In The Real World Is This Study A Game
While the findings could be seen as game-changing, we dont know how much impact theyll actually have. For example, if every household in the country received this information, how many people would switch to the DASH diet and stick with it? How many people who usually drink alcohol would give it up? And how many overweight and obese individuals would manage to achieve and maintain a normal BMI?
As for diuretic use, doctors often prescribe diuretics, such as hydrochlorothiazide or furosemide, for people with high blood pressure and other health conditions. The risk of future gout is unlikely to alter this. However, there are many alternative medications available to lower blood pressure. So if gout is diagnosed in a person taking a diuretic, switching to a different drug is worth considering.
Take Care Of Yourself
Get regular exercise and stay at a healthy weight. If you’re overweight or obese, your body has more uric acid. Weight loss may help lower it.
Get other health conditions under control. Gout is linked with high blood pressure, diabetes, metabolic syndrome, heart disease, and kidney disease. If you have any of those problems, get treatment.
Ask your doctor if you need to make changes to the medications you take. Aspirin, diuretics for high blood pressure, and drugs for people whoâve had an organ transplant can trigger gout. Your doctor can help you find other alternatives.
Drink more fluids. You may lower your odds of gout if you drink at least eight glasses of fluids a day. Make sure that at least half of that is water.
Starting On Uric Acid Medicine
Your doctor, nurse or pharmacist should start you on a low dose and slowly build up to a stronger dose. Remember when you start on uric acid medicine you also need to take a low dose of a gout attack medicine such as colchicine. You will be taking at least two medicines for up to 6 months. Some people might have to take three medicines.
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Dietary Causes Of Gout And Gouty Arthritis
Some people with gout find it helpful to eliminate specific high-purine foods from their diet. Certain high-purine foods may trigger gout attacks in some people.
Most people with gout will still need medication even if they follow a diet for gout.
Dietary changes alone can lower your uric acid levels by up to 15 percent, according to the Institute for Quality and Efficiency in Health Care , an independent scientific institute that evaluates the benefits and harms of medical interventions.
Its not necessary to avoid all high-purine foods if you have gout. Studies have shown that purine-rich vegetables dont trigger gout. And certain high-purine foods can be a good source of lean protein to incorporate into your diet.
Purine-rich vegetarian foods to include in your diet are:
- Peas
- Alcoholic beverages, especially beer, whiskey, gin, vodka, or rum
- Sugary drinks, including sodas, juices, energy drinks
- Coffee and other caffeinated beverages. While some studies show that caffeine can actually protect against gout pain, others find that sudden spikes in caffeine intake can trigger a gout attack.
Checking Your Uric Acid Level
When you take uric acid medicine your target is to get your uric acid levels down to 0.36. You need to get your uric acid level checked regularly. You might need to take a stronger dose of your uric acid medicine if your levels dont come down. If you have tophi you might need to get your uric acid levels down to 0.30 to get rid of your tophi.
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How To Know If Your Gout Is Progressing
As you become more familiar with gout symptoms, you may be able to sense that a gout attack is coming on. Worsening of pain, swelling, redness, and warmth of the affected joint during the attack is the sign of progression of that attack, Dr. Meysami says.
In addition, the disease overall may progress with recurrent or more frequent gout attacks with longer duration, the involvement of more joints, and the presence of tophi, Dr. Meysami says.
If you have more than one gout flare a year, its really important to get on a regular gout medication, says Dr. Fields.
Celery Or Celery Seeds
Celery is a food traditionally used to treat urinary issues. For gout, extract and seeds of the vegetable have become popular home remedies.
Experimental use is well-documented, though scientific research is scant. Its thought that celery may reduce inflammation.
Adequate celery amounts for treating gout arent documented. Try eating celery many times per day, especially raw celery sticks, juice, extract, or seeds.
If purchasing an extract or supplement, follow label directions closely.
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What Increases Your Chances For Gout
The following make it more likely that you will develop hyperuricemia, which causes gout:
- Being male
Getting The Right Diagnosis
If you experience joint issues, receiving a timely, accurate diagnosis from a rheumatologist is essential. You want to be sure you receive proper treatment and prevent long-term damage or complications.
We will use all the tools we have to get an accurate diagnosis, says Zhanna Mikulik, MD, a rheumatologist at the Ohio State Wexner Medical Center in Columbus. Your rheumatologist will look at what joints are affected, what the pattern is, and how it started.
