eight grams of this supplement every day- on an empty stomach. You can typically get this in a flavored powder. Methylsulfonylmethane, or MSM, is wonderful for decreasing inflammation. You should take 3,000 milligrams of this twice daily.
So, as you can see, while diet is very important for controlling attacks of gout, there are also many other things that are very effective as well.