What is gout?
Causes of gout
Remedies for gout
What is gout?
Gout (podagra) is a form of acute inflammatory arthritis. It is characterised by sudden sharp, unexpected pains in joints, and swelling, redness, warmness and stiffness around the affected joint. Low-grade fever can also occur.
An elevated level of uric acid in the blood seems to be part of the mechanism of gout. The uric acid crystallises and is deposited in joints and tendons. These deposits provoke an inflammatory reaction in surrounding tissues.
The patient usually suffers from two sources of pain. The crystals in the joints cause intense pain when the affected area is moved. The inflammation of the tissues around the joint causes the skin to be swollen, tender and sore if it is even lightly touched. For example, a sheet or blanket covering the affected area can cause extreme pain.
Gout affects about 1% of the Western population at some point in their lives. It is most common in the toes of men (particularly the big toe), but affects other parts of the body, and occurs in both sexes. Gout was historically known as "the disease of kings" or "rich man's disease".
Causes of gout
- Abnormally high level of uric acid in the blood (hyperuricemia) is the underlying cause of gout. This can occur for dietary, genetic, or metabolic reasons.
- Fructose. High levels of fructose consumption are associated with gout (1, 2), especially if you have a weak liver causing impaired fructose metabolism. Avoid sweets (candy), sweetened drinks, fruit juice and processed foods which have high fructose corn syrup added - unfortunately, this is the majority of processed foods in the USA today.
- Alcohol consumption is associated with gout. Try to avoid alcohol, especially sweet yeasty alcoholic drinks, port and beer.
- Gout frequently occurs in combination with other medical problems, particularly those associated with high levels of uric acid such as metabolic syndrome. A combination of obesity, insulin resistance, hypertension (high blood pressure), erectile dysfunction and abnormal lipid levels. These ailments occur in nearly 75% of cases of gout.
- Diet. In addition to the fructose sugar mentioned above, sweetened foods, meat and seafood consumption are associated with gout.
Foods high in purines cause gout. The worst offenders are brewer's yeast, bacon, game meat, beef and lamb.
A pseudo gout may be caused by the accumulation of calcium oxylate crystals in joints. High oxylate foods include beans and lentils, particularly peanut and soy products (tofu, grits, soy milk etc), wheat germ, tea & coffee, dandelion root & greens, cranberry juice, cocoa & chocolate, beets, blueberries, carrots, grapes & wine, nuts, oranges, strawberries, sweet potato, spinach and cauliflower. Did you start eating any of the above, or eat larger quantities, prior to the onset of the (apparent) gout? Again, experiment with removing them to see whether it makes a difference.
- Deficiency and imbalance in a range of minerals. This is both an effect of, and cause of inefficient metabolism of sugars, alcohol and protein.
- Lack of physical fitness.
- Exposure to lead is a risk factor due to the harmful effect of lead on kidney function.
Remedies for gout
- Exercise (aerobic exercise) and physical fitness.
- Avoid fructose.
- Avoid high-purine foods like brewer's yeast, baker's yeast, bacon, game meat, beef and lamb. Other foods also have some level of purines, such as asparagus, cauliflower, chocolate/cacao/cocoa, green peas, legumes (beans\lentils\split peas), mushrooms, offal, parsley, rhubarb and sweet potato. Purine-containing foods from the ocean include anchovies, herrings, mackerel, sardines, sprats, mackerel, scallops and other shellfish. However it is difficult to avoid all of them in a healthy diet so stick to keeping them in balance and having them fresh and home-prepared rather than processed, sweetened and packaged products from a store.
- Correction of mineral imbalance, particularly boron.
- Hydration. Drink sufficient pure water.
- Moderate coffee consumption decreases the risk of gout.
- Sour cherries. Various berries, plums and sweet cherries are also beneficial, but sour cherries are the most effective.
- Vitamin C, best from food sources such as the berries above, and from sour fruits.
- Alkaline-forming diet.
1. Underwood M.
Sugary drinks, fruit, and increased risk of gout.
BMJ 2008 Feb 9, 336(7639):285-6.
2. Seegmiller JE et al. Fructose-induced aberration of metabolism in familial gout identified by 31P magnetic resonance spectroscopy. Proc Natl Acad Sci USA. Nov 1990, 87(21):8326-30.