Getting on your gout

Gout is a form of recurrent acute arthritis or the peripheral joints that result from the deposition of monosodium urate (uric acid) crystals in the joints, tendons and tendon sheaths. The crystals derive from high levels of uric acid in the blood, tissues, and urine.

Cause

Uric acid is more likely to crystalise at lower temperature, which may explain why the majority of gout attacks affect cooler extremities like the big toe. However, other joints are also vulnerable, including the mid-foot, ankle, knee, elbow, wrist and fingers. 

Uric acid is a by-product of certain foods (the end result of purine metabolism). Excessive levels of uric acid are usually passed through the kidneys and out of the body via urine, however the level of uric acid can rise too high if:

  • the kidneys have an impaired ability to excrete excess uric acid quickly enough; and/or
  • the body producing too much uric acid.

As a result uric acid accumulates in the blood and tissues and, eventually, crystallises.

Sudden and acute pain in one or a number of joints is usually the first symptom. Often the pain becomes increasingly severe and can be excruciating, waking the person up from sleep. The affected joint is red, hot, swollen, extremely sensitive to touch, with the overlying skin appearing shiny. Acute attacks may be accompanied by fever, chills or tachycardia.

An attack of gout often occurs for no clear reason, but may be triggered by an illness, injury or drinking too much alcohol.

Typically gout is a recurrent disease with the periods between attacks becoming shorter and the attacks lasting longer to subside if left untreated. As the disease progresses, chronic joint symptoms may develop and degeneration of the joint results in functional impairment. 

You are more likely to have gout if you:

  • are a man aged 30 to 60;
  • eat a diet high in purines – commonly found in red meat and seafood;
  • drink too much alcohol;
  • take diueretic medication that increases the flow of urine from the body;
  • have a family history of gout;
  • are overweight;
  • have kidney disease;
  • have psoriasis;
  • have high blood pressure; and/or
  • injure a joint.

 

Please note that uric acid is not always a harmful substance. It is a powerful antioxidant (like Vitamin C) that helps to protect cells from oxidative damage. It is only when levels become abnormally elevated that it becomes a problem.

Diet and Lifestyle

Increase consumption of:

  • a well balanced diet high in fluids to help promote uric acid excretion, as well as an adequate amount of purified water and celery juice;
  • apple cider vinegar, which may also help to promote uric acid excretion;
  • berries and cherries; and
  • nettle and dandelion.

Decrease or avoid consumption of:

  • food high in purines, such as meat, meat gravies and broths, crab, prawns and oily fish such as mackerel, sardines and anchovies, asparagus, cauliflower, lentils, mushrooms, spinach, oats, eggs and yeast products;
  • fried food and processed foods, especially cakes and pies;
  • caffeine and alcohol, especially beer;
  • foods or supplements with glycine;
  • high doses of vitamin C or niacin should be avoided as they may provoke an attack.

Other considerations:

  • make an effort to lose weight if you are overweight.

 

by Sam Sample