Tuesday, May 17, 2022

What Is The Leading Cause Of Gout

Is There A Test For Gout

Gout, Pathophysiology, Causes, Symptoms, Risk Factors, Diagnosis and Treatments, Animation.

There is no one test for gout, and its symptoms are similar to several different conditions. To see if you have gout, your health care provider may:

  • Ask you to provide your medical history, including:
  • Your symptoms.
  • Any other medical problems you have.
  • Any medications you are taking.
  • Examine the affected joints.
  • Order laboratory tests, take a sample of fluid from one of your painful joints, or order imaging tests.
  • Should You See A Doctor

    If you experience sharp, sudden pain in your foot or toe joint or notice any other signs of gout, its best to contact a physician. Untreated gout can lead to worsened pain and potentially permanent joint damage. And if you have a fever in addition to swelling and severe gout pain, you should seek immediate care, as it could be a sign of a serious infection.

    Points To Remember About Gout

    • Gout is a type of arthritis that causes pain and swelling in your joints, usually as flares that last for a week or two, and then go away.
    • With early diagnosis, treatment, and lifestyle changes, gout is one of the most controllable forms of arthritis.
    • The most common symptom of gout is pain in the affected joint, such as the big toe.
    • Your doctor may recommend taking medications to manage the cause of your gout and treat active gout flares, and making changes to your diet and lifestyle.

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    What Is Leading Cause Of Gout In Vegetarians: You Have To Know This

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    Gout And Heart Disease

    What is The Leading Cause of Gout ?

    Gout is found in higher rates in people with high blood pressure, coronary artery disease, or heart failure. A high level of uric acid has been linked to a high risk for death from heart conditions. Studies have also found an association between gout and having metabolic syndrome. This is a collection of health problems, including abdominal obesity, high blood pressure, high triglyceride levels, and low HDL cholesterol level. This syndrome increases a person’s risk of developing heart disease and diabetes. Studies are being done to find out whether treating asymptomatic hyperuricemia in such people is beneficial.

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    The Role Of Physical Activity In Prevention Of Gout

    Along with diet, physical activity can help with weight loss, and gout has been associated with being overweight.7 in patients with well-established gout, especially if X-rays have demonstrated joint damage in the foot, a low-impact exercise program is reasonable. An exercise program combined with diet in gout can reduce risk for attacks.7 If an attack seems to be coming on in the lower extremity, patients are well-advised to try to get off their feet, since impact seems to worsen gout attacks. Clues to an attack of gout coming on include local swelling, heat, redness, and tenderness in a joint, especially in the foot, ankle, or knee. Some patients have fever and chills as the first warning that an attack of gout is coming on.

    What Is The Main Cause Of Gout

    When it comes to what causes gout, higher levels of uric acid in your body may be caused due to various reasons including obesity, diet pattern, genetic reasons etc. Higher levels of uric acid are also termed as Hyperuricaemia. If you are more than the normal weight, then the fatty tissues in your body also enhance the production of uric acid in your body.

    We also get lots of purines through our diet and it has been proven that around 15% of purine is sourced from our diets. Foods that are rich in purines, main gout causing chemicals include red meat, sugary beverages, asparagus, spinach, turkey, beer, herring and scallops.

    Our body also produces its own uric acid and normally most of the excess ones are eliminated from our body, but in certain conditions, it is not able to eliminate the uric acid content thus increasing the levels of uric acid in the body. The reason why your body couldnt remove the uric acid may vary including obesity, being diabetic, alcoholic and consuming certain kind of diuretics.

    Major factors that cause higher levels of uric acid in your blood include:

    • Drinking too much alcohol
    • Hypothyroidism

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    Myth: Only Wealthy And Obese People Get Gout

    Truth: People of all sizes get gout although extra pounds increase the risk, says John Reveille, M.D., director of rheumatology at the University of Texas Health Science Center in Houston. Gout is also more common in people who have other, often weight-related health problems, including diabetes and high blood pressure or cholesterol. And while income has nothing to do with the condition, genes do play a part: If your parents had gout, you’re more likely to have it as well.

    Gout is not a gender-specific disease.

