How Can An Attack Of Gout Be Treated
The management of an acute attack of gout is very different from the prevention of subsequent attacks.
Treatments used for prevention, such as allopurinol can actually make things worse if given during an attack, and so need to be held back until the attack has resolved for several weeks.
There are a number of measures that can help resolve an attack of gout. See Table 2 for summary of treatment strategies for acute gout. One principle is that treatment for an attack of gout should be instituted quickly, since quick treatment can often be rewarded with a quick improvement.
If an attack of gout is allowed to last more than a day or so before treatment is started, the response to treatment may be much slower.
Table 2: Medications to treat acute attacks of gout
More Reasons To Avoid High Fructose Corn Syrup
Aside from avoiding a gout attack, there are more reasons why you should steer clear of this ingredient. Heres just some of them:
The high fructose content in HFCS can increase your risk for fatty liver disease because it is metabolized differently from carbs. In one study on overweight men and women, they found that those who drank sucrose-sweetened soft drinks had increased their liver fat compared to those who only water, milk, or diet soda.
Its easy to gain weight when youre constantly consuming foods that contain HFCS. Its because the ingredient increases your appetite. So even after youve eaten, youll still feel hungry. The fructose in HFCS is also responsible for the visceral fat surrounding your organs. This is very dangerous as it can lead to more serious health conditions like heart disease and diabetes.
Theres no doubt that sugar plays a big role in a person developing diabetes. Even more so, when youre consuming the artificial kind of sugar such as HFCS, it gets more dangerous since it makes the body resistant to the effects of insulin. This means your body is unable to control blood sugar levels. Another related condition to diabetes is metabolic syndrome which is also associated with HFCS. When you have metabolic syndrome, youre also at higher risk for heart disease, stroke, and certain cancers.
What You Need To Know About Sugar And Gout
Refined sugars arent particularly good for anybody, but they can be downright dangerous when combined with certain conditions. Gout is one such example: those who enjoy a diet high in sugar and alcohol are at a far greater risk of developing the painful swelling and inflammation that comes with uric acid buildup.
The fact that gout is associated with diabetes and metabolic syndrome two conditions sprung from a regular overload of sugar strengthens the theory that sugar and gout go hand-in-hand.
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Dont Be Scared Of Beans Legumes Vegetables
The most inconsistent recommendations are for beans, legumes and certain vegetables. No source indicated to avoid these food groups. However, many state they are high risk like some seafood.
From this particular purine table, beans, lentils and peanuts have far less purines than the other food groups mentioned previously. Therefore, they are not as high-risk for gout. Keep in mind, cured or dried food, such as beans, will have a higher purine concentration per weight because of shrinkage.
Some sources caution eating asparagus, cauliflower, peas, chickpeas, spinach and broccoli because it contains more purines than most vegetables. However, the purine amounts for asparagus, spinach and broccoli are less than half of pork or beef. Lastly, a recent study concluded purine-rich vegetables are less of a risk than animal based purines.
Diagnosing Gout In Hands
Gout in the hands is not particularly common.
It usually appears in the big toe, ankles, and knees before advancing to the upper body parts.
If it is in your hands, it often appears in the knuckle first.
The joints will be inflamed, irritated, and youll feel painful swelling and limited mobility.
Your doctor will conduct a physical examination in addition to fluid removal, blood tests, and possibly X-rays to diagnose your gout.
A doctor will help determine it is not another form of arthritis, like rheumatoid arthritis.
If you already know you have gout, additional tests are usually not needed.
Tophi underneath the skin or large painful bumps is a sure sign of inflammation and gout in the hands.
Your doctor will check for tophi and recommend a treatment plan.
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Alcohol And Gout Risk
Although beer may be the worst drink for gout, any alcoholic beverage can trigger gout symptoms in people who are prone to the disease. “Alcohol causes the kidneys to excrete alcohol instead of excreting uric acid. That increases the amount of uric acid in the blood, which could provoke a gout attack in about one or two days,” warns David Freeman, MD, a rheumatologist at the Lahey Clinic in Burlington, Mass.
Nutritional Value And Purine Content In Tuna
Tuna and other cold-water fish are considered healthy, but they have relatively high amounts of purines, which can be problematic if you have gout. Purines are chemical compounds that break down to form uric acid, a substance that triggers gout attacks in people who are susceptible.
When you have gout or kidney disease, consuming too much tuna can result in elevated blood uric acid levels .
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Chicken Beef And Other Meats Appear To Be Foods To Avoid With Gout
The conversion of purines to uric acid, in theory, causes gout.
Therefore high-purine foods are often suspected to trigger symptoms.
