Patients With Gout Need To Stay Active To Maintain Cardiovascular Health And Protect Joints From Long
Should I walk or engage in any exercise when I have gout? Many people with gout ask themselves this question. And the answer is yes except during a painful gout flare, according to Maura Daly Iversen, PT, MPH, DPT, SD, FAPTA, a physical therapist and behavioral scientist/clinical epidemiologist with a primary focus in rheumatology and Dean of the College of Health Professions at Sacred Heart University in Fairfield, Connecticut.
When in a gout flare, even the pressure of a bed sheet can be extremely painful, Dr. Iversen says. Most patients feel better by elevating their feet and resting and thats okay.
Nominal Group Technique Sessions And Analyses
Patient nominal group sessions lasting 11.5 h to understand the impact of gout on sleep were conducted. The study primary investigator drafted the study question with four potential formulations and shared it separately with other physicians and researchers, and patients with gout, at the UAB gout clinic. An iterative process that included several discussions with various stakeholders led to the final study question: in what ways is your sleep influenced by your gout? The study primary investigator , with extensive experience in conducting nominal groups , conducted the Nominal Group Technique sessions. Each session started with introductions , followed by asking the participants if the main question was clear and if they had any questions about it before starting the NGT meeting. All patient queries related to the study question or the study were answered before the start of the NGT session. The main question was written on a flip chart and printed on top of a blank sheet of paper provided to each participant. An administrative assistant recorded and fully transcribed the discussions and a research assistant , took notes during NGT.
How To Choose The Right Cbd For Gout
There are three types of CBD oils: full-spectrum CBD oil, broad-spectrum CBD oil, and isolates.
Full-spectrum oils make use of all the ingredients of cannabis plants, including less than 0.30% THC, fatty acids, flavonoids, terpenes, and essential oils.
The main advantage of using a full-spectrum oil is that its active ingredients synergize to produce an entourage effect. This mechanism is believed to generate maximum therapeutic benefits from the ingredients of the cannabis plant.
Full-spectrum oils contain THC, which may be detected via drug tests. THC may also cause mild psychoactive effects in some individuals.
Gout patients who want to avoid these potential risks may choose to buy broad-spectrum CBD oil. This type of oil has all the ingredients of a full-spectrum oil sans the THC.
Those who are looking for a CBD oil made of pure cannabidiol may purchase CBD isolates.
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Sleep With A Thin Pillow
Sleep problems were actually how I discovered I have osteoarthritis in my neck, says Nancy B., 52, of Gig Harbor, Washington. For years, all she knew was that lifting her head, even a little, caused terrible pain and a night of no sleep. To keep her neck straight, she slept with the thinnest pillow possible. Last year she started having neck spasms, which lead her to get diagnosed with arthritis. Ive had to change a lot of things since my diagnosis, but the flat pillow has stayed. People think Im weird when they see my sad little pillow its actually a pillow designed for backpacking but its the only way I can sleep without my neck hurting, she explains.
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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.
Or Sleep With Ice Packs
Everyone says heat for arthritis but for me ice is the best, especially if I cant sleep, says Jennifer D., 28, of Washington, D.C. Heat makes the rashes from my psoriatic arthritis feel worse so I have ice packs I keep in the freezer and put them down my pajamas at bedtime. It takes some getting used to but its worth it for me to sleep better. Her trick is to buy ice packs that dont leak or sweat so she doesnt wake up in a wet bed.
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Treating Acute Pain To Help You Sleep
Take Your Prescription Drugs
If you’ve had a gout attack before, your physician may have prescribed drugs to treat attacks. This may be your first line of defense or you may decide to use them only when NSAIDs fail to relieve your pain.
Prescription medications to treat gout include:
- Prednisolone oral tablets, which has been shown to work as well as NSAIDs and often doesnt cause the same stomach upset. Prednisolone is a type of corticosteroid and does carry other potential side effects, particularly if it is taken for longer than the recommended 5 days.4
- Colchicine, which has been shown effective in reducing pain and inflammation if taken in the first 24 hours of an attack. Always follow your physicians instructions regarding dosing to decrease your risk for potential complications and side effects.
Opioid painkillers, such as codeine, hydrocodone, and oxycodone, are not recommended to treat the pain caused by gout.
See Pain Medications for Arthritis Pain Relief
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What Causes Gout
Gout is caused by elevated uric acid levels in your blood, known also as hyperuricemia. This creates urate crystals, which cause the inflammation and pain associated with gout. Uric acid is a waste product naturally produced by your body and is a normal part of your body functioning. In excess, however, it can be harmful to your health.
