The Ultimate Guide to Understanding What Gout Is (and Isn’t)

What Is Gout?

Gout is a condition that plagues millions of people. It’s caused by a buildup of uric acid in the body either because there is too much or the body is excreting too little.

Referred to as the “disease of kings," gout was historically associated with the royalty back then since only the rich could afford to drink alcohol, eat meat, and feast on other indulgences while the poor were stuck eating carbs and whatever produce they could harvest from their land.

Today, nearly 8 million Americans are affected by this type of arthritis, with most of it being older men.

What Causes Gout?

A condition where there are high levels of uric acid in the blood is called hyperuricemia. And although not all who have it develop gout, it is the underlying cause of people who have it.

Gout is a result of the body not being able to handle uric acids properly. Uric acid is a result of the breakdown of purines from the foods that we eat.

For people without gout, uric acid dissolves and goes into the urine through the kidneys, but too much uric acid causes buildup that accumulates in the joints and surrounding tissue. This sharp urate crystals that look like needles are what cause immense pain to the gout sufferer.

What Are the Symptoms of Gout?

Gout manifests itself through flares which can happen anytime without warning. The pain caused by a gout attack can range from mildly annoying to debilitatingly painful.

The affected area will feel hot and sensitive – so sensitive that even a light touch can feel so excruciating. It will also appear swollen, red or purplish and shiny. As the inflammation slowly goes away, the skin on the affected joint might feel itchy and flaky.

Attacks can last anywhere between a few hours to three weeks, and usually occur in the middle of the night when you least expect it. Experts suspect this is because of the lower body temperature at night accompanied by overnight dehydration and falling levels of the hormone cortisol.

It’s hard to fall back asleep during a gout attack due to the pain. This is why doctors recommend having medicine ready in your cabinet. The frequency of gout attacks and the level of pain all depends on how religious you are with taking your medication and following a strict gout-friendly diet.

When you experience a gout attack, it’s best to rest the affected joint to prevent the pain from getting worse. Also, make sure to have medication ready as this is the best relief to gout pain. Otherwise, you’d have to call your doctor to get a prescription.

For those who have chronic gout, the symptoms may not be as painful, but they are frequent. 62 percent of gout sufferers say they experience at least another one attack within a year. Careful not confuse this with arthritis by checking in with your doctor.

Some people go through life not knowing their uric acids are high until they get their first gout attack. If left untreated, gout symptoms can worsen, causing joint damage, kidney damage, and tophi.

Tophi are hard swellings that form in the joints and can grow so large that it affects your mobility or even break through the skin. In most cases, tophi have to be removed surgically if it already impairs movement.

Diagnosis for gout requires a sample fluid from the affected joint to check if uric acid crystals are present. Your doctor may take an x-ray of your joint and check how often you experience the pain, the intensity, and how swollen the affected area is.

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Statistics About Gout

Here are important statistics to help you get more insight on gout:

  • 75 percent of gout sufferers are men.
  • Over 8.3 million Americans suffer from gout.
  • The average overall cost of gout is $2,800 per person.
  • Gout is partly genetic, contributing to about 60 percent variability in uric acid level.
  • About 10 percent of people with hyperuricemia, develop gout at some point in their lifetime.
  • A combination of abdominal obesity, hypertension, insulin resistance, and abnormal lipid levels, occurs in nearly 75 percent of gout cases.
  • A body mass index greater than or equal to 35 increases the male risk of gout threefold.

Where Can You Get Gout?

People who have gout typically experience pain, swelling, and redness in the feet, particularly the joint behind the big toe. This is the most common joint involved; however, gout symptoms can also manifest in the wrists, fingers, ankles, knees, heels, elbows, or nearly any joint in the body.

10 percent of sufferers get theirs on the wrist and elbow while 11 percent experience an attack in more than one area. Over time, the symptoms can manifest on multiple joints which makes immediate treatment very necessary.

Areas that are affected by tophi are also signs of gout. It commonly appears in the elbows, upper ear cartilage, and on the surface of the joints. Tophi is an indication that the body is overloaded with uric acid.

Having kidney stones are also an indication of gout since uric acid crystals could have built up in the kidney.

Who Gets Gout?

Gout is more prevalent in men than in women, particularly those between ages 40 and 50. For women, this is likely to happen after menopause.

