How Does Diet Impact Gout
Though diet isnt the only factor that leads to gout, it can play a role. To know why, its important to understand what causes gout in the body .
Gout occurs when an excess of uric acid in the body crystallizes in the joints, most commonly in the big toes, fingers, wrists and knees. These sharp crystals cause sudden swelling and are the source of the pain associated with a gout attack.
Uric acid is produced naturally when the body breaks down purines. Most purine is produced inside the body, though purines are also contained in some foods. Normally, uric acid doesnt cause problems because the body is able to secrete it easily through urine. However, some people produce too much uric acid or are unable to secrete enough of it. In these cases, the result is gout.
Though the body produces uric acid naturally, making gout largely unavoidable, consumption of foods rich in purines can exacerbate the problem. In fact, one study found that high purine intake was associated with five times greater risk of recurrent gout attacks .
In addition to foods rich in purine, those with gout should also avoid foods with lots of added sugars and refined carbs. Though more research needs to be done, reducing glycemic index seems to correlate with lower uric acid levels .
Choose A Diet You Can Live With
If you are overweight, losing weight can protect you from gout flare-ups. However, losing weight fast can do more harm than good for gout, as rapid weight loss can raise uric acid levels in your bloodstream. Avoid fad diets and “crash” diets. Consider consulting a dietician, who can help you choose a diet plan that works for you.
Foods That Trigger Gout And How To Prevent Flares
Gout is an arthritic condition that causes severe pain in the joints flare-ups occur unpredictably and with varying frequency, beginning when excess uric acid develops in the blood. Under normal circumstances, the body dissolves uric acid and removes it via the kidneys and urination. Trigger foods prompt excess uric acid to build up and crystalize at the joints. People prone to gout should avoid or minimize specific foods to reduce flare-ups.
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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.
What Should I Consider If I Take Medication
There are certain medications that can raise the levels of uric acid, thereby increasing the risk of gout. These include diuretics , acetylsalicylic acid and some medications that are taken after an organ transplant. Levodopa and some cancer medications can also increase the risk of gout.
If you take any of these medications, it’s best to discuss with your doctor whether it would be possible to switch to a different medication.
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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.
First Foods That Can Help
- There are actually several types of foods that may help protect against gout attacks. These include low-fat dairy foods, complex carbohydrates, coffee, and fruits, especially citrus fruits. You should also be sure to get 12 to 16 cups of fluid daily.
- You don’t necessarily have to drink only wateryou can choose non-sweetened juice, tea, and coffee too.
- Any kind of fluid that keeps that blood flowing and urine flowing is a good choice, says Lona Sandon, PhD, RDN, an assistant professor of clinical nutrition at the University of Texas Southwestern Medical Center in Dallas.
Next up: The foods to avoid. Read on for a list of potentially problematic eats.
Scallops are okay for an occasional indulgence, but you should cut back on themand all types of meat and seafoodduring a flare-up, says Sandon. These animal foods are rich in purines, which your body breaks down into uric acid.
You have a little more freedom in your food choices when your gout is at bay, but its still a good idea to keep meat and seafood intake to a minimum4 to 6 ounces daily at most.
All meat is not created equal when it comes to purine content: White meat is generally better than red.
But it is okay to eat some types of red meat once in a while. Youre a bit better off if your occasional indulgence is beef or pork rather than lamb, says Dr. Zashin.
And lamb chops are a better choice than leg meat.
Organ meats, such as liver, kidneys, and sweetbreads, are a major no-no.
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Gout Caused By Genetics More Than Diet
And the memory of the last attack is bound to fade, no matter how excruciating it might have been. Like allopurinol, it’s been on the market for decades, so it has a long track record. Probenecid works by increasing uric acid excretion by the kidneys so it can trigger the development of kidney stones and is not a good option for people with kidney problems. Another drawback to probenecid is that it has to be taken twice a day. Purines are a group of chemicals present in all body tissues and in many foods.
Choosing the right foods for gout could ease your journey through risky holidays. suffering with renal failure and chronic urate deposits in the joint spaces. Ankle sprains are injuries to the ligaments that support the ankle, and are quite common among athletes. When you sprain your ankle, it is generally recommended that you avoid sports and other strenuous activities that put pressure on the affected ankle. Prior to returning to your typical activities, you will want your ankle sprain to be fully healed.
Who Should Diagnose And Treat Gout
The disease should be diagnosed and treated by a doctor or a team of doctors who specialize in care of gout patients. This is important because the signs and symptoms of gout are not specific and can look like signs and symptoms of other inflammatory diseases. Doctors who specialize in gout and other forms of arthritis are called rheumatologists. To find a provider near you, visit the database of rheumatologistsexternal icon on the American College of Rheumatology website. Once a rheumatologist has diagnosed and effectively treated your gout, a primary care provider can usually track your condition and help you manage your gout.
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What Else Can Trigger Gout Flares
When it comes to medication, you must watch out as well, the wrong kind may really affect your uric acid levels. Some drugs that you may take to treat your high blood pressure or heart disease may also cause gout flares. Avoid diuretics, cyclosporine, beta-blockers, levodopa and even aspirin. Always take your doctors advice if prescribed any of these medications.