Your body produces uric acid when you break down chemical compounds known as purines, which are created by the foods you eat.
Uric acid normally dissolves in your blood and leaves your body through your urine, but excessive uric acid in the body can build up and form sharp urate crystals in your joints or tissue. Gout is the pain created by these sharp crystals in and around your joints.
Gout Symptoms
Gout symptoms often occur at night, and without warning. These symptoms can include:
- Severe joint pain, normally around your big toes it can affect the joints in your fingers, wrists, elbows, knees, and ankles too
- Prolonged joint discomfort after a gout attack ends
- Inflammation, tenderness, and redness of the affected joint or joints
Risk Factors for Gout
Your gout risk can increase if you meet any of the following criteria:
So now that weve talked about gout, what is its connection to sleep apnea?
How Can I Self
The methods of managing an acute attack of gout differ from the ongoing methods for managing gout. If youve been diagnosed with gout, youll benefit in the long term from making healthy changes to your lifestyle, such as:
- maintaining a healthy body weight. If you do need to lose weight, make sure your weight loss is gradual as crash diets can increase uric acid levels
- drinking alcohol in moderation and avoiding binge drinking
- drinking plenty of water, and staying hydrated
- avoiding, or eating in moderation, foods that are high in purines. Talk with a dietitian for tips and advice
- exercising regularly aim to complete at least 30 minutes of physical activity most days of the week
- working closely with your GP to prevent further attacks and actively manage your condition.
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The Connection Between Sleep Apnea And Gout
If youre reading this article or have been reading our blog for a while, then you probably have a good idea of what sleep apnea is and how it impacts your health.
Maybe you even know someone who has sleep apnea.
We wont go into detail on the condition here, but if you need more information about obstructive sleep apnea, we recommend checking out our information about Sleep Apnea Diagnosis and Treatment once you finish reading about how sleep apnea contributes to gout.
While sleep apnea does not cause gout, multiple studies have found that sleep apnea and gout are linked. Sleep and gout also have a correlational relationship, since gout attacks may be influenced by your circadian rhythm, and your sleep quality is likely affected by nighttime gout flares.
According to one study published by BMC Rheumatology, diagnosed or suspected OSA patients are at higher risk of developing gout, and patients with gout often reported disorders including insomnia, restless legs syndrome, and obstructive sleep apnea.
Obstructive sleep apnea patients were nearly 3 times as likely to also have gout. Gout patients were also more likely to have more comorbidities, or accompanying conditions, alongside sleep apnea including diabetes and heart disease.
But why is this the case? Researchers believe that sleep apneas characteristic breathing cessation and low oxygen levels can lead to increased production of uric acid in your body, which can cause gout.
Should I Drink Lots Of Water
Dehydration may be a risk factor for gout although this is not well proven in research. Drinking 1 1.5 litres of fluids a day is recommended for general health benefits. However if you are taking diuretics or have heart or kidney problems, talk to your doctor about the right amount of fluids for you to drink.
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What Are The Symptoms
An attack of gout usually comes on very quickly, often overnight. The joint becomes very red, swollen and extremely painful. Often the joint is intensely sore to touch. Gout normally affects one joint at a time, often the joint of the big toe. Other joints, such as the hands, wrists, knees, ankles and elbows, can also be affected by gout.
Treat Sleep Apnea To Treat Gout Alternative Natural Methods
The most common and accepted treatment for sleep apnea is sleeping with the mask that provides continuous positive airway pressure for many this is an uncomfortable and embarrassing way to treat sleep apnea. Fortunately, new alternative methods of sleep apnea treatment are demonstrating to be effective in preventing the condition and the harmful effects sleep apnea has on uric acid levels in the blood. In addition to losing weight and regular exercise, acupuncture has proven to be a viable treatment option for sleep apnea . While further research is needed, initial indications are that the herbs passionflower and valerian are effective in treating sleep apnea.
Gout and Sleep Apnea References
Sleep apnea MayoClinic.com
Sleep Apnea American Sleep Association
Marinchev Rheumatology Oxford Journals
Wiener, RC. Association between Serum Uric Acid Levels and Sleep Variables.
Freire, AO. Immediate effect of acupuncture on the sleep pattern of patients with obstructive sleep
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What Will Happen To Me
Without treatment, a gout attack usually lasts about one week. Another attack may not happen for months or even years. If gout is not managed well, the time between attacks may get shorter, the attacks more severe and the joints can be permanently damaged. Sometimes gout can progress into a chronic condition, causing:
- constant mild pain and inflammation of the affected joints
- tophi solid lumps of urate crystals, especially on the toes, ears, fingers, hands, forearms, knees and elbows
- kidney stones.
