Gout Triggers and How to Avoid Them
I can remember being in high school when my father was diagnosed with gout. As a very active man who downhill skis, cross-country skis, and golfs, watching him hobble around the house without knowing what he had done to himself was disconcerting.
After missing work for a few days, he came home from the doctor with several prescriptions and a fistful of patient education handouts. “Gout,” he said. He was a bit miffed.
A distant relative had gout but there had been no warning signs — just a swollen big toe one morning that was more painful than anything that he had ever experienced.
It has been almost 20 years since that day, and while he has had exacerbations, his gout has largely been under control through the use of prescription medication and dietary modifications. Through trial and error he has discovered that certain foods and beverages trigger his gout, whereas other well-known gout triggers will have no effect.
Gout Triggers
Gout is actually a form of arthritis. It comes on suddenly due to a buildup of uric acid in a joint, most commonly in the big toes or a joint in the lower body, although it can occur in any joint.
Uric acid is a normal byproduct of the breakdown of purines, which are found naturally in our bodies and in certain foods. The uric acid should then be transported to the kidneys and excreted in the urine. However, people with gout have an overproduction of uric acid or their bodies do not metabolize it properly, causing the development of gout.
Triggers for gout can be medical, dietary or lifestyle-related.
Medical- or lifestyle-related triggers include:
- Injury to the joints
- Illness or infection
- Chemotherapy
- Diuretic medications that treat edema and/or heart failure
- Taking the drug Cyclosporine
- Dehydration
- Crash diets
Dietary-related triggers:
- Consuming too much alcohol
- Diets rich in purines
- Consuming too much sweet soda
There may be little that we can do to prevent gout if we are predisposed due to medical triggers. However, we can certainly prevent it if we know we are predisposed, such as having a family history, by avoiding dietary triggers. If you already have gout, avoiding dietary triggers and lifestyle-related triggers is helpful as well.
Let's take a closer look at some of these triggers of gout.
Joint Injury
Gout can be triggered by a wide range of things, and one of the main causes of gout can be joint injury. It is important to take good care of your joint by not overworking yourself or your joints.
Be sure to take breaks when you feel fatigued or feel pain in your joint. These rest breaks and appropriate care could stop an injury from happening, which could then hopefully stop gout attacks.
Diuretic Medications
Another common trigger of gout is taking certain diuretic medications, which are used for high blood pressure, heart failure, or swelling of the leg.
Medications, such as hydrochlorothiazide and furosemide, can cause gout attacks in your body. If you find that you have had a gout attack while on these medications, it is recommended that you speak to your doctor about your course of treatment and how it is not working for you.
Chemotherapy, alcohol, and other gout triggers to avoid.
Chemotherapy
Chemotherapy, a treatment usually undergone for cancer, can unfortunately be a trigger of gout as well. If you experience gout attacks while undergoing chemotherapy, while it might not be possible to stop chemotherapy, it is possible to manage and treat your gout attacks and symptoms. Talk to your doctor about your gout, and he or she should be able to help.
Alcohol
While medications and injuries are common causes of gout, there are many lifestyle activities that can act as triggers for gout as well. One of the most common lifestyle activities that leads to gout is drinking too much alcohol.
While having one or two drinks is acceptable once in a while, alcohol consumption should be limited to a certain amount of drinks once or twice a week. If you drink too much, it is possible that your gout attacks will become more frequent and painful.
Sweet Drinks
Drinking too many sweet drinks, like soda and sweet tea, is another noted trigger of gout. Like stated above, these foods that trigger gout are okay in small serving sizes. However, it is generally recommended that patients who suffer from gout regularly should try to eliminate these from their diets.
If you are having trouble learning how to eliminate cola and sweet drinks from your diet, try keeping a food journal so that you can know when you want these foods and when you can replace them, while still keeping yourself full and happy, but without the worry of another gout attack.
Dehydration
Not drinking enough water has a power impact on your body and has the potential to disturb many of your body’s normal functions. Another downside to being dehydrated is that it has been shown to cause gout attacks as well.
It is important to drink at least six to eight servings of water each day to help maintain your body’s hydration. However, to ensure that you stay far away from dehydrating yourself, especially on hot or work filled days, talk to your doctor about what amount of water is best to consume for your body and lifestyle.
Foods Rich in Purines
One of the best things you can do if you have gout is to limit the amount of purines you consume in your diet. Below is a reference for foods that are rich in purines:
- Foods that are very rich in purines include: organ meats (liver, kidneys, brain), beer, wild game meats, meats such as bacon, beef, lamb and pork, meat in general if it is consumed in a large amount, fish such as anchovies, sardines, scallops, mackerel, and herring, and gravy. People with gout should limit these foods.
- Foods that are moderately high in purines include: fish and seafood in general (aside from the types listed above in the very high category), oatmeal, wheat bran and wheat germ. People with gout can consume these foods on occasion.
- Foods that are low in purines include: green, leafy vegetables, fruits, breads that are not whole-grain, chocolate, cheese and eggs, peanut butter and nuts, and coffee. These foods are completely safe to be eaten by people with gout.
- Foods that may actually help to lower the risk of gout include: low-fat yogurt and low-fat milk.
The Bottom Line
Not all foods will trigger your gout symptoms. However, it is best to avoid most of these foods, at least until your symptoms are medically under control. Add foods back into your diet only under the supervision of your physician or dietitian.
