Fact: Diet In Addition To Medication And Lifestyle Changes Can Help Manage Gout
Gout treatment aims to get your uric acid level to 6 mg/dL or lower to dissolve or prevent crystals, according to the American College of Rheumatology. Even with super rigid diet restrictions, most gout patients will only be able to lower their uric acid levels slightly as little as 1.0 mg/dL, according to the Gout and Uric Acid Education Society.
Treatment for gout generally falls into two categories: Medications that help reduce pain and inflammation during a gout attack, and medications that help prevent future gout attacks by lowering uric acid levels. According to guidelines from the American College of Rheumatology, people with gout who get two or more attacks a year should be on medication to lower uric acid levels. People with gout tophi or evidence of joint damage from gout should also be taking uric acid-lowering medication.
In addition to medication, your doctor may also suggest a few lifestyle changes to reduce your risk of a gout attack and protect your joints. Exercise, increasing your fluid intake, and losing weight are all helpful to lessen the wear and stress on your joints, adds Dr. Prest.
Try Natural Remedies For Gout
There are some nutrients that could be helpful.
- Proanthocyanidins can help neutralise uric acid and reduce inflammation
- Quercetin can reduce uric acid and may also provide relief
- Omega-3 fatty acids can reduce inflammation, so add a supplement if youre also cutting out certain seafoods that are rich in purines
- Heard about cherry juice for gout? Its proposed that tart cherry juice could temporarily lower blood uric acid levels, but more research is required to fully understand this link5
What Happens At Your Appointment
The GP may ask about your diet and if you drink alcohol.
They may refer you to see a specialist and arrange a blood test and scan. Sometimes a thin needle is used to take a sample of fluid from inside the affected joint, to test it.
The blood test will find out how much of a chemical called uric acid there is in your blood.
Having too much uric acid in your blood can lead to crystals forming around your joints, which causes pain.
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Treating A Gout Attack
Treating an attack of gout doesnt lower your urate levels or stop future attacks. The treatment helps you to manage your symptoms when an attack happens.
The most commonly used drug treatments for attacks of gout are:
Some people will be better suited to NSAIDS, while others will be suited to colchicine. But your preference is also taken into consideration many people with gout quickly learn what works best for them.
In cases where one drug doesnt seem to be working on its own, your doctor might suggest a combination of NSAIDs with either colchicine or steroids.
Non-steroidal anti-inflammatory drugs
Attacks of gout are often treated with NSAID tablets, which can help with pain and reduce some of your inflammation. Ibuprofen, Naproxen and diclofenac are three NSAIDs you could be given.
If youve been prescribed NSAIDs to treat an attack, you should start taking them as soon as you notice signs of one coming on. Your doctor may let you keep a supply so you can start taking them at the first signs of an attack.
The earlier you start treatment, the better.
NSAIDs arent suitable for everyone, so talk to your doctor about them first if you have any other conditions. They can also interact with other drugs, so make sure you talk to a doctor before starting on any new medication.
Colchicine
Colchicine isnt a painkiller, but can be very effective at reducing the inflammation caused by urate crystals.
Colchicine tablets can cause diarrhoea or stomach aches.
Steroids
Who Is Affected By Gout
Gout can affect anyone. It usually occurs earlier in men than women. It generally occurs after menopause in women. Men can be three times more likely than women to get it because they have higher levels of uric acid most of their lives. Women reach these uric acid levels after menopause.
People are more likely to get gout if they have:
- Obesity, or a lot of extra weight.
You are also more likely to develop gout if you:
- Consume a diet high in animal proteins
- Consume a significant amount of alcohol
- Are on water pills .
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Where Can I Get Advice About My Diet
An accredited practising dietitian can provide you with personalised advice to give you the confidence to eat in a way that is best for you. APDs are university-qualified experts in nutrition and dietetics and are committed to the Dietitians Association of Australias Code of Professional Conduct, continuing professional development and providing quality services.
Can Losing Weight Help Gout
If you are overweight, gradual weight loss can help lower uric acid levels and reduce the risk of gout attacks. However, it is important to avoid fasting or crash dieting, where you go without adequate food for long periods and lose weight rapidly. This type of dieting can actually increase uric acid levels and trigger a gout attack. A combination of balanced healthy eating and regular physical activity is the best way to lose weight safely. Talk to your doctor or see a dietitian for advice.
