What Are The Signs And Symptoms Of Gout
Gout flares start suddenly and can last days or weeks. These flares are followed by long periods of remissionweeks, months, or yearswithout symptoms before another flare begins. Gout usually occurs in only one joint at a time. It is often found in the big toe. Along with the big toe, joints that are commonly affected are the lesser toe joints, the ankle, and the knee.
Symptoms in the affected joint may include:
- Pain, usually intense
Can I Drink Alcohol
Drinking alcohol can increase your risk of a gout attack as it can raise the level of uric acid in your blood. While it is possible to control gout attacks without completely cutting out alcohol, try to reduce the amount of alcohol you drink and avoid binge drinking . Talk to your doctor or read the Australian government guidelines on recommended alcohol intake.
Emmitt Smith Gains Ground On Gout
The 4 Stages of Gout Heres whats happening with each stage of gout, and how to keep it from progressing to the next level. Its not enough just to limit those food items that are particularly bad for gout, such as meat, alcohol, and sugary drinks. Although switching to a different blood-pressure drug may help, some people get the best results with a diuretic, Dr. Saag says. Please see the Medication Guide and Prescribing Information for more information.
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Foods To Avoid When You Have A Gout Flare Up
Gout is caused by the buildup of uric acid in the bloodstream, and there are certain foods that promote the production of uric acid because theyre high in purine. If youve had gout flare ups in the past, its likely youll have them again, and your food choices are critical for keeping your joints free of pain.
Vegetables Like Beetroot And Gout
Most vegetables fall into the low-purine category, so vegetables are not usually on the list of foods to avoid with gout. However, there are a few vegetables containing a moderate amount of purines that people with gout should be aware of.
According to the American Academy of Family Physicians, moderate-purine vegetables include:
- Asparagus
- Cauliflower
- Mushrooms
Simply because these vegetables contain moderate amounts of purines does not mean that people with gout should avoid them altogether. According to Mayo Clinic, the purines in vegetables do not increase the risk of gout or recurring gout attacks.
Similar to purines, oxalates are another type of natural substance that increases the uric acid content in the body. Vegetable sources of oxalates include rhubarb, turnips, beets and okra. This is why there is speculation of a negative association between beetroot and gout. Since beets contain oxalates, beetroot and gout may not not be a good combination. The same is true of okra. Though it has many health benefits, it is not true that okra is good for gout.
If you have gout, you may choose to consume or avoid vegetables that contain purines and oxalates.
Read more:List of Foods That Raise Uric Acid
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No Gout About It: Decreasing Flare
Did you know diet can impact the frequency of gout flare-ups? In combination with medical treatment and a healthy lifestyle, a research-backed meal plan can support your joint health. Were serving up the foods to avoid and the foods to enjoy so you can lower your number of flare-ups.
Medications That Can Trigger Gout
Some medications can trigger gout symptoms. This includes common pain medications. Even small amounts of these drugs can impact gout. Your doctor may recommend changing these medications if you notice more gout symptoms.
Aspirin or acetylsalicylic acid raises uric acid in your blood. Even low doses of aspirin can trigger gout. Research shows that this effect of aspirin is more common in women than in men.
Diuretics or water pills help to treat conditions such as high blood pressure and edema or swelling in the legs. These medications work by getting rid of excess water and salt from the body. However, they can also cause a side effect of too much uric acid in the body, triggering gout. Diuretic drugs include:
- chlorothiazide
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Avoid Sweets And Sodas
Unlike fruit with its natural sugar, artificial sugars are widely recognized as gout flare dangers. Consuming too many sugary sodas has been found to provoke attacks, but no association has been found with artificially sweetened sodas. Other foods loaded with high-fructose corn syrup can also bring on gout pain.
Alcohol Because Of The Yeast
Alcohol was on the avoid or high-risk list by every major health source referenced. Abstaining from drinking could be a tough ask for many. The point here is there is plenty of scientific evidence confirming drinking alcohol directly increases uric acid levels that induces gout.
Yeast, in general, contains a high amount of purines. The most common gout triggers made with yeast are beer, liquor, wine, cider, marmite, vegemite, processed meats, cured meats, and extracts.