Meat, and to a lesser extent seafood, are prime suspects. This includes all the most common meats like beef, chicken, pork and lamb.
The data available somewhat confirms suspicions.
Each additional daily serving of meat or seafood is associated with a 21% or 7% increased risk of gout, respectively . This implies meat could be three times worse than seafood.
There was another similar study that found even greater risks associated with meat intake, but none for seafood. Overall this suggests seafood is far less of a concern than meat .
For those who already have gout, the impact of meat intake on symptoms is even worse. This is likely due to sharper increases in blood uric acid, as well as poorer clearance by the body .
Therefore if you have a history of gout, it is best to dramatically reduce your meat intake, and seafood as well to a lesser extent. Anecdotal evidence suggests avoiding dark part of salmon, and de-veining prawns/shrimp before eating.
You should also buy your meat direct from the butcher where possible, or at least the better quality choices in the supermarket. Sausages and low-quality ground beef may contain traces of organ meat that can cause big problems .
Summary: Frequent consumption of meat is strongly linked with gout risk. The impact of seafood appears far less severe, but there is a link.
First Foods That Can Help
- There are actually several types of foods that may help protect against gout attacks. These include low-fat dairy foods, complex carbohydrates, coffee, and fruits, especially citrus fruits. You should also be sure to get 12 to 16 cups of fluid daily.
- You don’t necessarily have to drink only wateryou can choose non-sweetened juice, tea, and coffee too.
- Any kind of fluid that keeps that blood flowing and urine flowing is a good choice, says Lona Sandon, PhD, RDN, an assistant professor of clinical nutrition at the University of Texas Southwestern Medical Center in Dallas.
Next up: The foods to avoid. Read on for a list of potentially problematic eats.
Scallops are okay for an occasional indulgence, but you should cut back on themand all types of meat and seafoodduring a flare-up, says Sandon. These animal foods are rich in purines, which your body breaks down into uric acid.
You have a little more freedom in your food choices when your gout is at bay, but its still a good idea to keep meat and seafood intake to a minimum4 to 6 ounces daily at most.
All meat is not created equal when it comes to purine content: White meat is generally better than red.
But it is okay to eat some types of red meat once in a while. Youre a bit better off if your occasional indulgence is beef or pork rather than lamb, says Dr. Zashin.
And lamb chops are a better choice than leg meat.
Organ meats, such as liver, kidneys, and sweetbreads, are a major no-no.
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Ten Tips For Beating Gout
If you have gout, use these nutrition tips to lower your risk:
See your GP to check or monitor gout risk factors
Drink up to four cups of regular or decaffeinated coffee a day
Have two to three serves of reduced-fat or skim dairy foods daily
Eat cherries regularly . Add to breakfast cereal and snacks, or mix with yoghurt
Avoid fasting and feasting. Both increase purine turnover and blood uric acid
How Much Is Ok To Eat
Bottom Line: The high nutritional value and gourmet delicacy of organ meats must be reserved as a reward for having diligently brought yourself to a state of being completely gout-proof!
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Look Forward Not Back
Give your taste buds time to adjust. Sugar is a big part of the modern American diet, and your body has become used to the taste, feeling, and consequences of a sugary snack.
It can be difficult to adapt to your new healthier diet, but if you stick with it, soon youll notice the natural sweetness in certain foods, and youll be able to satisfy your sweet tooth while you boost your health with wholesome ingredients.
Attitude and commitment are important parts of any healthy lifestyle change. Stay focused on your goal, appreciate every small gain you make, and keep your health and wellbeing firmly at the top of your priority list.
Realize that sugar is a drug, and cutting it out wont be a walk in the park, but your life will be a lot more comfortable and fulfilling once you reduce your gout risk by limiting your sugar intake.
Aspirin And Diuretics Significantly Increase Gout Risk
Not exactly foods to avoid with gout, but the ingestion of some common medications sharply raise the risk of a gout attack.
Specifically, low doses of aspirin, which one in three middle-aged Americans takes regularly to help prevent heart disease .
The emphasis is on low doses because aspirin has a dual effect on uric acid levels. Very high doses above 3,000 mg promotes excretion of uric acid , whereas low doses prevent excretion .
In a study of 49 elderly patients, just 75 mg of aspirin per day increased blood uric acid levels by 6% within one week. A daily dose of 150 mg kept levels high during the second week, before coming down with 300 mg doses in the third week .
Considering the typical dose for heart disease prevention is 81-325 mg per day, it is no real surprise this dosage is associated with a doubling in gout risk. In fact, even the use of a low-dose aspirin for two consecutive days increases risk of recurrent gout attacks .
