Gout also known as Gouty Arthritis is sometimes considered as a disease of over indulgence in food.
Gout is a form of arthritis and It is one of the oldest and better known form of rheumatic diseases. It can be described as sudden and sever pain attack in the joints which is usually accompanied by redness and tenderness of the affected joints. The most common location of gout attack is the big toe; however, it can affect any other joint in the body.
What causes Gout?
When there is very high concentration of uric acid (hyperuricemia) in your blood, it can accumulate in joints or surrounding tissues in the form of urate crystals.
They are sharp needle like crystals that can cause intense pain, swelling, tenderness and inflammation in the affected joints and this is called gout.
Apart from having debilitating effect on the effected individuals, gout can cause serious and permanent damage to the joints if left untreated.
When the blood uric acid remains greater than 7.0 mg/dl in men and 6.0 mg/dl in women the condition is called chronic hyperuricemia. This is often the case in individuals with high risk of gout attacks.
Blood test for uric acid level is called serum uric acid test. A doctor may prescribe allopurinol for treating chronic gout.
What causes increased concentration of uric acid in blood?
As a byproduct of purine metabolism our bodies produce uric acid.
Purine is a naturally occurring substance in all body tissues. It can also be found in various food items like red meat, sea food, sweet drinks and beer.
Our kidneys can normally remove uric acid from blood through urine. However, in some case when the body is producing excess amounts of uric acid or the kidney is not able to remove sufficient uric acid for any reason, it can accumulate in your blood and cause a gout attack.
Gout usually happens during the nigh time, when the body is producing maximum amounts of uric acid. When it happens, the person is woken up from the severe pain. The affected joint is swollen and tenderness is so severe that even the light rubbing of the bed sheets can be uncomfortable.
Who can get Gout?
In ancient times it was considered as the disease of powerful and affluent people but nowadays it can affect people of any socioeconomic class.
It is one of the most common type of inflammatory arthritis in men above the age of 40. In women, though much rarer than men, it is usually found in post-menopausal women. However, younger men and women can also get gout.
Famous people who had gout:
- Benjamin Franklin
- King of England Henry VIII
- Leonardo da Vinci
- Louis-Napoléon Bonaparte
- Ludwig Van Beethoven
- Samuel Johnson (English writer)
- Sir Isaac Newton
What are risk factor for gout?
Anything that can increase you blood uric acid level can increase your risk of developing gout.
Some people are more susceptible to gout attacks and in these individual certain risk factors can increase the frequency and intensity of gout attacks.
- Being overweight increases the production of uric acid in the body.
- High purine diet.
- Medical conditions: Untreated high blood pressure, diabetes, heart and kidney diseases.
- Gender and genetics: Men are more likely to get gout and a family history increases the risk further.
Is there treatment for Gout?
Yes, there is treatment options available for managing gout. In fact, in many cases with proper diet management, lifestyle changes and natural remedies, gout can be managed perfectly fine without the need for additional medications.
It is important to note that if you are already on any gout medication, you should consult with your doctor before you discontinue the medicine.
This article is split into the following subsections for easy reference
Section 1: Natural remedies for gout
Section 2: Prevention tips for gout
Section 3: Foods to avoid for gout
5 Natural remedies for gout
We have put together a list of natural remedies that is good for treating gout.
Probably this is the single best natural remedy for gout. You need to increase your daily intake of water to help your kidneys flush out the excess uric acid from your blood.
Being dehydrated can drastically increase your recovery period when having a gout attack.
Here is an article that will give you an idea how much water you need to drink
Vitamin C has shown to be very effective in lowering blood uric acid levels during a gout attack. You can get vitamin c from citrus fruits like lemon. You can also take vitamin c supplements during a gout attack to quicken the recovery period.
However, it is important to note that orange juice which is rich in vitamin c, may actually increase the risk of gout.
Dairy products, especially low fat milk products have a uricosuric effect that increase the excretion of uric acid through various mechanisms and thus reduce the risk of gout.
Milk products are low in purines and increase the excretion of xanthine which is a precursor of uric acid thought the kidneys.
Sodium bicarbonate commonly known as baking soda is an effective natural salt against gout. Add half teaspoon of baking soda to a glass of water and consume 3-4 times a day. baking soda can reduce the buildup of uric acid by altering the pH level in the body.
People with high blood pressure should avoid baking soda. This home remedy has had mixed results and you should use it with caution because of the possible side effects.
Apple Cider Vinegar
Apple cider vinegar is a popular home remedy for treating gout. Like backing soda, this home remedy works by altering the pH level in the body.
Add two tablespoons pf apple cider vinegar to a glass of water and drink twice a day.
These above mentioned natural remedies though very effective in treating gout, may not be enough during an acute gout attack episode. Fortunately, there are medications available that can help manage the situation.
Before taking any medication, you should consult with your doctor to accesses the possible side effects of these options.
These are short terms treatment options for immediate relief from gout pain. You should take these medicines immediately during a gout attack to reduce inflammation, pain and other symptoms.
- NSAIDs (Nonsteroidal anti-inflammatory drugs): ibuprofen, naproxen or indomethacin. You should not use aspirin during a gout attack.
- Colchicine: It is extracted from Colchicum autumnale plant. It can prevent the formation of urate crystals deposits in the joints.
- Corticosteroids: People who cannot tolerate NSAIDs or colchicine are prescribed corticosteroids like dexamethasone or prednisolone.
