What Is The Gout Diet
Gout is caused by high uric acid levels in your blood. Extra uric acid forms sharp crystals that settle in your joints, causing swelling and pain. But you can help reduce the amount of uric acid in your body by maintaining a low-purine diet. Reducing uric acid levels can help prevent new crystals from forming, reducing gout attacks.
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 .
Another type of medication known to trigger gout is diuretics. They are typically used to treat high blood pressure and oedema, and if feasible should be discontinued in gout sufferers.
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.
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
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Shopping List For Gout
What to put in your cart and what to pass up when planning your gout diet.
A diet to lower uric acid levels, along with medications prescribed by your doctor, makes gout one of the most controllable forms of arthritis. While you should always discuss the merits and drawbacks of specific foods with your doctor, use this shopping checklist as a general guide to food choices to improve your overall health, lower uric acid levels and reduce your risk of painful gout attacks. Put in Your Cart
- Skim milk.
- Low-fat dairy products .
- Whole-grain products .
- Plant oils .
- Vegetables.
- Cherries.
- Vitamin C supplements .
- Coffee .
- Water bottles .
Pass Up
- Red meat and organ meats .
- Shellfish such as shrimp and lobster.
- Refined carbohydrates .
- Processed foods .
- Sugary beverages.
- Alcohol .
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What Is The Fastest Way To Get Rid Of Gout
Medications for acute gout attack: These medications are usually prescribed to treat an acute attack of gout:
- Nonsteroidal anti-inflammatory drugs : These can quickly relieve the pain and swelling of an acute gout episode. They can shorten the attack, especially if taken in the first 24 hours.
- Corticosteroids: These drugs can be taken by mouth or injected into an inflamed joint to quickly relieve the pain and swelling of an acute attack. Corticosteroids usually start working within 24 hours after they are taken.
- Colchicine: An anti-inflammatory medicine that works best if taken within the first 24 hours of a gout attack.
Medications for reducing uric acid levels: These are usually prescribed after an acute attack ends to reduce uric acid levels in the body to prevent future attacks.
- Colchicine: Regular and low doses of colchicine may be given along with other medications below to prevent flare-ups.
- Allopurinol: It reduces uric acid production in the body.
- : It reduces uric acid production in the body.
- Probenecid: It acts on the kidneys to help eliminate uric acid.
- Pegloticase: This is a medication that is injected every 2 weeks. It reduces uric acid quickly and used when other medications fail.
Lifestyle and home remedies to treat acute gout and can prevent recurrent attacks:
- Limiting or avoiding alcohol consumption and drinks sweetened with fructose
- Limiting intake of foods high in purines, such as red meat, organ meats, and seafood
- Drinking plenty of fluids
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Hot And Cold Compresses
Switching between a hot compress for three minutes and a cold compress for 30 seconds on the affected area can help reduce pain and swelling that occurs during a gout attack.
In most people, a first acute gout attack comes without warning, and there arent any other symptoms of high uric acid. Prevention efforts for gout are focused on preventing future attacks or lessening their severity.
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What Else Should I Ask My Healthcare Provider About Gout
Consider asking your healthcare provider:
- What is causing the gout?
- Do I have any joint damage?
- What can I do to prevent future attacks?
- Can any gout medications help me?
- How long will I need to take gout medications?
A note from Cleveland Clinic
Gout is a painful form of arthritis. Extra uric acid in your body creates sharp crystals in the joints, leading to swelling and extreme tenderness. Gout usually starts in the big toe but can affect other joints. Gout is a treatable condition, and the uric acid level can be decreased by medication and lifestyle changes. Talk to your healthcare provider about medications that can reduce uric acid levels. They can also discuss changes you can make to your diet and lifestyle to prevent and reduce gout attacks.
Last reviewed by a Cleveland Clinic medical professional on 11/15/2020.
References
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Gout Treatment And Diet
Avoiding purine-rich foods is only part of your gout treatment. Losing weight can also help your gout symptoms. Just be sure your weight loss is slow and steady if you lose weight too rapidly, the amount of uric acid in your body may increase. Overall, the best diet is one based on foods that are low in fat and sugar and high in fiber. Talk to your doctor about how to create a gout diet thats right for you.
Reducing Inflammation And Preventing Damage
A balanced, nutritious diet will give the body the tools it needs to prevent further damage to the joints, which is essential for people with osteoarthritis.
Some foods are known to reduce inflammation in the body, and following an anti-inflammatory diet can improve symptoms. Eating enough antioxidants, including vitamins A, C, and E, may help to prevent further damage to the joints.
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Weight Management And Exercise
The Arthritis Foundation emphasizes how important it is for people with gout to manage their weight.
Obesity is a risk factor for developing gout. If a person with gout has excess weight, losing a few pounds can help them:
- reduce pressure on painful joints
- lower the risk of heart disease
- build strength and flexibility
To achieve this, the person should ask a doctor about a suitable diet to help them manage their weight and an exercise plan.
Anyone who smokes should also ask a doctor to help them with a plan to quit.
The Mediterranean diet contains plants, grains, and healthy fats. It may help people manage their weight while encouraging them to eat healthily.
