Who Is At Risk For Gout
Anyone can be affected by gout.
Gout is most common in middle-aged men, especially those with a family history of the disease. Women can get gout, too, most often after menopause.
Your chances of developing gout are higher if you:
- Are overweight
- Drink too much alcohol, especially beer
- Eat a diet rich in meat and fish, which can be high in chemicals called purines
- Take certain medicines, like water pills , that can trigger an attack
Recent research also indicates that genetics may play a big role in determining who gets gout. Ask your doctor if you have questions about your risk for developing this condition.
Home Remedies For Gout
Because of the rise in health care costs and the popular inclination to try natural home remedies to prevent the need for prescription drugs and surgeries, many people are turning toward alternative remedies to treat gout. A number of these home remedies have been acknowledged for treating gout. But, are they effective or not? We will present a number of them below and discuss their likelihood of success.
1. Apple Cider Vinegar
Apple cider vinegar is used to treat gout because its acidity relieves the acute pain associated with gout and other types of arthritis. The vinegar increases the bodys alkalinity and has anti-inflammatory properties. Some individuals also add honey to the apple cider vinegar because of honeys anti-inflammatory properties.
The bad news is that you take the concoction by the spoonful, and apple cider vinegar isnt exactly known for its amazing taste. To be most effective, you need to take up to two tablespoons of apple cider vinegar three times a day. Scientific results are lacking in evidence that apple cider vinegar really works. There was a study in Japan in 2010 which looked at different diets to improve alkalization of urine to increase the removal of uric acid from the body. Apple cider vinegar was in one of the diets, but was not tested alone.
Success stories are hit or miss with apple cider vinegar and the treatment of gout. We give it two stars.
2. Ginger Root
3. Baking Soda
4. Lemon Juice
5. Epsom Salt
6. Cherries
7. Bananas
The Four Stages Of Gout
Gout is best understood by seeing it as having four phases or stages :
Stage 1: High uric acid
Elevated uric acid without gout or kidney stone, this stage has no symptoms and is generally not treated.
Stage 2: Acute flares
This stage is marked by acute gout attacks causing pain and inflammation in one or more joints.
Stage 3: Intercritical periods
These are periods of time between acute attacks, during which a person feels normal but is at risk for recurrence of acute attacks.
Stage 4: Advanced gout
This is a stage of chronic gouty arthritis, in which there are lumps of uric acid, or tophi , frequent attacks of acute gout, and often a degree of pain even between attacks .
Figure 1: Stages of Gout
Figure 2: Illustration of Toe Joint with Gouty Tophus. normal toe joint Urate crystals, shown in white, at the “bunion joint,” represent a gouty tophus.)
Figure 3: Progression of Gout
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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
How Does A Doctor Diagnose Gout
If you have sudden or severe pain in a joint, you should talk to your primary care provider . Your PCP may send you to a rheumatologist, a doctor who specializes in gout and other kinds of arthritis.
Healthcare providers consider several things when confirming gout:
- Symptoms: The provider will ask you to describe your symptoms, how often they happen and how long they last.
- Physical examination: Your provider will examine the affected joint to look for swelling, redness and warmth.
- Blood work: A test can measure the amount of uric acid in your blood.
- Imaging tests: You may have pictures taken of the affected joint with X-rays, an ultrasound or MRI.
- Aspiration: The provider may use a needle to pull fluid from the joint. Using a microscope, a team member can look for uric acid crystals or a different problem .
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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 weightand 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.
Effective Medical Treatment For Gout
The American College of Rheumatology released gout management guidelines in 2012 and updated them in 2020. They recommend drugs classified as urate-lowering therapy for those who have experienced two or more gout attacks in a year as well as for those with joint damage from gout.
Specifically, the organization recommends allopurinol as a first-line treatment for all gout patients, even those with chronic kidney disease. Next in line is febuxostat both are a class of drugs called xanthine oxidase inhibitors.
In addition, the guidelines recommend use of anti-inflammatory medications including NSAIDs, prednisone, or colchicine along with the other medication.
