Gout Myths And Misconceptions And The Facts
Gout was once called the disease of kings, because of its propensity to affect overweight, rich men throughout history. Famous gout sufferers have included Alexander the Great, Charlemagne, Henry VIII of England, and Benjamin Franklin.
While gout is no longer thought to be a disease of the wealthy, it is more common in men and people with weight-related health problems including high blood pressure and type 2 diabetes.
Treatment For Gout And Gout Attacks
As soon as youve been diagnosed with gout, your doctor will aim to reduce your pain ASAP. In May 2020, the American College of Rheumatology updated its guidelines for gout treatment for the first time in eight years. There is more evidence in support of early diagnosis and treatment treat-to-target protocols and allopurinol as a first-line agent.
Which Medications Can Affect Gout
Date: 06/07/2018 | Topics : Gout Flare Prevention, Lifestyle Tips for Gout,
If you are like many American adults, you take multiple prescription medications each day to manage your chronic health conditions.1 Although these prescriptions may help to improve your overall health, you may not be aware of which medications can affect gout and increase your risk for gout flares.2
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Strengths And Limitations Of The Study
This study was carried out using a large UK general practice population therefore, findings are likely to be applicable to the general population. As antihypertensive drugs are used for other clinical conditions, the overall consistency of the results stratified by hypertension helped to sort out potential drug effects from those of the underlying conditions. Because the definition of gout was based on doctors diagnoses, a certain level of misclassification of use is inevitable. A diagnosis of gout could often have been recorded based on the suggestive clinical presentation of gout without documentation of monosodium urate crystals. However, any non-differential misclassification of these diagnoses would have biased the study results toward the null and would not explain the strong associations and dose-response relations observed in this study. Furthermore, when we used doctors diagnoses of gout combined with anti-gout drug use as our case definition, our results remained almost identical. Despite the large size of the study cohort, the number of participants in certain subgroups was relatively small, which limited our ability to obtain robust estimates. Replicating these results in the context of a larger prospective cohort would be valuable. Such a larger study context would also be useful for quantifying the effects of switching antihypertensive drugs.
Information About Medicines For Gout
Starting medicines which lower uric acid can set off an attack of gout. You should work with your doctor to learn which medicines and dosages may cause gout flare-ups. In general, it is best to increase the dose slowly over many weeks. Also, you may need a medicine such as colchicine to prevent gout flares for the first several months after starting the urate-lowering medicine. Your uric acid should be lowered to less than 6.0 mg/dL, and sometimes less than 5.0 mg/dL. Gout medications may interact with other drugs. Most people with gout will need to take the urate-lowering medicine for the rest of their life.
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Medication Options For Uric Acid Lowering
It is important to note that whenever starting a uric acid lowering treatment, there is a risk of precipitating a gout flare. A plan should be in place for management if this occurs. This generally can be avoided with the co-administration of prophylactic medications along with the uric acid lowering therapy.
Probenecid
Probenecid may be given to patients with decreased clearance of uric acid by the kidney and normal renal function. In general its use should be limited to patients under the age of 60. Probenecid acts by inhibiting reabsorption of uric acid in the proximal tubules of the kidney. Starting dose is at 500 mg to 1000 mg daily and increased to 1500 mg to 2000 mg as needed. Occasionally higher doses are needed. Probenecid may precipitate renal stone formation and good oral hydration should be encouraged. Probenecid is contraindicated in patients with renal stones and in patients with urate nephropathy. Probenecid given inappropriately to patients with hyperuricemia due to overproduction of uric acid can cause renal stones and urate nephropathy.
- uricosuric
- useful in patients with decreased renal clearance of uric acid
- can only be used if creatinine clearance > 40 cc/min
- must have 24 hour urine for uric acid < 800 mg/dl
- can be used in renal failure
- increased risk of renal stones
Allopurinol
Pegloticase
- pegylated porcine uricase
Things You Can Do About Hyperuricaemia
Make sure you tell your doctor, as well as all healthcare providers, about any other medicines you are taking . Remind your doctor or healthcare provider if you have a history of diabetes, liver, kidney or heart disease. Follow your healthcare provider’s instructions regarding lowering your blood uric acid level and treating your hyperuricaemia. If your blood levels are very high, they may prescribe medicines to lower the uric acid levels to a safe range. Read more about medicines for gout. Uric acid can also be reduced by avoiding some foods and drinks such as:
- all organ meats , meat extracts and gravy
- seafood
- yeasts and yeast extracts
- asparagus, spinach, beans, peas, lentils, oatmeal, cauliflower and mushrooms
- fizzy drinks as they often contain fructose which can make your gout worse.
Keep hydrated and drink plenty of water unless there is a medical reason not to do so. Keep active by exercising. Lose weight if you need to.
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How Do Health Care Providers Diagnose Gout
The most reliable method to diagnose gout is by demonstrating uric acid crystals in joint fluid that has been removed from an inflamed joint . Specially trained physicians, such as a rheumatologist or orthopedist, can carefully remove fluid from the joint. The fluid is then examined under a microscope to determine if uric acid crystals are present. This is important because other medical conditions and diseases, such as pseudogout and infection, can have symptoms similar to gout.
Gout Versus Rheumatoid Arthritis
Patients confuse these two conditions and cannot diagnose them on their own. Both gout and rheumatoid arthritis cause redness, pain in joints, and swelling. Moreover, both of them cause disability and discomfort.
