Everything You Ever Wanted to Know About Gout: Causes, Symptoms & Remedies
The debilitating symptoms of gout can cause weeks of pain and suffering for the afflicted. Incurring gout in the foot, ankle or knee can put you on crutches for weeks, causing immense pain and drastically interfering with your work and social life. Read on to discover everything you ever wanted to know about gout!
Did you know that gout is the most common form of inflammatory arthritis in the world? Affecting an approximate 12 million Americans, gout is triggered by a reaction to the body’s digestion of purine-rich foods, such as red meat & seafood. Gout begins when these purine compounds produce a metabolic by-product called uric acid. When uric acid levels rise to above normal amounts, the kidneys begin to struggle with filtration. As uric acid accumulates in the body, it forms sharp needle-like crystals, which settle in between joints to trigger a gout attack. Ouch.
Who Gets Gout?
Although gout is most common in men and people over age 50, it is on the rise among even younger populations, due to an increased intake of purine-rich foods. Levels of uric acid have been found to increase as Estrogen decreases (Estrogen assists the kidneys in processing uric acid) hence the frequency of gout in men and postmenopausal women. Gout can also occur in people with kidney diseases, joint disorders or injuries, people undergoing chemotherapy, those with a hereditary predisposition, or those who are overweight.
What Causes Gout?
Gout attacks can be triggered for several different reasons – but it all begins with an overload of purines in the blood stream. Since purines (organic nitrogen based compounds in foods) occur naturally in many of the foods we eat, they are difficult to avoid completely.
In order to dissolve purines, the body produces uric acid during the digestion process. When the level of purines is too overwhelming, the resulting imbalance will cause excess uric acid to crystallize in the blood stream. These sharp crystals settle into the joints, where they cause immense pain, inflammation and swelling. While some people can eat high purine foods for their entire lives without trouble, those with weaker kidneys or low blood levels may discover that such foods cause gout attacks.
Uric acid is a by-product of digestion, which is normally flushed out of the body through urination. However, if the kidneys aren’t functioning properly, or if a person becomes dehydrated for extended periods of time, the kidneys will excrete too little of the uric acid waste product. In this condition, known as hyperuricemia, crystalline deposits settle in the joints, causing a painful instance of gout.
High stress can even trigger a gout attack. When stressed, your body depletes Vitamin B5, which aids in the expulsion of uric acid from the body. In addition, severe anemia can also trigger gout attacks. The shortage of blood does not allow for proper circulation and removal of uric acid, causing purine levels to skyrocket and an overabundance of uric acid crystals to settle in joints.
As seen in the diagram below, the body sends out an abundance of white blood cells to attack the invading crystals during a gout attack. This reaction causing swelling, inflammation and fever. Unfortunately, your immune system's attempt at fixing the problem only assists in creating more crystals.
What Foods Trigger Gout?
The most delicious foods of course! People prone to gout attacks often notice a flare-up after drinking beer or eating red meat and seafood – all 3 of which are exceptionally high in purines. When a patient is diagnosed with gout, their treating physician will provide a list of gout-friendly foods, and a list of foods to avoid.
The following foods should be avoided due to their high purine content, which converts to uric acid:
- Organ meats
- Red meat
- Processed meat
- Carbonated beverages
- Processed foods sweetened with fructose or corn syrup
What Foods are Safe to Eat During a Gout Attack?
Those with gout often benefit from a primarily vegetarian diet. The following foods are lower in purines and safe to eat:
- Green vegetables
- Unsweetened cereal
- Peanut butter
- Chicken (in moderation)
These foods assist in balancing the body’s overall PH levels, and aid in reducing the production of uric acid. Blow is a quick reference food chart for which foods to eat and which foods to avoid if you have gout.
What are the Symptoms of Gout?