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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 of and reduce the risk of others.
What Are The Symptoms Of Gout
If you think you are suffering from gout, how can you be sure? One of the tell-tale signs of gout is excruciating swelling and pain in the big toe, usually resultant of an injury. Gout may affect other joints intermittently, though, most often it affects the joints in the foot and knee. If left untreated, gout can become a chronic condition.
If you do not treat gout symptoms, your body may produce something called tophi which are little crystals that form disfiguring lumps near your joints and can also produce painful kidney stones.
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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 .
What About Prp Injections For Gout
PRP injections for gout are only reserved for special cases. Just like cortisone injections, PRP injections are anti-inflammatory and will have a beneficial effect. This effect is probably better if the injected joint has underlying degenerative changes such as osteoarthritis. Nevertheless, the effect of PRP is less than cortisone. Overall, we would only consider PRP injection for gout if the risks of a cortisone injection are too great.
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Warm Water With Apple Cider Vinegar Lemon Juice And Turmeric
Apple cider vinegar, lemon juice, and turmeric are each frequently recommended anecdotally for gout. Together, they make a pleasant beverage and remedy.
No strong research supports apple cider vinegar for gout, though studies show it may support the kidneys. Otherwise, research is promising for lemon juice and turmeric for lowering uric acid.
Mix juice from one squeezed half lemon into warm water. Combine with 2 teaspoons turmeric and 1 teaspoon apple cider vinegar. Adjust to taste. Drink two to three times per day.
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
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Where Does A Gout Attack Occur
Gout often attacks the largest joint in your big toe. However, it can also attack the foot, ankle knees, hands, or wrists. Intense pain, redness, and swelling can start with no warning, although you may have warning signs of an impending attack. If you start to feel tingling, burning, or itching in a joint, your body is giving you a warning signal that a flare-up is imminent.
Ways To Deal With Painful Gout Attacks
Its difficult to focus on work or other daily activities when youre experiencing gout inflammation and pain. Symptoms can last for a few days or even weeks, with the worst pain usually occurring in the first day or two.
While the best thing to do is talk to your physician, there are several steps you can take right away ease your gout symptoms:
Excess uric acid in the bloodstream can lead to the formation of uric acid crystals in one or more joints, resulting in gout.Read:All About Gout – Symptoms, Diagnosis, Treatment
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Using Tart Cherry Juice For Gout
Tart cherry juice may help decrease uric acid levels and inflammation in gout. Research is limited, with often small numbers of study participants and short-term follow-up.
Nevertheless, a 2019 review of six studies that looked at the effect of cherry juice or cherry extract intake on gout concluded that cherry intake was associated with a reduced risk of gout attacks. Researchers did note that larger, more long-term studies are needed to clarify this association.
When choosing tart cherry juice, be sure to look for unsweetened varieties to help reduce the amount of added sugar in your diet.
What Can Increase Your Risk
A high level of uric acid in the blood is the main factor that increases your risk of developing gout. However, it’s still uncertain why some people with a high level of uric acid in the blood develop gout, while others with an equally high level don’t.
Other factors that may increase your risk of developing gout are outlined below.
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Dietary Changes To Improve Gout Symptoms
As gout is associated with diet, here are my top foods to avoid or minimize:
Foods to avoid or minimize:
- Purine-rich foods including: beef, goose, organ meats, sweetbreads, mussels, anchovies, herring, mackerel, yeast, spinach, asparagus, beans, lentils, mushrooms and dried peas. 00099-2/fulltext” rel=”nofollow”> 18)
- Oxalate-rich foods including: spinach, rhubarb, beets, nuts, chocolate, black tea, wheat bran, strawberries and beans.
- Common allergens including dairy, wheat , corn, and food additives.
- Refined foods including white breads, pastas and sugars.
Foods to eat and enjoy:
- High fiber foods including: barley, bran, rye, brown rice, avocados, potatoes and bananas.
- Vitamin C-rich foods including: oranges, red and green bell peppers, broccoli, strawberries, guava, kiwi and Brussels sprouts.