Prevention tips for gout
Anything to reduce the levels of uric acid in blood can help prevent gout attacks. You will need to make lifestyle and dietary changes to reduce your risks.
We have also included a list of food items that are good for managing gout by lowering your blood uric acid levels.
Losing weight will drastically improve overall health of an overweight individual. Maintaining a healthy BMI (Body Mass Index) is also an important long term strategy for preventing gout attacks in future.
However, it is important to note that your blood uric acid level may briefly increase during the weight loss period. You can easily manage this by avoiding foods mentioned below and increasing your daily intake of water to help your kidneys flush out the excess uric acid from your blood.
Avoid Excess Calories
Over eating can lead to increase in body weight and increase in overall cell turnover rate or cell renewal rate because of the increased body mass. Two-thirds of the daily purine production in our body is a result of cell turnover while the remaining one-third is due to our diet.
It is considered as one of the healthiest diet in the world because it is a diet rich in fresh vegetables and fruits, with moderate intake of olive oil and fish and limited intake of red meat.
Incorporating Mediterranean diet into your lifestyle may give you many benefits like helping you maintain a healthy weight, reduce risk of cardiovascular diseases and diabetes, improve overall health and reduce risk of gout attacks.
However, it is important to note that consuming too much fish or seafood can increase the risk of gout. Therefore, it is important to consume these items in moderation.
To know more about Mediterranean diet, read more: 11 Secrets of the Mediterranean Diet for a healthy and longer life
Drink enough Water
Water helps your kidneys to flush out toxins from your body and is key to maintaining a healthy body, therefore we have to mention it once again in this section.
It is important to keep yourself well hydrated by drinking enough water so that you blood uric acid levels do not reach chronic levels and increase your risk of gout attacks.
Aspirin can increase the blood uric acid levels and increase the risk of a gout attack. If you using aspirin, you should talk with your doctor about it for other alternatives.
Avoid Alcoholic Beverages
Since ancient times, it was a known fact that excessive alcohol intake increases the risk of gout.
Alcohol can force your kidneys to give preference to alcohol excretion instead of uric acid, which leads to the sudden buildup of the later which increase the risk of a gout attack. Beer is one of the worst enemy for gout sufferers because of its high purine content.
Avoid Sugar-sweetened Beverages
Studies have found that soft drinks and sugar-sweetened fruit juices with high fructose corn syrup can drastically increase the risk of gout attacks in both men and women.
However, researchers also found that diet soft drink consumption is not associated with an increased risk of gout.
Caffeine from moderate coffee drinking seems to reduce the overall risk of gout, however there is not enough evidence to support the same benefits from other caffeine containing drinks like soft drinks and energy drinks.
It is important to note that, increasing your coffee intake during a gout attack may actually increase your gout symptoms.
Eat more complex carbohydrates rich food in the form of fruits, vegetables and whole grains. Avoid baked items like white bread and cakes. Eating cherries seems to reduce the risk of gout.
Fruits with antioxidants
Cherries, raspberries, blueberries, blackberries and tomatoes are good for reducing the blood uric acid levels.
Reduce Proteins and Fats
During an episode of gout attack, you should reduce protein intake in the form of fish, red/lean meat and poultry. Ideally it would be best to totally ignore these protein sources during this period and substitute your daily required protein intake from safer sources like low-fat dairy products and yogurt.
You should also reduce your saturated fat and trans-fat intake during a gout attack. It is best to substitute these unhealthy fats with healthier fats.
Foods to avoid for gout
Additionally, we have also put together a list of food items you should completely avoid in order to lower your risk of any further gout attacks.
The purine content in food items vary greatly, therefore it is important to know what foods you should totally avoid, what you can consume moderately and the type of food items you may consume occasionally.
High purine foods
You should avoid the following food items because they contain more than 400mg of purine per 100g.
- Animal organs like liver, heart, brain, kidneys, lungs, spleen, Fish roe, Sweetbreads etc.
- Beer and other
- Food high in yeast and yeast extracts
- Fatty fish like sardines, herring, tuna, salmon, smoked sprat etc.
- Broths and gravies
Avoiding fatty fish might be bad news because they are rich in essential fatty acid omega-3 that contain EPA and DHA.
You may need to supplement your diet with fish oil for omega-3 fatty acids. Fish meat is high in purine but fish oil is not high in purine.
Moderate purine foods
You may need to limit these foods to no more than one serving per day, would be better if you can consume them 2-3 times per week.
These food items contain purine in the range of 100mg to 400mg of purine per 100g
- Legumes like lentils, beans, chickpeas and peas
- Beef, veal, pork, fish, sea foods, poultry other lean/red meats
- Processed foods like sausages
Low purine foods
These food items contain less than 100mg of purine per 100g. You may consume them on a regular basis, provided that you keep yourself hydrated and avoid high purine diet completely.
- Vegetables: potatoes, asparagus, broccoli, cabbage, carrot, cauliflower, corn, cucumber, lettuce, mushroom, radishes, spinach, squash, bell peppers etc.
- Fruits: apple, apricot, avocado, banana, grape, gooseberry, kiwi, melon, olive, plum, pumpkin, raspberry, strawberry etc.
- Carbohydrates: bread, cereal, pasta, barley, millet, wheat
- Proteins: eggs, low fat milk, cheese, yogurt, tofu, nuts like almonds and walnuts, cocoa products.
- Fats: olive oil, avocado oil, butter, flaxseed oil
Specialist physician: Rheumatologist is a doctor specializing in rheumatic diseases.