At the beginning stage of a gout attack, the patient may notice a heated, tingling sensation on the effected area. This is the initial indicator of irritation and can last for 24-48 hours before swelling begins. Since the body is sensing inflammation somewhere in the body, it may also trigger high fever in general.
The joint of the big toe is often the first area of the body where a person will notice gout. It can also affect the ankles, knees, elbows, and wrists. After this initial warning sign, the gathering of uric acid crystals in the joint will begin to cause the acute stage of inflammation. The area becomes red, puffy, rigid, and very sensitive to touch. Many people who develop gout in the foot, ankle or knee joints are unable to walk without crutches until the symptoms subside. The full range of symptoms usually last for 2 days at a minimum (treated), or 30 days maximum (untreated).
In advanced chronic gout, where the patient has suffered from high untreated uric acid levels for 10 years or more, severe joint pain may not ever subside. In an additional complication, uric acid crystals can clump together and build up under the skin, forming round white or yellow lumps known as subcutaneous tophi. They may look like cysts, but can become inflamed and produce a paste like substance composed of pus and uric acid crystals. In most cases, the subcutaneous type of tophi can be surgically removed.
If gout is left untreated, uric acid crystals can form tophi within the cartilage between joints. This leads to permanent damage, and surgery is often required to repair or replace the damaged joint. In advanced cases, a portion of the finger or toe may be removed.
What Other Health Problems can be Caused by Gout?
In addition to pain, inflammation & swelling of joints, those who suffer from gout may also incur additional health problems as a result of high uric acid levels. If uric acid crystals settle in the kidneys, painful kidney stones are formed. Their presence can prevent the kidneys from removing other waste products, which may lead to kidney infections and full body toxicity. If gout is not treated & allowed to persist, the rough edges of crystals can also scar kidneys, leading to kidney disease or even kidney failure over time.
Kidneys aren’t the only organ affected when gout is left untreated. High uric acid levels can irritate and inflame the lining of the blood vessels, triggering a condition called endothelial dysfunction. The resulting disruption of proper blood flow can be a precursor to heart attacks and strokes. The production of nitrous oxide (the gas that allows blood vessels to relax) is also inhibited by high uric acid levels. When vessels don’t dilate fully, high blood pressure results. With all these residual effects lurking, it’s important that you adjust your diet to include as many low-purine foods as possible.
How is Gout Diagnosed?
If gout is suspected, the doctor will administer a blood test to check uric acid levels. The normal uric acid range should land between 3.5 and 7.0, with any higher level indicating the need for treatment. Occasionally, blood samples do not show abnormally high uric acid levels, so he may then take a sampling of joint fluid by inserting a tiny needle into the effected joint while the patient is under local anesthesia. The fluid will then be inspected under a microscope for the presence of uric acid crystals. Once gout is confirmed, the doctor will check kidney function and output. Since kineys are responsible for filtering out the uric acid, those with kidney problems are often prone to gout.
How can I Prevent Gout with Medications?
Left completely untreated, a gout attack can take 3-4 weeks to subside. That’s a long time to have limited functionality! In many cases, the simple decrease in high purine foods can help prevent gout attacks. However, those prone to exceptionally high uric acid levels, who suffer from very frequent gout attacks may be prescribed gout medication. The two most commonly prescribed are:
- Allopurinol (to lower uric acid levels and help prevent a gout attacks from occurring in the first place, and
- Colchicine (to take immediately at first sign of a gout attack). Normally, when Colchicine is taken at the onset of symptoms, the gout attack will subside within a couple of days.
Unfortunately, these are only available by prescription in the USA, which makes obtaining them difficult for the uninsured. If this is the case, try doing an online search for overseas pharmacies, where you can order online and have the medications shipped to you. Alternately, you can try the natural gout remedies below.
How can I Get Rid of Gout Using Natural Remedies?
If you’re having a gout attack and are unable to get to a doctor to obtain the above medications, there are some natural solutions available. Along with completely avoiding high purine foods, these natural remedies will help you get rid of gout.