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Gout Symptoms And Complications
Gout is not gout until symptoms occur. When they do, they usually come on suddenly and, at least initially, affect a single joint. Within hours, that joint becomes red, swollen, hot, and painful they’re called gout attacks for a reason. It’s easy to mistake a gout attack for a localized infection of a joint. The metatarsophalangeal joint at the base of the big toe is often the site of the first attack, but the knees, ankles, and joints between the many small bones that form the foot are also common sites. People who already have osteoarthritis the most common form of arthritis often experience their gout attacks in the joints of the finger
Cherries Uric Acid And Gout Attacks
A painful gout attack occurs when excess uric acid in the body forms crystals that collect in one or more joints, causing inflammation. Cherries have been shown to lower the levels of uric acid in the body and therefore might lower the risk of a gout attack.
See Hyperuricemia – High Uric Acid Levels and Gout
For example, one large online survey3 asked people with gout to report their experiences over the course of one year. People answered questions about their intake of cherries and cherry extract, alcohol, and certain foods and medications in the two days leading up to a gout attack.
The survey results found:
- People who ate cherries or supplemented with cherry extract were 37% less likely to report gout attacks than people who had no cherry intake.
- People who ate cherries or supplemented with cherry extract and also took allopurinol, a drug prescribed to reduce urate in the blood, were 75% less likely to report gout attacks than people who did neither.
For this study, researchers defined one serving of cherries as ½ cup, or about 10 to 12 cherries. More than 3 servings did not seem to provide additional benefits.
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Characteristics Of The Trials
The literature search retrieved 2021 references, of which 20 were duplicates 1856 articles were rejected on reading their titles and abstracts, and 145 articles were identified for detailed review. Finally, 9 articles were included .
Risk of bias summary.
A total of nine RCTs with 1156 participants were included in this review. Seven trials were conducted in China , 1 in the USA , and 1 in New Zealand . All the studies were published from 2008 to 2019. Seven studies evaluated herbal therapies, with the remaining two evaluating skim milk and cherry extract. Six trials had two arms two trials had three arms one trial had four arms. Five trials reported natural product formulation in decoction, two in capsules, and one in powder. Five trials recorded gout flare-up four trials did not record gout flare-up. Five trials reported no AEs four trials reported AEs. Two trials assessed the compliance of patients .
Does Fructose Cause Gout
Fructose is a sugar that is found in fruits and vegetables. It is also found in high levels in foods sweetened with corn syrup, such as bread, cereal, soft drinks and fruit juices. An American study found that men who drank five to six servings of fructose-sweetened soft drinks per week were more likely to have gout. However there is no research showing that fructose actually causes gout. Cutting down the amount of food artificially sweetened with high fructose corn syrup may be beneficial for your overall health. However naturally occurring fructose in fruit and vegetables also provides general health benefits and should not be completely avoided without advice from your doctor or dietitian.
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How Is Gout Affected By Diet
Gout is a type of arthritis that is associated with elevated levels of uric acid in the blood. High levels of uric acid can cause crystals to form in the joints, causing pain and swelling. Uric acid is a normal waste product formed from the breakdown of food, particularly compounds called purines. It is believed that lowering uric acid levels through small changes in your diet may help reduce the chance of future gout attacks.
A healthy, balanced diet may help reduce the risk of gout attacks.
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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Fact: Not Having Symptoms Doesnt Mean Your Gout Is Gone For Good
Gout attacks typically last one to two weeks and then subside. Some people can go months before getting another gout attack others may get them more frequently. If gout is not properly treated such as with taking medication to reduce uric acid levels gout attacks can start to occur more frequently and affect more joints.
In between gouts attacks, you may have no painful symptoms and feel more or less fine. But your uric acid levels may still be high, which is why its important to stick to your treatment plan: If you are on a uric acid-lowering drug, you have to continue to take it every day, says Nilanjana Bose, MD, MBA, a rheumatologist at the Rheumatology Center of Houston in Texas. If you start and stop it, your uric acid fluctuates, and thats the perfect setup for another gout flare.
What Are Causes Of Gout
Uric acid is generated as we metabolize the food we eat and as the body’s tissues are broken down during normal cell turnover. Some people with gout generate too much uric acid and are medically referred to as “over-producers.” Other people with gout do not effectively eliminate their uric acid into the urine and are medically referred to as “under-excreters.”
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How Will Gout Affect Me
Attacks can vary from person to person. Some people only have an attack every few years, while others have attacks every few months.
Without medication attacks tend to happen more often and other joints can become affected.
Having high urate levels and gout for a long time can lead to other health problems, including:
- narrowing of the arteries – which can lead to an increased risk of stroke or heart attacks or other heart problems
- osteoarthritis, which occurs when the urate crystals and hard tophi cause joint damage.
- an increased risk of developing kidney disease or worsening of the condition if you already have it
- kidney stones
- an increased risk of some cancers, especially prostate cancer
- mental health problems, including depression
- underactive thyroid
- erectile dysfunction in men.