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.
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Tuesday Q & A: Paying Attention To Diet May Help Prevent Gout Flare
DEAR MAYO CLINIC: What causes gout? I have had one attack and am not on treatment but am watching my diet. Is it possible that I wont have additional attacks or need treatment for it, or is it likely to come back again?
ANSWER: Gout is a form of arthritis that happens when sharp particles, called urate crystals, build up in a joint, causing severe pain, tenderness and swelling. As in your situation, treatment usually is not recommended after just one attack. But gout can come back. Being careful about what you eat may help prevent another gout flare-up. If it does come back, medication is available that can effectively control gout.
The urate crystals that lead to gout form when you have high levels of uric acid in your blood. Your body produces uric acid when it breaks down purines substances found naturally in your body, as well as in certain foods. Uric acid usually dissolves in your blood and passes through your kidneys into your urine. But sometimes your body either makes too much uric acid or your kidneys flush out too little uric acid. When this happens, gout is often the result.
Certain foods and beverages have been shown to increase the risk of gout attacks, including those that are rich in fructose, such as fruit-flavored drinks, non-diet soda and many processed foods. Seafood, fatty fish and red meat also are associated with increased risk of gout.
How Is Gout Diagnosed
In a clear-cut case, a primary care physician can make the diagnosis of gout with a high level of confidence. However, often there are two or more possible causes for an inflamed toe or other joint, which mimics some of the symptoms of gout, so tests to identify the presence of uric acid is performed.
Since the treatment for gout is lifelong, its very important to make a definitive diagnosis. Ideally, the diagnosis is made by identifying uric acid crystals in joint fluid or in a mass of uric acid . These can be seen by putting a drop of fluid on a slide and examining it using a polarizing microscope, which takes advantage of the way uric acid crystals bend light. A non-rheumatologist, when possible, can remove fluid from the joint by aspirating it with a small needle and send it to a lab for analysis. A rheumatologist is likely to have a polarizing attachment on their microscope at their office. Gout crystals have a needle-like shape, and are either yellow or blue, depending on how they are arranged on the slide .
Figure 11: Uric Acid Crystals Under Polarizing Light Microscopy
There are many circumstances where, however ideal it would be, no fluid or other specimen is available to examine, but a diagnosis of gout needs to be made. A set of criteria has been established to help make the diagnosis of gout in this setting .2
Table 1: Diagnosing gout when no crystal identification is possible
Ideally, 6 of 10 features will be present of the following:
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How Does Indian Keto Diet Work
If you are a beginner in Indian, then you need to understand that Keto diet works on the principle of body burning fats for fuel, instead of carbohydrates. Lets simplify it further. Our body is designed to convert carbohydrates that we eat into glucose and use it for fuel. Glucose is then carried into the bloodstream by insulin to keep our body powered. Simply put, the glucose level in our body is directly promotional to the amount of carb intake Keto breaks this rule of thumb, as the diet encourages extremely low carb intake to deliberately create a carb deficit in your body. When carbs are limited, your body seeks another source of energy to keep things running.
This is where fats stored in your body come into play. Due to low or no carbs, the liver starts utilizing fats stored in your body and converts them into ketones as an immediate source of energy.
This process is called Ketosis. In Ketosis, your body is completely dependent on fats for fuel. When your metabolic rate increases, your body burns more and more fat. Reaching this state is the sole purpose of the Ketogenic diet.
What You Can Do
- Write down your symptoms, including when they started and how often they occur.
- Note important personal information, such as any recent changes or major stressors in your life.
- Make a list of your key medical information, including any other conditions for which youre being treated and the names of any medications, vitamins or supplements youre taking. Your doctor will also want to know if you have any family history of gout.
- Take a family member or friend along, if possible. Sometimes it can be difficult to remember all the information provided to you during an appointment. Someone who accompanies you may remember something that you missed or forgot.
- Write down questions to ask your doctor. Creating your list of questions in advance can help you make the most of your time with your doctor.
Questions to ask the doctor at the initial appointment include:
- What are the possible causes of my symptoms or condition?
- What tests do you recommend?
- Are there any treatments or lifestyle changes that might help my symptoms now?
- Should I see a specialist?
Questions to ask if youre referred to a rheumatologist include:
If any additional questions occur to you during your medical appointments, dont hesitate to ask.
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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.
Lifestyle And Home Remedies
Medications are often the most effective way to treat gout attacks and prevent recurrent symptom flares. However, lifestyle choices also are important, and you may want to:
- Choose healthier beverages. Limit alcoholic beverages and drinks sweetened with fruit sugar . Instead, drink plenty of nonalcoholic beverages, especially water.
- Avoid foods high in purines. Red meat and organ meats, such as liver, are especially high in purines. Purine-rich seafood includes anchovies, sardines, mussels, scallops, trout and tuna. Low-fat dairy products may be a better source of protein for people prone to gout.
- Exercise regularly and lose weight. Keeping your body at a healthy weight reduces your risk of gout. Choose low-impact activities such as walking, bicycling and swimming which are easier on your joints.
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