Brewerâs yeast is used to make drinking alcohol. It is the main ingredient that contains purines. Beer gets the bulk of its purine content from brewerâs yeast, which has about three times the purines as bakerâs yeast.
Some sources stated that wine is less of a risk than beer and liquor. However, a 2015 study published by the American Journal of Medicine stated otherwise.
Episodic alcohol consumption, regardless of type of alcoholic beverage, was associated with an increased risk of recurrent gout attacks, including potentially with moderate amounts. Individuals with gout should limit alcohol intake of all types to reduce the risk of recurrent gout attacks.
-Am J Med. Author manuscript available in PMC 2015 Apr 1.
Another point was that drinking alcohol hinders the kidneysâ ability to remove waste products such as uric acid. Drinking alcohol can also cause dehydration, which leads to unnecessary uric acid production.
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Foods That Could Cause Gout And Resulting Pain
Gout is a type of arthritis that causes individuals severe pain, redness, and tenderness in affected joints. This inflammatory disease commonly develops in individuals who have high levels of uric acid in their blood. The acid creates needle-like crystals that get trapped in the joints. Studies find that certain types of food irritate this condition, causing individuals to suffer severe, sudden episodes.
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 .
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How Is Gout Treated
Gout can be effectively treated and managed with medical treatment and self-management strategies. Your health care provider may recommend a medical treatment plan to
- Manage the pain of a flare. Treatment for flares consists of nonsteroidal anti-inflammatory drugs like ibuprofen, steroids, and the anti-inflammatory drug colchicine.
- Prevent future flares. Making changes to your diet and lifestyle, such as losing weight, limiting alcohol, eating less purine-rich food , may help prevent future attacks. Changing or stopping medications associated with hyperuricemia may also help.
- Prevent tophi and kidney stones from forming as a result of chronic high levels of uric acid. Tophi are hard, uric acid deposits under the skin. For people with frequent acute flares or chronic gout, doctors may recommend preventive therapy to lower uric acid levels in the blood using drugs like allopurinol, febuxostat, and pegloticase.
In addition to medical treatment, you can manage your gout with self-management strategies. Self-management is what you do day to day to manage your condition and stay healthy, like making healthy lifestyle choices. The self-management strategies described below are proven to reduce pain and disability, so you can pursue the activities important to you.
Instead Of Gravies And Sauces Use Vegetable Broth Or Dairy
Since they are made with the fat and drippings from meat and poultry, gravies and sauces made from beef, pork, and poultry should be avoided because they contain high amounts of purine. Try making sauces with vegetable broth or tomato sauce. Dairy-based sauces, such as a low-fat cream sauce, are also safe alternatives.
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Processed Foods And Refined Carbs
The modern Western diet is often high in processed foods and refined carbohydrates. In addition, processed foods and refined carbohydrates have been linked to an increased risk of type 2 diabetes, heart disease, and weight gain.
A 2017 study looked at gout incidence in people who followed either a Western diet or the Dietary Approaches to Stop Hypertension diet. The researcher found the DASH diet was associated with a lower risk of gout, whereas the Western diet was associated with a higher risk of gout.
To help prevent gout symptoms, its best to limit highly processed foods and beverages and foods high in refined carbohydrates, such as sweets, baked goods and pastries, chips, crackers, cookies, candies, soda, ice cream, white breads, and some pre-made frozen meals.
Eating highly processed foods and refined carbohydrates in moderation will not only help with your gout, but your overall health as well.
Can Gout Be Cured
Gout cannot be cured. However, most patients can manage their symptoms and largely avoid gout flare-ups. Your doctor will discuss diet and lifestyle changes that may help. If symptoms are intense, persistent, or highly resistant to these changes, prescription medication can reduce the level of uric acid in the body. Anti-inflammatory medication is used during attacks.
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How Does Diet Impact Gout
Though diet isnt the only factor that leads to gout, it can play a role. To know why, its important to understand what causes gout in the body .
Gout occurs when an excess of uric acid in the body crystallizes in the joints, most commonly in the big toes, fingers, wrists and knees. These sharp crystals cause sudden swelling and are the source of the pain associated with a gout attack.