If you take medication to lower your urate levels, and have a healthy diet and lifestyle, most of the damage and complications caused by gout can be stopped.
Treatments for gout are incredibly successful. There are two main parts to treating gout, which are:
- treating the acute attack
- treatments to prevent future attacks.
Gout And Supplements: What You Need To Know
Here’s what you should know about supplements to ease gout symptoms.
1. Gout and Supplements: What You Need to Know
2. Discuss with the Doctor
3. Get Going with Good Fats
4. Reduce Pain with GLA
5. Make a Move for MSM
6. Get a Folic Acid Fix
7. Rev up the Vitamin C
8. Consider Eastern Medicine
9. Embrace Herbs
10. Get Charged on Cherries
11. Learn More
Complementary Therapies
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Fact: You Can Eat Meat And Other High
Dr. Prest says cutting back on purine-rich foods can help manage gout and may help reduce symptoms during a flare or gout attack. But you dont have to eliminate red meat or other high-purine foods entirely just limit your intake of them. Dr. Bose suggests you keep a food and symptom diary to help identify triggers. That way when you have a gout flare, you know which foods to cut back or avoid until your symptoms improve.
Assessment Of Risk Of Bias In Included Studies
The potential bias of each trial was assessed using Cochrane Risk of Bias Tool for Randomized Controlled Trials by two reviewers independently in the following domains: risk of selection, reporting, performance, detection, attrition, and other sources of. Each domain was assessed as either high,low, or unclear bias. Any discrepancy was resolved by consensus or resort to a third review author.
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What Are The Symptoms Of Gout
An episode of gout is called a gout attack. Gout attacks are very painful and can happen quite suddenly, often overnight. During a gout attack, symptoms in the affected joint may include:
- Intense pain.
- Tenderness, even to light touch, such as from a bedsheet.
- Warmth, or a feeling like the joint is on fire.
- How long does a gout attack last?
A gout attack can last a week or two. Between gout attacks, you may have no symptoms at all.
Sodium And Uric Acid Levels
When the team examined the interaction between sodium levels and uric acid, the findings surprised them they were the opposite to expectations. During the low salt phase of the DASH diet, uric acid levels were at their highest during the medium and high sodium diets, levels were reduced.
These changes due to salt intake were small but significant.
The authors, however, do not recommend that people with gout start adding salt to their diet. More than 70 percent of people with gout have high blood pressure, says Dr. Juraschek. If one was to consume more sodium to improve uric acid, it could worsen blood pressure.
The results of the analysis are published this week in the journal Arthritis and Rheumatology. Although further studies will be necessary to confirm the findings, the researchers are optimistic. If the DASH diet can prevent or at least minimize gout flare-ups, it would be of substantial benefit for gout sufferers.
Gout currently costs the healthcare system of America around $7.7 billion. A dietary change that controls gout while simultaneously controlling hypertension and cholesterol levels could make a significant difference to millions of lives.
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Fact: Quitting Drinking Can Help Reduce Not Stop Flares
Not drinking alcohol excessively is good for your overall health, and a positive step toward gout management, says Dr. Bose, as alcohol molecules tend to increase uric acid levels. And research supports this. A 2018 review published in the Asia Pacific Journal of Clinical Nutrition Researchers analyzed 19 studies that evaluated dietary factors and risk of gout. The researchers found drinking alcohol to be positively correlated to high uric acid levels.
But abstaining from alcohol completely wont cure or prevent gout from occurring, says Dr. Prest. If you are diagnosed with gout, you should limit beer, which is extremely high in purines, and other types of alcohol. Talk to your doctor to determine how much alcohol and what type is appropriate for you. And if you are having a gout flare, stick to water and tea.
Avoid Consuming Large Amounts Of Food High In Purines
Purines are chemical compounds found in some foods and drinks.
Gout sufferers find the chemical harder to metabolise, so avoiding consuming large amounts of high purine foods is advisable.
Beef, lamb, game, offal, and some seafoods such as mackerel, mussels, anchovies, sardines, crab and herring are all examples.
High-fat dairy products, yeast, beer and gravy are also sources.3,4
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How To Prevent Gout
Some things that increase the risk of gout are out of your control your age, gender and family history for example.
However, your body weight and diet are also important factors.
The rise in gout in recent years is linked to our widening waistlines.
Being overweight, eating fatty foods and consuming too much alcohol are established triggers of flares of gout.
And although losing weight and avoiding certain foods may not be the magic answer to how to get rid of gout, it may help to reduce the likelihood of a future attack.