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Rheumatoid Arthritis Vs Gout: Causes And Risk Factors
Rheumatoid arthritis is an autoimmune disease, meaning, the bodys immune system attacks the joints wrongfully, setting off the symptoms associated with rheumatoid arthritis. Inflammation causes the synovium to thicken, which over time destroys the cartilage, allowing bones to rub together.
Risk factors for rheumatoid arthritis include being a female, being over the age of 40, having a family history of RA, smoking, being exposed to environmental pollutants, and being obese.
Gout is a result of crystallized uric acid, which occurs when a person has high levels of uric acid in their blood. Uric acid results from the breakdown of purines found in some foods like red meat and alcohol.
Normally, uric acid passes through our systems and is released through our urine, but with excessively high levels, the uric acid can build up and crystallize in joints and surrounding tissues, causing discomforting symptoms.
Risk factors for gout include eating a diet high in uric acid-promoting purines, being overweight or obese, having an untreated medical condition like hypertension, taking certain medications, having a family history of gout, being male over the age of 40, and recovering from a recent surgery or trauma.
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If You Have Rheumatoid Arthritis Avoid Soda And Other Sugary Beverages
Add rheumatoid arthritis to the long list of conditions that are made more difficult to manage by eating a diet high in added sugar. In a 2018 study published in Arthritis Care & Research, researchers polled 217 individuals with RA about the ways 20 common foods affected their RA symptoms. Sugar-sweetened soda was the most troublesome food, with 12.7 percent of respondents saying it worsened their symptoms. Desserts came in as a close second, with 12.4 percent of respondents linking sweet treats to RA flare-ups.
Another study, published in 2014 in The American Journal of Clinical Nutrition, tried to determine if drinking sugar-sweetened soda increased risk for developing RA in women. They followed nearly 187,000 women for an average of 18 years. The researchers found that women who consumed one or more sugary sodas a day had a 63 percent increased risk for developing seropositive RA. This is the most common type of RA, in which a blood test detects antibodies the immune system produces against body tissue . Soda consumption appeared to have no impact on potential for developing seronegative RA, the other main form of RA in which antibodies cant be detected but an individual still has RA symptoms.
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How To Manage Gout Attacks
- Medically reviewed by
Gout attacks, also called flares or flare-ups, can come on suddenly and be extremely painful. During a gout attack you may have pain, swelling, and/or redness in your affected joint.Gout attacks can last anywhere from a few hours to several days. When you have acute gout, you may only have attacks once or twice a year. When you have chronic gout, attacks happen more regularly, with shorter breaks in between attacks.There are things you can do to manage your symptoms during gout attacks. The main goal of treatment during an attack is to decrease joint pain and swelling. If you already take a medicine to lower uric acid at the time of an attack, you should continue your regular treatment. If you do not already take a medicine to lower uric acid at the time of an attack, you should not start treatment during an attack, but rather start treatment afterwards, on your doctor’s advice.Some ways to manage gout pain and swelling during an attack are:
If the pain during a gout attack does not get better at all within 48 hours, call your doctor to ask about other treatments you can try.Treatments are also available to prevent gout attacks from happening in the first place. Having gout attacks more often can increase your chances of having even more attacks in the future, so controlling the condition from the start is important. Talk to your doctor about whether medicines to prevent gout attacks are right for you.
Managing A Gout Flare
Gout flares are unexpected and painful heres how to get a handle on them.
Few things in life are more painful than a gout flare, so if youre awakened in the wee hours by a joint that is tender, swollen, red and radiating heat, youll want to act fast. Heres what you can do when a gout flare starts to ease the pain and reduce the risk of others.
Take Medicine You Have on Hand. Start treatment immediately with over-the-counter ibuprofen or naproxen , but never take aspirin, which can worsen a flare. If you have had a flare before and your doctor has prescribed an anti-inflammatory medication to take in the event of another, take your prescribed medication as your doctor directed. If you are already taking a uric acid-lowering drug to reduce the risk of flares, continue to take that drug.
Ice Down. Applying an ice pack to the painful joint may help ease pain and inflammation. Wrap a pack in a dish cloth and apply to the area for 20- to 30-minutes at a stretch several times a day.
