What Is Gout And What Causes It
Before we can look at foods to avoid with gout, it is necessary to briefly understand what it is.
Gout is a form of joint inflammation, caused by excessive uric acid in circulation .
When the bodys natural uric acid threshold is exceeded, painful crystals can form in and around the joints. These crystals trigger the characteristic symptoms and pain.
Not everybody with high uric acid levels will get gout, but those who do always have high uric acid levels. This indicates there are other factors at play, but from a dietary perspective uric acid is the focus.
Excessive uric acid in the blood stream is typically driven by two factors: genetic predisposition and the ingestion of high-purine foods. Obviously, the dietary factor we can control.
When purines we eat are broken down and metabolised by the body, uric acid is formed as a by-product of this process. Its normal and healthy for uric acid to be formed, but excessive amounts are problematic.
Therefore, consuming less purine-rich foods should lower uric acid levels in your blood, lowering gout risk.
At least, in theory.
Its actually not that clear-cut because other nutrients appear to aggravate gout symptoms too
Heres a list of foods to avoid if you have gout, based on real scientific evidence.
How To Get Rid Of Gout Fast
Gout is a painful type of arthritis that feels similar to the pain experienced with rheumatoid arthritis, as both diseases cause inflammation in the joints.
Gout is caused by a buildup of uric acid in the blood.
When the body cannot get rid of the excess uric acid, that buildup ends up accumulating as crystals in a joint, such as the big toe.
This creates swelling, redness, warmth, and severe joint pain in the affected area.
This condition has historically been seen as a disease that only affects old, wealthy men.
Since gout can be caused by genetic, environmental, and lifestyle factors, anyone can get gouteven if they eat what would typically be deemed a healthy diet.
Attacks and flare-ups of the condition can be painful.
While there is no cure for gout, there are things you can do to get relief from the pain and inflammation.
In this article, Ill talk about ways to get fast relief from a gout attack, treatment options for these flare-ups, and warning signs that an attack may be coming.
Ill also tell you when its best to talk to your doctor or another healthcare provider about gout symptoms.
Frequent Consumption Of Certain Fruits May Trigger Recurrent Gout Attacks
High sugar drinks may not be the only stimulant of gout flare ups.
Certain fruits which are a natural source of fructose have also been linked with gout.
This is a highly contentious area, because several studies have linked higher fruit intake with less incidence of gout. This is probably due to their high fibre content .
And unlike fruit juice and other sugar-sweetened drinks, whole fruits are nutritious and generally good for health. There is no disputing this.
However, if you continually have gout attacks despite cutting out alcohol and sugar-sweetened drinks then Im not convinced a large amount of fruits are safe for you. Especially if you are overweight and eat a Western diet.
So cutting back on certain very high-fructose fruits is like a Plan D, if you will.
The link comes back to fructose, which stimulates uric acid production in a similar manner to alcohol. Fructose is naturally found in fruit and honey.
One study found that the consumption of apples or oranges the most popular fruits in this study was linked with an increased risk of gout compared to those who consume less than one serving of fruit per month. No link was found with other fruits however .
While most fruits are very low in fructose, a few are very high. Frequent consumption of these could theoretically causes problems for gout sufferers.
Foods Highest in Fructose per 200 Calories :
Note this list is ranked on a per calorie basis, not per serving.
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Different People May React Differently
The risk of experiencing the effect of an interaction from grapefruit can vary a lot from person to person. The interaction can be different depending on the person, the medicine and the amount of grapefruit you eat or grapefruit juice you drink. Some problems are mild, while others are more serious. For some medicines you may need to limit the quantity of grapefruit you have, while with others you may need to avoid it completely. If you have grapefruit or grapefruit juice in your diet, talk to your pharmacist about any prescription medicine or over-the-counter medicine to find out:
- if the medicine you are taking may be affected
- how much, if any, grapefruit juice you can have
- what other fruits or juices may also affect your medicine in a similar way to grapefruit juice.
Side Effects Of Colchicine
Colchicine may cause some side effects, such as:
- Stomach pain or cramping
If these persist for hours or are severe, let your doctor know. Also, if you experience any of these side effects, alert your doctors office immediately:
- Muscle pain or muscle weakness
- Signs of an infection: sore throat, fever, chills, body aches u Fatigue or weakness
- Numb fingers or toes
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Which Fruit Should We Avoid With Gout
Other fruits with high oxalate values should be avoided. They can transform the calcium in the kidneys into kidney stones. Your kidney function will be decreased and uric acid wont be properly removed from the body. Fruits of this caliber include mangoes, kiwi, peaches, and apricots.