Treating Nighttime Gout Flares With Drugs
Avoid the temptation to take aspirin during any gout flares since this drug can actually increase uric acid levels.
Regular gout attacks can be treated with anti-inflammatory steroids and nonsteroidal anti-inflammatory drugs so talk to your doctor if you are struggling. Early treatment is better than late treatment, and its often more effective.
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Consider Taking A Sleep Aid
Several sleep-enhancing preparations are available over the counter to help promote better sleep. While some are available as tea bags for brewing, others can be taken orally in the form of tablets or capsules. Here are a few common examples:
- Herbal preparations: Valerian capsules and chamomile tea 11 13
- Fruit extracts: Cherry juice or capsules of tart cherry extract 14
- Micronutrient supplements: Zinc and/or magnesium 15 17
- Synthetic preparations: Melatonin capsules or tablets 18
These supplements may help improve the onset, duration, and quality of sleep in some people.
When you are sleep deprived due to your chronic pain, it may be worth trying one or more of these little-known options to help you get more sleep. A process of trial and error will help you understand which option works best. If youre not able to sleep well despite trying these tips, consult a doctor for prescription medications or other medical treatments.
Consume Foods That May Help Promote Sleep
Consuming certain foods in your evening meal may help increase the level of tryptophan in your body. Tryptophan is a type of protein that is essential for the production of the sleep-regulating hormone, serotonin. Increased tryptophan levels help reduce the time taken to fall asleep, promote more restful sleep, and improve alertness in the morning. 3 Examples of such sleep-promoting foods are 3 :
- Carbohydrates with a high glycemic index, such as rice.
- Fruits, such as cherries and kiwis.
- Whole foods, such as milk, pulses, fatty fish, and shellfish.
When you plan to make dietary changes, consult with your doctor to ensure that the new food or supplement that you try does not adversely affect any existing medical condition or medication that you may be taking. Also, consider abstaining from foods and drinks that may adversely affect your sleep, such as coffee, tea, and chocolates. These food contain caffeine and theobromine that may disrupt your sleep cycle. 3
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The Link Between Sleep Apnea And Gout
For the study, published in Arthritis & Rheumatology, researchers combed through records in a British health database to compare people with and without sleep apnea. They selected a total of 9,865 people with sleep apnea and matched them to a control group of 43,958 people without the disorder. After one year, people with sleep apnea were about 50% more likely to have had an attack of gout compared with the control group.
The exact nature of the association between gout and sleep apnea is unknown, but there are two possible explanations, according to the researchers. First, both conditions share a common risk factor: being overweight. Although it is not clear how excess weight is linked with gout, many people who suffer from the condition tend to be overweight, says Dr. Robert Shmerling clinical chief of rheumatology at Harvard-affiliated Beth Israel Deaconess Medical Center.
The other theory may be related to hypoxia, a complication of sleep apnea that causes a persons oxygen levels to fall during sleep. This can cause tissue damage and cell breakdown, both of which may make uric acid levels rise, says Dr. Shmerling.
What You Need To Avoid Consuming To Help Tame Gout
7) Alcohol and Gout Do Not Go Together
Okay, this can really suck, but unfortunately, alcohol can worsen the symptoms of gout by increasing the level of uric acid in your body. Beer, in particular, is high in purines, which the body breaks down into uric acid. If you suffer from gout, it is essential that you avoid beer, and other alcoholic beverages, which we know is especially hard during the holidays.
8) Seafood and Meat Are Healthy for Some, but Not if You Have Gout.
Consumption of seafood and meat puts you at greater risk of developing gout or contributes to its severity. Red meat reduces the excretion of uric acid by the kidneys, thus increasing its level in the body.
While seafood is rich in omega-3 fatty acid, which is essential for a healthy heart, it also is high in purines. Individuals suffering from gout must avoid seafood. It can be replaced with soy and walnuts, which are also good sources of omega-3 fatty acids. Not all seafood is necessarily a problem if eaten in moderation, though certain seafood should be avoided whenever possible.
Youll want to pass on meats such as liver, kidney, and sweetbreads, which are high in purines and contribute to increased blood levels of uric acid. Stay away from seafood that is high in purines such as anchovies, herring, sardines, mussels, scallops, trout, haddock, mackerel, and tuna .
9) Alcohol and Seafood or Meat Together, a Double Whammy
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