Uric acid is produced naturally when the body breaks down purines. Most purine is produced inside the body, though purines are also contained in some foods. Normally, uric acid doesnt cause problems because the body is able to secrete it easily through urine. However, some people produce too much uric acid or are unable to secrete enough of it. In these cases, the result is gout.
Though the body produces uric acid naturally, making gout largely unavoidable, consumption of foods rich in purines can exacerbate the problem. In fact, one study found that high purine intake was associated with five times greater risk of recurrent gout attacks .
In addition to foods rich in purine, those with gout should also avoid foods with lots of added sugars and refined carbs. Though more research needs to be done, reducing glycemic index seems to correlate with lower uric acid levels .
Or Dilute Your Favorite Cocktails
Another tip is to make a cocktail with your favorite spirit, such as vodka or rum, and dilute the drink with as much water or non-alcoholic mixer as possible. Create your own spritzer by adding extra club soda, seltzer, and/or lime juice to limit the dehydrating effects of the alcohol. Avoiding alcohol altogether, especially beer, is the best way to avoid a flare of your gout.
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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.
Should I Cut Out Purine
There is very little scientific proof that avoiding the purine-rich foods listed above can successfully reduce gout attacks. You may miss out on important nutrients and vitamins by completely cutting these foods from your diet.
If you notice certain foods trigger your gout attacks, you may benefit from cutting down the amounts of those foods in your diet. However not all purine-rich foods are thought to cause gout. For example, a number of vegetables are also rich in purines but appear less likely to cause gout than diets containing meat and shellfish.
Dairy foods, which can contain purines, actually appear to lower the risk of gout. For most people with gout, a healthy balanced diet is all that is needed, alongside medicines to reduce uric acid levels. Most people taking medicines to reduce uric acid levels find they can still eat purine-rich foods without attacks of gout by being careful with the quantity they eat.
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Do I Need To Stop Eating Meat If I Have Gout
No, but practice moderation, Dr. Burg reiterates. Avoid organ meats such as liver because they have higher levels of purines, which can cause flare-ups. Moderate intake of lean meats such as chicken and turkey should not affect your condition. Seafood such as shrimp and lobster tends to be higher in purines, though, so dont make it a regular part of your diet.
Follow A Healthful Pattern
Vegetables, cherries, high vitamin C foods such as citrus, and plant oils, including olive, sunflower and soy have all been associated with a lower risk of gout.
Since this gout-specific research has not been completed on all common foods, and because an emerging theme is that most plant foods are protective, a more comprehensive gout-prevention strategy may be to emphasize a plant-based pattern of eating, rather than a focus on individual foods.
In fact, the Dietary Approaches to Stop Hypertension diet, a commonly prescribed diet pattern that provides this emphasis, has been associated with a lower risk of gout. This diet pattern includes a strong emphasis on fruits and vegetables, daily inclusion of legumes, nuts, seeds, whole grains and low-fat dairy products, limited portions of meat, chicken and fish, and a low intake of sodium and sweetened beverages.
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Health Conditions And Treatments
Certain drugs, health problems, and lifestyle choices can trigger gout, too.
Medications. Aspirin, certain diuretics for high blood pressure , and drugs for people who had organ transplants can trigger gout. After a flare, go over all the medicines you take with your doctor. If needed, they should be able to find another option.
Being overweight. When you slim down, you can protect yourself from another flare.
Fasting or crash diets. If you lose weight too quickly or fast, you could raise your chances of an attack.
High blood pressure, kidney disease, diabetes, and heart disease. These health conditions make you more likely to have gout, especially if you donât get treatment. Work with your doctor to keep them under control.
Injuries or surgery. When your body is stressed or sick, youâre more likely to have a flare. Of course, you canât always avoid this trigger. But if you need to have an operation, make sure your doctor knows youâve had gout in the past.
Do Certain Foods Cause Gout
There are many misconceptions about diet and gout. For example it is commonly thought that foods such as citrus foods cause gout. There is no evidence that this is true. However several studies have shown that people with gout are more likely to eat certain foods. These foods tend to contain high levels of purines, a substance that can be made into uric acid in the body. Purine-rich foods include:
- meat particularly red meat and offal, such as liver, kidneys and heart
- seafood particularly shellfish, scallops, mussels, herring, mackerel, sardines and anchovies
- foods containing yeast such as Vegemite and beer.
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