The powerful antioxidants and vitamin C content of Black Cherry Juice Concentrate has been found to dissolve uric acid crystals, and is frequently used to prevent gout and treat an existing attack. It is important that the patient drink 100% pure black cherry juice, without any added sugar, as excess sugar can exacerbate a gout attack. Drinking the juice is normally more effective than taking capsules, which do not immediately enter the blood stream.
It has also been found that adding a tablespoon of baking soda to a glass of water can help the uric acid crystals dissolve, allowing them to be eliminated during urination. The intake of Vitamin B5 has a similar effect, as it helps dissolve crystals into a solution that can be flushed out with urine. You should drink plenty of water during gout treatment in order to remove as much uric acid from the body as possible.
For pain control, most gout patients find it helpful to use nonsteroidal anti-inflammatory drugs such as IB Profin, along with heating pads and Epsom salt/warm water soaks to decrease pain and swelling on the affected areas. It’s also important to keep the area with gout at an even level with your heart, or slightly elevated, in order to reduce water retention and swelling.
The Best Natural Remedy for Gout (Works Fast!)
A friend told me about this natural remedy for gout & it's a must to add to this article! It was 2 days before a big vacation when my boyfriend felt a gout attack coming on in his back and ankles. This worked to banish the gout in 24 hours.
In an electric juicer, juice the following items:
- 2 cucumbers
- 5 celery stalks
- 1 inch fresh ginger
- Juice from 1/2 lemon
Drink this on an empty stomach, or 2 hours after your last meal (to ensure the juice goes directly into your blood stream). Since this is pure juice extract, it enters the blood stream immediately to being dissolving the uric acid crystals. My boyfriend said he could literally feel it working in all of the areas where he gets gout attacks! He drank it around 7pm, and by the next morning had 80% restored mobility of his back and ankles. It's a true miracle cure! In the past he has tried black cherry juice, which had a similar effect where he could feel the crystals breaking up, but he said it did not work nearly as fast as the above remedy.
Am not sure whether or not it works as well when done in a blender (probably not, as you'll have pulp and fibers interfering with the purity of the juice). But if you don't have access to a juicer, use 2x the ingredients in a blender, and strain through a mesh strainer to obtain the juice. We bought the Cuisinart Juice Extractor at Kohl's for $149 and it works great for this purpose, but I haven't tried making the concoction in a blender.
Can Massage Therapy Help Gout?
Due to the high concentration of uric acid crystals in the blood stream, people with gout often suffer from sluggish circulation. They are frequently prone to water retention, a cold feeling in the extremities and fatigue. While massage would not be appropriate directly on the location of an acute attack, it can be very beneficial as ongoing therapy. Since massage increases body-wide circulation, it can help prevent uric acid crystals from settling into joints by increasing the flow of fresh, oxygen-rich blood. For this same reason, light daily exercise is also encouraged for gout patients.
When gout is dormant and an active attack is not occurring, several types of massage are beneficial, including Acupressure, Aromatherapy, Hot Stone Massage, Reiki, and occasionally Deep Tissue. Most of these modalities, with the possible exception of Deep Tissue, can also be performed during a gout attack, as long as local contraindications are considered, and pressure is not applied directly to the inflamed area. Gout sufferers will greatly appreciate massage for its ability to boost immunity, lower blood pressure, increase circulation, provide muscle pain relief, lower stress, and aid in the removal of waste.
Aromatherapy for Gout
In addition to the above treatments, some essential oils can help sooth away the pain of gout. These can be added to an Epsom Salt foot bath, applied to a damp hot towel & placed on the effected area, or gently applied directly to the area.
- Ginger Oil: has warming properties to minimizes pain, stimulates circulation, anti-inflamatory
- Lavender Oil: provides relaxation & stress relief, acts as an anti-inflammatory
- Rosemary Oil: stimulates circulation, increases warmth, soothes sore muscles