Im by no means recommending you cease your medications if you have gout, but its important to understand the pharmaceutical triggers. First speak with your doctor and closely monitor uric acid levels before making any changes.
And if you need a temporary painkiller, choose paracetamol or ibuprofen. No aspirin.
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Treatment For Gout In Hands
Through a combination of diet and medication, gout can be easily managed.
Just like for other joints, gout in the hands can be treated with nonsteroidal anti-inflammatory drugs like ibuprofen and the prescription anti-inflammatory medicationscolchicine and/or indomethacin.
Dont dismiss good old-fashioned ice and rest for alleviating your pain and discomfort.
Intentionally making certain dietary choices, like severely limiting your alcohol consumption and sugar, can also make all the difference in your gout treatment.
Additionally, you can start exercising regularly to try and overcome your gout symptoms.
The Cause Of Gout Is More Than Just Diet
While diet is critical, dont overlook other important factors that affect gout. These include family history, sleep apnoea, and lack of physical exercise to name a few.
And as much as I prefer focusing on what you should eat to prevent health scares, there are just so many clear trigger foods for gout.
Its important to deal with these factors first and foremost.
About Joe Leech, Dietitian
Joe Leech is a university-qualified dietitian from Australia.
He graduated with a Bachelor’s degree in exercise science, followed by a Master’s degree in Nutrition and Dietetics in 2011.
Learn more about him on the About page.
Joe Leech, Dietitian
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Eating High Purine Foods
The biggest and most common trigger for gout is high purine foods. This is because purine breaks down into uric acid in the body which can accumulate and lead to a gout attack. In order to stay healthy with gout, you need to keep an eye on your purine intake making sure you are not consuming too much.
Foods that are high in purine include seafood, alcohol, organ meats, red meat, desserts, and sugary beverages. Some vegetables are also high in purines. That said, they are not as risky to eat since their vitamin and mineral content often counteracts the harmful effect of the purines.
Are Some Types Of Alcohol Better Than Others
It seems that gout attacks are more common in beer and spirits drinkers than in people who drink wine. Many beers contain large amounts of purines, which can lead to elevated uric acid levels in the blood. However, there is no scientific proof that only certain types of alcoholic drinks can lead to gout attacks.
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Sneaky Gout Triggers: Yeast Extract Msg Fructose Sauces
Yeast extract and MSGâYeast extract plus other additives is basically MSG . MSG powder contains purines that immediately metabolizes to uric acid. Although there is proof linking yeast to purine content via alcoholic beverages, only a few sources warn yeast extract as a high-risk gout trigger.
MSG and yeast extract are flavor-enhancers in several products such as processed meat, canned food, bouillon, sauces, soup mixes, gravies, and salad dressings. Since the ingredient percentages are not typically listed or shared, it is very risky for people with chronic gout .
Manufactures will camouflage MSG by listing these these sub-ingredients instead of yeast extract, protein isolate, hydrolyzed vegetable protein, hydrolyzed yeast, and soy extracts.
MSG is not only associated with gout. It is also linked to other health problems and allergies. Known side effects from MSG overconsumption are heart palpitations, headaches, numbness and drowsiness.
Fructose â Even though there is plenty of evidence that fructose causes the body to produce purines, most major sources did not account for it as a major gout trigger. Research from 2016 linked fructose consumption to increased uric acid levels which leads to gout flares.
Sauces â Popular sauces that may cause or contain purines are fish sauce, worcestershire sauce , oyster sauce, barbecue sauce , and Maggi seasoning .
How Our Bodies Produce Uric Acid
A great article written by Dr. Solomon Fourouzesh does a good job of explaining how our bodies produce uric acid:Its a byproduct of cellular breakdown. As cells die off, DNA and RNA degrade into chemicals called purines. Purines are further broken down into uric acid.Fructose increases uric acid through a complex process that causes cells to burn up their ATP rapidly, leading to cell shock and increased cell death.
After eating excessive amounts of fructose, cells become starved of energy and enter a state of shock, just as if they have lost their blood supply. Massive cellular die-off leads to increased uric acid levels.And cells that are depleted of energy become inflamed and more susceptible to damage from oxidative stress.
Fat cells actually become sickly, bloating up with excessive amounts of fat.There is a simple, inexpensive blood test for determining your uric acid level, which I recommend you have done as part of your routine health checkups. Your level should be between 3.0 and 5.5 mg/dl, optimally.There is little doubt in my mind that your uric acid level is a more potent predictor of cardiovascular and overall health than your total cholesterol level is.
Dr. Johnson further elaborates how being sensitized to sugar is so dangerous to your health:
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