    What Happens At Your Appointment

    Gout – causes, symptoms, diagnosis, treatment, pathology

    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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    Which Joints Are Involved In Gouty Arthritis And Why Is It Most Common In The Foot

    As with all other known types of arthritis, Gout has particular joints it tends to attack, and the foot is its most common location. Gout especially favors the bunion joint, known as the first metatarsophalangeal joint , but the ankle, midfoot and knee are also common locations, as is the bursa that overlies the elbow.

    The bunion joint is the first joint involved in 75% of patients and is ultimately involved in over 90% of those with this condition. . It is thought that this joint is especially involved in gout because it is the joint that receives the highest pounds per square inch of pressure when walking or running.

    Late in gout, if untreated, multiple joints can be involved, including the fingers and wrists. The shoulder joint is very rarely involved by gout and the same is true of the hip.

    Figure 5: Location of Gout Attacks

    Can You Drop 8 Pounds Weight Loss Helps Prevent Gout

    If youre overweight, you are likely to have higher-than-normal uric acid levels, a primary risk factor for developing gout. Thats why weight loss is an important part of a gout diet.

    Losing weight may help lower uric acid levels and reduce the risk that you will experience future gout attacks. In fact, a weight loss of about eight pounds or more led to long-term reductions in uric acid levels and gout attacks in overweight or obese people, according to a review of studies published in 2017 in the Annals of the Rheumatic Diseases.

    While some people with gout benefit from cutting back on foods that are high in purine, a chemical that contributes to uric acid formation, it is not clear how much purine intake makes a difference. You dont have to avoid all high-purine foods. Moderate changes to your eating style may help you feel better and reduce gout risks, and research suggests that purine-rich vegetables dont trigger gout. High-purine foods such as lentils and beans can be a smart source of lean protein.

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    How To Prevent Gout Attacks

    There are drugs for lowering uric acid content, they are known as urate-lowering therapies or ULTs.Treatment with ULTs generally starts after a gout attack is completely gone. It takes a few months for the drugs to cure your body completely of gout. But, once they are gone, you will no longer have gout, tophi or joint damage due to gout. Its important to remember that drugs do not clear away gout straight forward.

    You could experience more attacks and symptoms for the first six months of starting them. If this happens to you dont stop taking drugs. This is actually the sign of drugs are working. When the drug gets dissolved in the blood, it becomes smaller and can get into joints more easily and triggers the attack.

    I hope you liked and found useful this article on Gout-causes, symptoms and the best treatment. Do leave a comment if you have any queries regarding this and we will try our best to answer you.

    Chronic Gout Signs And Symptoms

    What are the causes and treatments of gout?
    • Compared with the dramatic nature of acute gout pain, chronic gout pain is more of a soreness or persistent ache.
    • Pain that tends to be a more continuous feeling of dull aching or soreness in the joints
    • Hard white deposits or lumps under the skin, called tophi, found on the elbows, ears, or fingers.

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    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

    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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    What Should People With Gout And Mthfr Know

    People with gout should be aware that their condition may not be preventable through lifestyle changes alone, especially if they have an MTHFR mutation. In the case of an MTHFR mutation, mediation and/or supplements may help to get their condition under control.

    Uric acid is a significant factor in gout, and many epidemiological studies have shown the relationship between uric acid and obesity, metabolic syndrome, hypertension, and coronary artery disease. These disorders are also linked to elevated homocysteine.

    Several studies have shown a link between uric acid concentrations and homocysteine levels. However, this exact relationship is uncertain.

    It is vital to note that deficiencies in folic acid, vitamin B12, and vitamin B6 levels have also been linked to both elevated homocysteine and uric acid levels.

    Folate, vitamin B6, and vitamin B12 all play crucial roles in lowering homocysteine. Folate also helps to inactivate xanthine oxidoreductase , the enzyme responsible for the oxidation of hypoxanthine to xanthine and xanthine to uric acid.

    The most effective way to overcome this impairment and optimize folate levels is to take a bioactive form of folate. L-Methylfolate is the only form of folate that crosses the blood-brain barrier and can be used instantly in the body.

    What Else Should I Ask My Healthcare Provider About Gout

    GOUT Symptoms & Treatment & causes | WHAT IS GOUTY ARTHRITIS

    Consider asking your healthcare provider:

    • What is causing the gout?
    • Do I have any joint damage?
    • What can I do to prevent future attacks?
    • Can any gout medications help me?
    • How long will I need to take gout medications?