Medical stress like hospital visits, surgery, pneumonia and other medical conditions can cause gout flares. Injury like twisting your ankle or stubbing your toe can also trigger a gout attack in some people. Uric acid tends to form more readily on injured joints. Episodes of stress can also cause an attack. Be careful when exercising since too much strenuous exercise can also trigger an attack.
In the end everybody has their own little nuances, for some gout sufferers certain foods will trigger it and for others not. Unfortunately, there is no test that lets gout sufferers figure out what triggers will cause their uric acid levels to rise. But mostly all of yous are able to determine the source the very first time you had an attack. For me it was alcohol. What was it for you?
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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.
Regularly Eating High Purine Foods
Its well known that high purine diets could increase your risk of increasing your bodys uric acid levels, which is bad news for gout sufferers.
The research carried out so far is not clear just how much impact a high purine diet has on increasing uric acid levels, however, many gout sufferers who keep an eye on their behaviour before an attack believe that high purine foods have been potential triggers.
This varies from foods like bacon through to some seafoods.
Im personally a believer of everything in moderation and know myself that the times when Ive pigged out regularly on things that I know fit in the higher end of the purine scale, attacks have almost certainly followed.
Diet is generally a complex thing so having a well-balanced range of foods on the purine scale is probably the best way to go.
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Help Prevent Gout Flares With Weight Loss
In addition to avoiding problematic foods, there are also many steps people with or prone to gout can take to help reduce their chances of flare ups.Harboring excess body fat increases the risk of gout. Uric acid is eliminated through the kidneys, and being overweight or obese . The major culprit behind this is belly fat. This isn’t the fat that sits directly under the skin it’s the visceral type that wraps around the organs. Visceral fat releases chemicals that promote systemic inflammation and lead to related metabolic diseases, including insulin resistance. Weight loss reduces inflammation and gout attack risk.
How Gout Treatment Prevents Disease Progression
Fortunately, in part because of its long history, gout is one of the most well-understood and most medically treatable forms of arthritis. The progression of gout is preventable by starting appropriate treatment as soon as possible, Dr. Meysami says. Uric acid-lowering agents, such as allopurinol , can decrease uric acid levels and prevent gout attacks.
During flares, gout patients can take NSAIDs or corticosteroids to calm the attack. Local steroid injections may also be given. A medication called colchicine is also often used to stop acute attacks, but its given now at a much lower dose in order to avoid side effects, including stomach upset.
After a flare ends, long-term treatment can begin. Almost all people with gout will need medication to control their urate, Dr. Fields says. To get a good outcome, people with gout need to get their blood urate level below 6.0 mg/dl and keep it there. By doing that, the body will gradually pull the urate crystals out of their joints, and the flares can stop. Tophi will also gradually disappear.
Medications called xanthine oxidase inhibitors limit the amount of uric acid your body produces. These include allopurinol and febuxostat . Colchicine, which decreases the inflammatory response to gout, may also be given along with allopurinol at the start of long-term treatment after a flare subsides.
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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
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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Purines The Root Cause Of Hyperuricemia
A purine is an organic compound usually found in the same foods that contain protein. To break down purines the liver must produce uric acid. When there is a large presence of purines, the liver tends to produce more uric acid than the kidneys can filter out of the body. Hyperuricemia is the condition when uric acid levels are above normal levels. The excess uric acid builds up at a joint and causes inflammation and pain, which are symptoms of gouty arthritis or gout.
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
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Does Avoiding Alcohol Help
There are only a few studies looking into the influence of alcohol on gout. They suggest that people with gout are more likely to have an attack if they have had more than one or two alcoholic drinks in the last 24 hours. One alcoholic drink is equivalent to a small bottle of beer , a small glass of wine or a double schnapps .
There are various reasons why alcohol can trigger gout attacks. On the one hand, it increases uric acid production and reduces the amount of uric acid expelled by the kidneys. On the other, the diuretic effect of alcohol can increase the risk of gout. Uric acid crystals form more readily in joints if the surrounding tissue doesnt contain enough fluid. Beer in particular contains a relatively high amount of purines too, which could also be a factor.
Is Onion Bad For Gout
Drink plenty of water, milk and tart cherry juice. Drinking coffee seems to help as well. Be sure to talk with your doctor before making any dietary changes.
But research has identified other rare but more serious side effects may be linked to allopurinol use. The most serious is Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis . Allopurinol is marketed as Zyloric and Zyloprim, as well as in its generic form. Its creation dates back to research in the 1940s and it was first approved for use in the United States in 1966. Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development.
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How To Fight Gout Pain
Gout is an excruciatingly painful form of arthritis that often affects the feet. Dietary factors, such as red meat and alcohol, can trigger gout pain. However, medications and medical conditions can be a problem too, says Kenneth G. Saag, MD, a rheumatologist at the University of Alabama at Birmingham.”Non-food items are the major risk factors for developing gout,” he says. Here are nine such triggers, which could be causing your gout pain.
How Does Drinking Alcohol Affect Gout
Alcoholic drinks tend to be high in purines and consuming more than the recommended amount can increase the risk of a gout attack. It is therefore recommended to limit alcohol intake, avoid binge drinking and avoid all alcohol if you have painful gout or are having a gout attack. Try limiting alcohol to a maximum of 14 units per week for both men and women and 1-2 units per day with a minimum of two alcohol-free days a week. Beer, stout, port and fortified wines tend to be higher in purines and should be restricted. Moderate consumption of wine is not associated with a significant increased risk.
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