People with hyperuricemia have a chance of developing gout later on, but it’s also common for people with this condition to never develop gout.

If your family has a history of gout, you’re also more likely to have gout. People who have the following conditions or habits are also at risk for developing gout:

  • Obesity
  • Sleep apnea
  • Thyroid disease
  • Hypertension
  • Chronic decreased kidney function
  • Degenerative arthritis
  • Drinking alcohol excessively
  • Eating high-purine foods
  • Taking diuretics (water pills) and cyclosporine
  • Treatments for certain types of cancer

Can You Prevent Gout?

One of the risk factors for gout is genetic, so if you have a history of it in your family, you may not be able to prevent it.

Obesity, diet, and alcohol habits, however, are controllable. If you maintain a healthy weight, follow a healthy diet, and minimize alcohol consumption, you may lessen your chances of developing gout.

The best way to deal with the condition is by minimizing your risk of gout flares. Every patient is different therefore treatment is individualized. By taking your prescribed medicine consistently and modifying your diet, you can prevent gout attacks from happening.

Avoiding purine-rich foods is another way to prevent gout. Purines are proteins break down in the body into uric acid contributing to the buildup. The only problem is that purine can be found even in most of the healthy foods so it can be quite tricky to follow a low-purine diet.

One of the biggest culprits for gout attacks is alcohol, especially beer, which has high-purine content. Most people’s social lives revolve around drinking so it can be quite hard to quit this.

If you must drink, opt for wine instead as it does not appear to increase your risk of gout. If you want beer, choose a light beer or locally brewed ones instead of the mainstream beers since those tend to contain GMO ingredients in them.

Traditional Treatment for Gout

Treatment for gout generally serves three purposes: provide immediate relief, lower uric acid, and prevent future gout attacks.

Here we will discuss the medical, natural, and alternative treatments that help you achieve these three.

Medical

Colchicine, corticosteroids, and NSAIDs are medicines that can help lessen pain and inflammation during a gout attack.

NSAIDs

Depending on the level of gout symptoms you are experiencing, you may receive a low or high prescription dose of NSAIDs.

Be careful though as this drug can have side effects including as nausea, diarrhea, and stomach ulcer. The worst side effect is damage to your kidney and liver.

Your doctor may prescribe you the following NSAIDs: aspirin, ibuprofen, indomethacin, celecoxib, ketoprofen, or naproxen.

Colchicine

Colchicine is the drug commonly prescribed to gout sufferers as it helps stop the uric acid forming into urate crystals.

It’s often taken during a gout attack to help lessen the pain and swelling. In some cases, colchicine is taken to prevent future gout attacks from occurring.

Just like NSAIDs, colchicine has its side effects like nausea, vomiting, and diarrhea. For people who can’t tolerate NSAIDs, colchicine is the next best medicine to take.

Corticosteroids

Corticosteroids are also used to reduce inflammation during a gout attack. They can be consumed orally or injected into the affected joint. However, it has some serious side effects which can impact your health in the long run.

Some conditions associated with prolonged use of corticosteroids include osteoporosis, high blood, cataracts, diabetes, higher risk of infection, and bone tissue death in the hip and shoulder joints.

This medication is the last option if your body cannot tolerate both colchicine and NSAIDs.

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Allopurinol or Febuxostat

Xanthine oxidase inhibitors like allopurinol and febuxostat are taken regularly to help regulate the production of uric acid in the body, thus avoiding gout attacks.

The saying “it gets worse before it gets better" applies to this drug in the sense that your gout attacks will become more frequent in the beginning and will lessen over time. This is because your uric acid levels rise slightly before it falls back to normal.

It is for this reason that colchicine is prescribed together with allopurinol to help you cope with the attacks as your uric acid levels normalize. It takes about 2 to 3 months before the drug becomes effective.

Probenecid

Probenecid is a medicine that helps the kidneys excrete uric acid from the blood, thus preventing future gout attacks from happening. Like any drug, probenecid has its side effects including an upset stomach, rashes, and kidney stones.

Herbal or Natural Treatment for Gout

Aside from medication, gout sufferers are also encouraged to use the following natural home remedies to help treat gout.

Water

Drinking plenty of water helps dilute uric acid in the body. Make sure you stay well-hydrated to prevent gout attacks.