    A note from Cleveland Clinic

    Gout is a painful form of arthritis. Extra uric acid in your body creates sharp crystals in the joints, leading to swelling and extreme tenderness. Gout usually starts in the big toe but can affect other joints. Gout is a treatable condition, and the uric acid level can be decreased by medication and lifestyle changes. Talk to your healthcare provider about medications that can reduce uric acid levels. They can also discuss changes you can make to your diet and lifestyle to prevent and reduce gout attacks.

    Last reviewed by a Cleveland Clinic medical professional on 11/15/2020.

    References

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    Natural Remedies For Gout

    A.Vogels Stinging Nettle tincture, made from the anti-inflammatory and slightly diuretic plant, has been successful in resolving excess uric acid, when 25 drops are taken with a little water, three times a day.

    For general intestinal and digestive health Molkosan and Bio-Strath can help balance the bodys pH, maintain healthy intestinal flora and help with the digestion of nutrients and elimination of toxins such as uric acid.

    Once an attack of gout is under control, a detox treatment can be useful in boosting the ability of the kidneys and intestines to flush out the toxins. A treatment using A.Vogels Boldocynara or Milk Thistle products, which are rich in herbs with choleretic, cholagogue, diuretic and toning effects, is recommended at least twice a year.

    Topical use of Absolüt Arnica Gel or a green clay poultice can also be very soothing.

    Gout is probably one of the easiest forms of arthritis to manage through a healthy lifestyle. And anything that promotes digestive health and aids the body in efficiently eliminating toxins can do nothing but help prevent or heal gout and optimize ones overall health.

    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.

    Read more about the complications of gout.

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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:

    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 Are Tophi And What Causes Them

    Hyperuricemia and Kidney Disease

    Tophi occur when the persons blood uric acid level remains high over a long period of time. The uric acid deposits in joints and forms precipitates. These precipitates can become quite large, resulting in bumps and swellings on the joints. These swellings can occur on the knee, the elbow, the big toe, and many other joints. They can be quite painful. Sometimes they open up and leak white, chalky material that is composed of uric acid.

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    The Role Of Medication In Prevention Of Gout

    Table 3: Medications to pevent attacks of gout

  • Colchicine: to decrease the ability of uric acid crystals to cause inflammation.
  • Allopurinol and febuxostat: to decrease production of uric acid
  • Probenecid and lesinurad: to increase the excretion of uric acid
  • Pegloticase: to increase the breakdown of uric acid
  • Standard medications in preventing gout attacks

    i. Colchicine : using the matches analogy discussed above1, using colchicine can be seen as dampening the uric acid matches. Colchicine does not lower the bodys store of uric acid, but it decreases the intensity of the bodys inflammatory reaction to these crystals. Recent studies have shown that at least one mechanism of colchicines action is by acting to prevent a cascade of reactions that lead to the production of interleukin 1-beta, which is an inflammatory protein , which is important in gouty inflammation.8

    ii. Allopurinol: This agent is presently the most commonly used drug for the prevention of gout. Allopurinol blocks the enzyme xanthine oxidase, which blocks the breakdown of purines, thus decreasing the bodys total amount of uric acid. Allopurinol is effective in preventing gout no matter what the mechanism of the elevated uric acid was. Whether a person is making too much uric acid, or has difficulty excreting it via the kidney, allopurinols decrease in uric acid production leads to the same goal: a decreased total body uric acid.

    Table 4: Reasons to use medication to lower uric acid

    Health Conditions And Treatments

    Certain drugs, health problems, and lifestyle choices can trigger gout, too.

    Medications. Aspirin, certain diuretics for high blood pressure , and drugs for people who had organ transplants can trigger gout. After a flare, go over all the medicines you take with your doctor. If needed, they should be able to find another option.

    Being overweight. When you slim down, you can protect yourself from another flare.

    Fasting or crash diets. If you lose weight too quickly or fast, you could raise your chances of an attack.

    High blood pressure, kidney disease, diabetes, and heart disease. These health conditions make you more likely to have gout, especially if you donât get treatment. Work with your doctor to keep them under control.

    Injuries or surgery. When your body is stressed or sick, youâre more likely to have a flare. Of course, you canât always avoid this trigger. But if you need to have an operation, make sure your doctor knows youâve had gout in the past.

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