Let your doctor know what is going on right away. She may prescribe a new medication, or have you come to the office for a joint fluid test or an injection of a corticosteroid to start relieving inflammation quickly. Getting treatment within the first 24 hours of the start of a flare can lessen its length and severity.
Get a Cane. Walking with a cane during an acute gou flare can help keep pressure off your painful joint.
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Tips For Avoiding A Gout Flare
Gout is a form of arthritis that usually affects the joint between your foot and your big toe. Its caused when theres a buildup of uric acid in your bloodstream, and the acid crystallizes. The crystals tend to form around that particular joint because its far from your heart, so your circulation may not be as strong there as in other parts of your body.
The uric acid crystals cause inflammation that can ultimately lead to joint damage and pain. Gout can be debilitating, but there are some things you can do to avoid the pain of a gout attack.
Dr. Michael Tran and the staff at AllCare Foot & Ankle Center present these five tips for avoiding gout flare-ups. Youll likely still need medication, but these lifestyle changes can also be an important part of your treatment plan.
Common Symptoms Of Gout
Pain that migrates: Gout usually affects the big toe, but it can also occur in the ankles, knees, elbows, wrists, and fingers. The symptoms are rarely symmetrical, and the location varies from flare to flare. For example, an attack in the left big toe might be followed by an attack in the right toe, and the next gout attack might strike one of the knees or wrists.
Fever: People with RA do sometimes experience a fever, but its much more commonly seen in those with gout, says Dr. Portnoff: The burden of inflammation in a gout flare and the bodys robust response to it can be so great that it causes a fever.
Tophi: Over time, people with chronic gout can develop tiny, hard lumps in the affected joints. These lumps, called tophi, are concentrations of uric acid crystals. They can also form in the kidneys and lead to kidney stones.
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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
Signs And Symptoms Of Gout
Any joint can be affected by gout, but it usually affects joints towards the ends of the limbs, such as the toes, ankles, knees and fingers.
Signs and symptoms of gout include:
- severe pain in one or more joints
- the joint feeling hot and very tender
- swelling in and around the affected joint
- red, shiny skin over the affected joint
Symptoms develop rapidly over a few hours and typically last three to 10 days. After this time the pain should pass and the joint should return to normal.
Almost everyone with gout will experience further attacks at some point, usually within a year.
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Summary: Is Food The Answer To How To Treat Gout
Gout is common but widely misunderstood.
There is a misconception that it is directly linked to alcohol consumption and gluttony, but diet is more likely to be a trigger for an attack rather than the sole cause.
Although dietary changes alone cannot get rid of gout, adapting what you eat can boost wellness and help with living with the condition.
And remember, it is a serious, chronic condition, so always follow the advice of a doctor on how to treat gout.
The advice in this article is for information only and should not replace medical care. Please check with your GP or healthcare professional before trying any supplements, treatments or remedies. Food supplements must not be used as a substitute for a varied and balanced diet and a healthy lifestyle.
: 17 August 2021
The Role Of Diet In Gout Prevention
Dietary control may be sufficient in a patient with mildly elevated uric acid, for example, 7.0 mg/dL
For those with a higher level, for example, 10.0 mg/dL, diet alone will not usually prevent gout. For the latter, even a very strict diet only reduces the blood uric acid by about 1 mg/dL- not enough, in general, to keep uric acid from precipitating in the joints. The cutoff where patients with gout seem to dramatically reduce their number of attacks is when their uric acid level is taken below 6.0 mg/dL.4
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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 .
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.
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Is It Gout Or Something Else
The pain and redness of gout can look like an infection or other conditions.
- Pseudogout is another form arthritis. The crystals formed in this condition are made of calcium pyrophospate, not uric acid. But like regular gout, the attack comes on all of a sudden. Joints become swollen, warm, painful, and stiff.
- Reactive arthritis is a reaction to infection that has similar signs.
- Psoriatic arthritis and infectious arthritis can look like gout, too.
Risk Factors For Gout
You are Mori or Pacific
Many Mori and Pacific people have genes that make it harder to get rid of uric acid from their bodies.
Your doctor has told you you have high uric acid levels
Uric acid is a chemical that everyone has in their body. Some people have higher uric acid levels than others. High levels of uric acid can turn into gout.
You can reduce your uric acid levels by keeping active, staying fit, keeping your weight down, eating a healthy diet and not drinking beer and sugary drinks.
You have a family history of gout
If people in your family have gout then you have a higher chance of getting gout.
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