- Magnesium-rich foodsincluding: pumpkin seeds, yogurt or kefir, almonds, avocados, figs, artichokes, cashews and wild-caught salmon.
- Cherries and unsweetened cherry juice. Try my recipe for cherry limeade.
- Omega-3 rich foodslike wild-caught salmon and tuna, walnuts, flaxseed, chia seeds, natto and grass-fed dairy.
Acute Attack Pain Management
Home remedies. Reducing inflammation during an acute gout attack will provide pain relief.
- Ice. Apply ice to the affected area to reduce swelling. Do not apply ice directly to the skin. Use an ice pack or wrap a towel around the ice. Apply ice for about 20 minutes at a time.
- Elevate. Frequently raise and keep the affected area above the level of the heart.
- Rest. Move the affected area as little as possible while symptoms are present.
- Over-the-counter non-steroidal anti-inflammatory medicines. If the gout attack is mild, anti-inflammatory drugs available without a prescription may relieve pain. Because there are serious side effect of using non-steroidal anti-inflammatory drugs even the over-the-counter strength be sure to check with your doctor before taking them.
Prescription medications. Your doctor may recommend a prescription-strength non-steroidal anti-inflammatory medicine such as indomethacin.
Colchicine is also given to reduce inflammation during an acute gout attack. This drug has recently been approved by the Federal Drug Administration for treatment of gout. Like all medications, colchicine has side effects that you will need to discuss with your doctor.
Your doctor may also prescribe corticosteroids for acute gout attacks. These are strong anti-inflammatory medications that can be taken either in pill form, intravenously, or injected into the painful joint. Cortisone may improve the severe inflammation very quickly.
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Treating Gout At Home
This section on how to relieve gout pain is a very useful reference for those nights when you wake
up in agony. When you have a gout attack, you need to get the uric acid out of your system and treat
the pain.
Relax and keep your body calm.
Take proper medication.
For some people an over the counter anti inflammatory such as ibuprofen may be helpful but read the package insert carefully or discuss with the pharmacist.
Ice the affected area and elevate the joint.
If the pain is severe and doesnt diminish, its recommended to seek medical advice.
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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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
Pain Relief Without Medicine
Use cold. If your pain isn’t too bad, try cold packs or compresses on the joint to lower inflammation and soothe the ache. Wrap ice in a thin towel and apply it to the joint for up to 20 minutes several times a day. Do not apply ice to your hands or feet if you have nerve problems from diabetes or other causes.
Rest the joint. It’s a good idea to rest it until the pain eases up. You probably won’t want to move it much anyway. If you can, raise the joint on a pillow or other soft object.
Drink water. When your body doesnât have enough water, your uric acid levels rise even higher. Stay hydrated to help keep those levels normal.
Watch what you eat and drink. Foods that are high in substances called purines, such as some seafood, organ meats like liver, and fatty foods, can raise the uric acid in your blood even more. So can fructose-sweetened drinks and alcohol — especially beer.
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What Does A Gout Attack Look And Feel Like What Would A Foot Or Toe With Gout Look Like
When gout occurs, the joint tends to be extremely painful and is warm, red and swollen . The inflammation that is part of a gout attack is systemic, so that fever and chills, fatigue and malaise are not uncommonly part of the picture of a gout attack.
Figure 6: Toe with Acute Attack of Gout
Gout attacks can occur in joints that look normal, or in joints that have easily visible deposits of uric acid. These deposits are called tophi and can be in numerous locations, but especially on the feet and elbows. In Figure 9, the little finger of the right hand is bandaged since fluid was just removed from it, which demonstrated innumerable uric acid crystals.
Figure 7a: Tophi on Foot
Figure 7b: Tophus Over Achilles’ Tendon
Figure 8: Tophus on Elbow
Figure 9: Tophi on Hands
Figure 10: Large Tophus of Finger
While some gout attacks will solve quickly by themselves, the majority will go on for a week, several weeks, or even longer if not treated. Since gout attacks are usually quite painful and often make walking difficult, most gout sufferers will request specific treatment for their painful condition.