I must add that the bad fruits can be consumed but in moderation and very small amounts.
Who Can And Can’t Take Colchicine
Colchicine can be taken by most adults aged 18 and over.
It can sometimes be prescribed for children by a specialist doctor.
Colchicine is not suitable for some people. To make sure it’s safe for you, tell your doctor if you:
- have ever had an allergic reaction to colchicine or any other medicines
- have a severe blood disorder
- have severe kidney or liver problems
- have problems with your heart or digestive system
- are pregnant, think you might be pregnant or are trying for a baby
Women who could become pregnant will usually only be prescribed colchicine if they are using suitable contraception.
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Can Colchicine Cause Problems
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with colchicine. You will find a full list in the manufacturer’s information leaflet supplied with your medicine. Speak with your doctor or pharmacist if any of the following continue or become troublesome.
|Common colchicine side-effects
|What can I do if I experience this?
|Feeling sick or being sick , pain in your tummy
|Stop your course of tablets and let your symptoms settle. If the sickness continues or is severe, speak with your doctor
|Stop your course of tablets and let your symptoms settle. If this is severe or contains blood, speak with your doctor straightaway
If you experience any other symptoms which you think may be due to the tablets, speak with your doctor or pharmacist for further advice.
Pharmacist Tips For Colchicine
Take colchicine with or without food.
For gout attacks take 2 tablets at the first sign of an attack, then after an hour take another 1 tablet. If you have an attack while you’re taking it to prevent an attack, wait 12 hours after the second dose and then restart your prophylaxis dose.
Wait 3 days before you repeat the gout treatment dose, even if you have a flare.
Avoid grapefruit & grapefruit juice while you are taking colchicine . It can make the medication levels in your body go too high.
If you’re a male with a female partner who can become pregnant, talk to your healthcare provider about plans for having children. Colchicine can cause infertility in men , which is reversible when the medication is stopped.
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What If I Forget To Take It
If you forget to take your colchicine, take it as soon as you remember. Unless it’s nearly time for your next dose. In which case, skip the missed dose and take the next one at the usual time.
Never have 2 doses at the same time. Never have an extra dose to make up for a forgotten one.
If you forget doses often, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to remember your medicines.
How Much Will I Take
The usual dose is 1 tablet , taken 2 to 4 times a day.
You’ll usually take colchicine for just a few days. Your doctor will tell you how long to take it for.
For familial Mediterranean fever
Doses can vary between 1 and 4 tablets , taken once a day.
Your doctor will probably recommend taking this medicine long-term.
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That Glass Of Grapefruit Juice Might Be More Dangerous Than You Can Imagine
This article was published more than 9 years ago. Some information may no longer be current.
Right now, there are thousands of Canadians taking a variety of prescription medications who have no idea they could suffer a potentially serious side effect because of what’s in their fridge.
Eating a grapefruit or consuming its juices while taking certain medications could lead to gastrointestinal bleeding, kidney failure, depressed breathing and sudden death, warns a new paper in the Canadian Medical Association Journal. More than 40 drugs, including anti-cancer agents, heart drugs and central-nervous-system drugs used to treat pain, schizophrenia and other conditions, can lead to significant problems if people on them consume grapefruit.
To make matters worse, many patients and even doctors and pharmacists aren’t aware of the risks, according to the new study, published Monday.
“I think it’s a lot more common than has been reported,” said David Bailey, a scientist at the Lawson Health Research Institute in London, Ont.
“We just basically feel it’s more urgent right now,” Bailey said. “This is what we’re trying to do, is change the emphasis by saying this is a ‘need to know.'”
The number of drugs that can lead to major adverse events if mixed with grapefruit has risen from 17 in 2008 to 43 in 2012, a sign of an alarming trend, Bailey said.
“This is what we call ‘unintentional overdosing,'” Bailey said.
“It’s really all about how do we protect the person on the street,” he said.
Chicken Beef And Other Meats Appear To Be Foods To Avoid With Gout
The conversion of purines to uric acid, in theory, causes gout.
Therefore high-purine foods are often suspected to trigger symptoms.
Meat, and to a lesser extent seafood, are prime suspects. This includes all the most common meats like beef, chicken, pork and lamb.
The data available somewhat confirms suspicions.
Each additional daily serving of meat or seafood is associated with a 21% or 7% increased risk of gout, respectively . This implies meat could be three times worse than seafood.
There was another similar study that found even greater risks associated with meat intake, but none for seafood. Overall this suggests seafood is far less of a concern than meat .
For those who already have gout, the impact of meat intake on symptoms is even worse. This is likely due to sharper increases in blood uric acid, as well as poorer clearance by the body .