Celery

Celery seeds are known to help decrease uric acid levels in the body. It contains antioxidants such as phenolic acids and flavonols which help treat conditions associated with inflammation.

Celery seed can also help with kidney and liver infections which are both essential organs that process uric acid. Celery can be consumed naturally or in supplement form.

Cherries

One study found that half a cup serving of cherries help decrease the risk of gout in participants by 35 percent. Furthermore, those who consumed up to three servings up their reduced risk to 50 percent.

To fully get the benefits of cherries, go for cherry juice concentrate minus the sugar or dried cherries. You can also take it in supplement form.

Bromelain

Bromelain is an enzyme whose only natural source is pineapple. It helps relieve pain from gout by decomposing the uric acid crystals and promoting blood circulation. It also accelerates healing by decreasing bruising, swelling, redness, and tenderness in the affected area.

The pineapple fruit itself does not have enough bromelain in it to provide medicinal effects, so the best way to take it is in supplement form. You can take it as treatment and prevention for gout.

Take 500mg of bromelain supplement during a gout attack every three hours until the pain subsides and take it twice a day between meals for prevention. You can take bromelain together with quercetin supplement which is a flavonoid that helps reduce uric acid levels.

Fish oil

Oily fish is not recommended for gout sufferers but highly purified, molecularly distilled fish oil, however, can be good for you. This is because fish oil contains omega-3 fatty acids which are known to reduce disease-causing inflammation in the body. Aim to take at least 2,000mg of fish oil a day to keep gout attacks at bay.

Vitamin C

Studies show that vitamin C can help reduce uric acid. Vitamin C can be found in many natural sources such as citrus fruits, pineapple, tomatoes, green and red peppers, kiwifruit, leafy veggies, and potatoes. You can also take vitamin C in supplement form.

Magnesium

People with magnesium deficiency are more likely to develop gout. It’s important to take enough magnesium because it helps improve blood circulation, making it easier to remove excess uric acid in the body.

If you have acute gout, magnesium should be a priority. It can be found in foods like romaine lettuce, spinach, nuts, and whole grains. It’s also available in supplement form and should be taken based on your age and gender.

Alternative Treatment for Gout

Alternative treatments have the same goal as medicinal and natural treatment, and that is to lessen the pain during gout attacks and prevent flares from happening by lowering uric acid levels.

Although minimal research backs these treatments, they have been used by several gout sufferers who found little relief in traditional treatments. It’s best to do your own research and dig a little deeper into these treatments before trying them out yourself.

Acupuncture

Acupuncture is a technique where tiny needles are placed in specific points of the body to treat chronic pain. Though there aren’t that many studies backing up its efficacy for gout, it’s worth a try for its pain-relieving effects.

Eat Alkalizing Foods

There is a viewpoint on gout on its cause relating to an imbalance of pH in the body.

The condition causes acidosis which means the pH in your body is out of balance and is trying to get back to normal pH levels anyway it can. These efforts are what causes arthritis, high uric acid, muscle spasms, and other problems.

One solution recommended by JB Bardot from Natural News is to eat alkalizing foods to help restore the body’s natural pH balance.

Foods that are rich in alkaline include apple cider vinegar, baking soda, citrus juices, brussel sprouts, broccoli, spinach, asparagus, bananas, and celery.

Foods for Kidney Health

Kidney health is strongly associated with gout. The kidney is responsible for secreting uric acid from the body and without it, you’d be overloaded with uric acid and experience more gout attacks.

Foods that are good for your kidney include cabbage, onions, garlic, apples, cranberries, cherries, red grapes, blueberries, strawberries, raspberries, cauliflower, wild-caught salmon, olive oil, and eggs.

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Essential Oils

You can take essential oils along with other gout treatments mentioned above. Some essential oils that are helpful for gout include:

  • Ginger extract is an antioxidant and anti-inflammatory which helps reduce uric acid and prevent gout attacks
  • Biota orientalis extract helps reduce uric acid
  • Lemongrass oil possesses antimicrobial and antibacterial properties and can reduce pain and inflammation
  • Chinese cinnamon helps with inflammatory disease and significantly decreases uric acid
  • Celery seed oil enhances the effects of gout medications and reduces swelling
  • Yarrow oil extract helps treat arthritis and reduce inflammation in the joints

Be careful when using essential oils for gout. Dilute it with a carrier oil before applying topically and never take it orally. It can be diffused as part of aromatherapy. Just be careful not to overdo it as it can have side effects like headaches.