Therefore if you have a history of gout, it is best to dramatically reduce your meat intake, and seafood as well to a lesser extent. Anecdotal evidence suggests avoiding dark part of salmon, and de-veining prawns/shrimp before eating.
You should also buy your meat direct from the butcher where possible, or at least the better quality choices in the supermarket. Sausages and low-quality ground beef may contain traces of organ meat that can cause big problems .
Summary: Frequent consumption of meat is strongly linked with gout risk. The impact of seafood appears far less severe, but there is a link.
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Important Information About All Medicines
This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
If you buy any medicines ‘over-the-counter’, always check with a pharmacist that they are suitable for you to take alongside your other medicines.
If you are having an operation or any dental treatment, tell the person carrying out the treatment which medicines you are taking.
Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
If you have any questions about this medicine ask your pharmacist.
How Grapefruit Juice Affects Some Drugs
When drugs are swallowed, they may be broken down by enzymes and/or absorbed using transporters in cells found in the small intestine. Grapefruit juice can cause problems with these enzymes and transporters, causing too much or too little drug in the body.
Some drugs, like certain statins used to lower cholesterol, are broken down by enzymes. As shown above, grapefruit juice can block the action of these enzymes, increasing the amount of drug in the body and may cause more side effects.
Other drugs, like fexofenadine, are moved by transporters into the bodys cells. As shown above, grapefruit juice can block the action of transporters, decreasing the amount of drug in the body and may cause the drug to not work as well.
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Fruits High In Oxalate
If you are predisposed to gout, there is a high likelihood that kidney stones may form, too, explains New York University. Kidney stones can form from either uric acid or calcium oxalate. Fruits do not cause uric acid formation but may cause the precipitation of calcium oxalate in the kidneys. Thus, maintaining low levels of oxalate in your diet may discourage calcium oxalate-based kidney stone formation. Check with your doctor to set the oxalate limit on your diet. High oxalate content is considered 26 to 99 milligrams per serving. Fruits high in oxalate include rhubarb raw, stewed or dried figs dried apricots and kiwi fruit.
Increased Risk Of Pectin
Pectin, a soluble dietary fiber in grapefruit provides several benefits like relieving constipation, improving digestive health, lowering cholesterol level, regulating blood sugar, and promoting weight loss, etc.
However, pectin is not suitable for individuals with pectin allergies.
If you have a pectin allergy or are allergic to cashews and pistachios, then you should avoid grapefruit as it may increase the risk of pectin-induced asthma, upset stomach, skin rashes, itching, irritation, swelling of lips and tongue, etc.
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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.
Why Lemon Juice May Be Helpful
Lemon juice may help balance uric acid levels because it helps make the body more alkaline. This means it slightly raises the pH level of blood and other fluids. Lemon juice also makes your urine more alkaline.
According to a study published in the British Medical Journal, this happens because drinking lemon juice causes your body to release more calcium carbonate. The calcium mineral bonds to uric acid and breaks it down to water and other compounds. This makes your blood less acidic and lowers uric acid levels in the body.
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Caffeine And Gout Risk
Studies show that caffeine may protect you from gout because caffeine is similar in chemical structure to a common gout medication. But other research shows that increasing your caffeine intake can actually trigger gout pain in fact, one study found that suddenly doubling your caffeine intake could increase the risk of gout symptoms by up to 80 percent. So if you are a coffee or tea drinker, caffeine could be helping protect you just remember that a sudden binge could bring on a gout attack.
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.
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Why Am I Taking Colchicine
Colchicine is prescribed as either a short-term medication to relieve your acute gout flare or as an ongoing, preventive treatment during the early stages of taking another medication to lower urate. Your doctor can prescribe colchicine to keep on hand in case you do have a gout flare.
Dont take colchicine to relieve other types of arthritis pain or back pain. Its effective in treating treat gout pain, but most types of arthritis dont respond to colchicine. Colchicine comes in a tablet that you swallow. You can take colchicine with or without food, but some people find it easier on the stomach to take with food. For an acute gout attack, its usually taken twice a day. You take one dose of colchicine when you first notice the symptoms, followed by a smaller dose one hour later, with no further doses for at least 12 hours.
This may be followed with doses of 0.6 mg once or twice daily . If you dont get relief within a few days, let your doctor know. You may need to switch to or add another medication.
Let your doctor know if you are allergic to any of these medications that could interact with colchicine:
Also, let your doctor know if you have ever had kidney disease, liver disease, or, for women, if youre pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while taking colchicine for gout, let your doctor know right away.
If you miss your dose of colchicine, take your dose as soon as you remember. Dont take your next dose for 12 hours.