You know your body best so listen to what it has to say. Observe its response to the treatment. If you find that your gout symptoms are getting worse, stop the treatment and try other methods.

Lifestyle Tips to Help Make Living With Gout Easier

From cutting out sugar to learning your triggers, below are the seven best ways to make living with gout easier.

1. Say Goodbye to Sugar

Quitting sugar can be hard, but if you want to continue living an easier life with gout, sugar has to go. Sugar may be low in purines, but it feeds yeast in the body which in turn affects your gout symptoms.

Not only is it addictive but it’s hard to avoid too since most items you see in the supermarket have sugar in them. The trick is to look at the label. Always check the label for sugars or high fructose corn syrup as these ingredients increase your uric acid levels.

If you’re craving for sweets, have some healthy alternatives nearby like fruits. Not only are they naturally sweet but they also possess nutrients which are good for your body.

2. Avoid Processed Meats and Organ Meats

Processed meats are filled with unhealthy hormones and antibiotics which are processed into acid in our system. You also want to avoid organ meats like kidney, liver, brains, and heart as well as oily fish like sardines, and anchovies. All these are high in uric acid which is very bad for your gout.

3. Reduce Alcohol, Especially Beer

You want to avoid alcohol – especially beer. It dehydrates the body and raises uric acid levels in the blood due to its high purine content. Studies show that drinking beer increases the frequency and intensity of gout attacks.

Prevent flares from happening by by avoiding alcohol when you can and limiting consumption. If you must drink, opt for wine.

4. Follow a Gout-friendly Diet

Diet is key when it comes to managing gout. Here is the list of foods recommended for gout sufferers:

  • High-fiber, low-calorie foods. High-fiber foods help you keep a healthy weight. Examples of high-fiber foods include spinach, leafy greens, peas, cauliflower, mushrooms, and asparagus
  • Fresh berries and cherries. Berries neutralize uric acid in the body
  • Wild caught fish. Wild caught fish are rich in omega-3 which reduce inflammation and pain
  • Complex carbs. Limit refined carbs and go for complex carbs found in fruits, veggies, whole grains, whole wheat pasta, and rice
  • Olive oil. Use olive oil whenever you can and avoid using unhealthy cooking oils like canola or vegetable oil

More foods that are healthy and generally safe for gout sufferers:

  • Legumes
  • Nuts
  • Eggs
  • Coffee
  • Green tea
  • Herbs and spices
  • Coconut oil
  • Flaxseed

The following foods are also good for gout but should be limited:

  • Poultry
  • Fresh or canned salmon
  • Nuts
  • Cheese
  • Milk
  • Butter
  • Yogurt

5. Drink Lots of Water

Drinking lots of water not only keeps you hydrated but also keeps the gout attacks at bay. It helps dilute excess uric acid in the body and helps the kidneys flush it out through your urine.

6. Exercise

Obesity greatly increases your risk of gout. If you are obese or overweight, exercise can help you lose that excess weight and reduce the likelihood of gout attacks. Exercise is also good for your bones and joints. Make sure to insert 30 minutes of exercise at least three times per week to keep your joints healthy and to achieve that ideal weight.

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7. Learn Your Triggers

As mentioned earlier, gout is a condition that can vary by person. What triggers one person’s gout may not necessarily trigger yours. Observe the food items that worsen your gout and do your best to eliminate them from your diet.

Experiment with the alternative treatments suggested above, and don’t hesitate to do research on your own. While doing so, you might just find the perfect combination of diet, medication, and lifestyle changes that work best in treating your symptoms.

In Conclusion

Most of these tips involve cutting out certain items from your diet.

It’s hard in the beginning, but the idea of not experiencing the excruciating pain of a gout attack is often enough motivation to stay away from these bad foods and follow a disciplined, healthy lifestyle.

Your success greatly depends on how well you are at maintaining these lifestyle habits.

Next page: Where can you get gout? How do you get out? Can you prevent gout? And treatment for gout options. 

Next page: natural treatment for gout, and alternative therapies for gout symptoms. 

Next page: several tips for making living with gout easier.

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