That is why you have to analyze the symptoms closely to differentiate them. The safest option for you is to have an appointment with a physician. He will help you best by diagnosing the signs.
In the case of rheumatoid arthritis, the pain may be severe, moderate, and mild. The joint parts can become stiffer due to this condition. Moreover, these affected parts will become swollen, red, and painful.
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Talk With Your Doctor
Be sure to tell your doctor about all of the medicines and supplements you takeboth prescription drugs and over-the-counter products. Your doctor can tell you which medications can affect gout or raise your risk of gout flares, if any. Your doctor may also be able to recommend alternative treatments.
NOTE: This article was not written by a medical professional and is not intended to substitute the guidance of a physician. These are not West-Wards recommendations for gout flare prevention, but rather facts and data collected from various reliable medical sources. For a full list of resources and their attributing links, see below.
All registered trademarks are the property of their respective owners.
How Is Pseudogout Treated
There is no cure for removing the calcium deposits that cause pseudogout. It is a progressive disorder that can eventually destroy joints. Treatments for acute attacks of pseudogout are similar to those for gout and are aimed at relieving the pain and inflammation and reducing the frequency of attacks.
- Nonsteroidal anti-inflammatory drugs are effective for treating inflammation and pain from pseudogout.
- For acute attacks in large joints, fluid aspiration alone or with corticosteroids may help.
- Colchicine may be used for acute attacks.
- Magnesium carbonate may help dissolve crystals, but existing hard deposits may remain.
- Surgery may be required for joint replacement.
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Antihypertensive Drugs And Risk Of Incident Gout Among Patients With Hypertension: Population Based Case
- Accepted 4 November 2011
Medications That Can Trigger Gout
Some medications can trigger gout symptoms. This includes common pain medications. Even small amounts of these drugs can impact gout. Your doctor may recommend changing these medications if you notice more gout symptoms.
Aspirin or acetylsalicylic acid raises uric acid in your blood. Even low doses of aspirin can trigger gout. Research shows that this effect of aspirin is more common in women than in men.
Diuretics or water pills help to treat conditions such as high blood pressure and edema or swelling in the legs. These medications work by getting rid of excess water and salt from the body. However, they can also cause a side effect of too much uric acid in the body, triggering gout. Diuretic drugs include:
- chlorothiazide
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What Can Cause Painful Gout Attacks
Excess uric acid in the blood may cause a condition that is known as gout. This is considered to be a form of arthritis, and causes severe pain and discomfort as a result of inflammation in the joints. Gout generally affects the joints in the big toe, and can occur due to genetics, or from eating foods that have high levels of purines. These types of foods can include shellfish, red meat, alcohol, and drinks that are made with large amounts of sugar. Gout can be common in patients who are obese, have diabetes, or kidney disorders. After a proper diagnosis is made, which can include having an X-ray taken or testing the blood for uric acid crystals, proper treatment can begin. If you are afflicted with gout, it is strongly suggested that you are under the care of a podiatrist who can offer you the right treatment options.
Gout is a painful condition that can be treated. If you are seeking treatment, contact Dr. John R. Northrup from Superior Podiatry. Our doctor will treat your foot and ankle needs.
What Is Gout?
Gout is a form of arthritis that is characterized by sudden, severe attacks of pain, redness, and tenderness in the joints. The condition usually affects the joint at the base of the big toe. A gout attack can occur at any random time, such as the middle of the night while you are asleep.
Symptoms
Risk Factors
How Is Gout Diagnosed
In a clear-cut case, a primary care physician can make the diagnosis of gout with a high level of confidence. However, often there are two or more possible causes for an inflamed toe or other joint, which mimics some of the symptoms of gout, so tests to identify the presence of uric acid is performed.
Since the treatment for gout is lifelong, its very important to make a definitive diagnosis. Ideally, the diagnosis is made by identifying uric acid crystals in joint fluid or in a mass of uric acid . These can be seen by putting a drop of fluid on a slide and examining it using a polarizing microscope, which takes advantage of the way uric acid crystals bend light. A non-rheumatologist, when possible, can remove fluid from the joint by aspirating it with a small needle and send it to a lab for analysis. A rheumatologist is likely to have a polarizing attachment on their microscope at their office. Gout crystals have a needle-like shape, and are either yellow or blue, depending on how they are arranged on the slide .
Figure 11: Uric Acid Crystals Under Polarizing Light Microscopy
There are many circumstances where, however ideal it would be, no fluid or other specimen is available to examine, but a diagnosis of gout needs to be made. A set of criteria has been established to help make the diagnosis of gout in this setting .2
Table 1: Diagnosing gout when no crystal identification is possible
Ideally, 6 of 10 features will be present of the following:
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Who Can And Cannot Take Allopurinol
Allopurinol can be taken by adults and sometimes children.
Allopurinol is not suitable for certain people.
Talk to a doctor or pharmacist if you:
- have ever had an allergic reaction to allopurinol or any other medicine
- are of Han Chinese, Thai or Korean origin
- have problems with your liver or kidneys
- currently have an attack of gout
- have thyroid problems
Diagnosing Gout In Your Fingers
A doctor diagnoses finger gout by checking the symptoms. He will also ask you to perform a physical examination with an X-ray of the joints. Uric acid crystal tests are also essential to diagnose gout in your finger. During a gout flare, the joint becomes swollen, hot, and painful.
Some patients mistakenly think of gout symptoms as an inflammatory condition. Thus, it is important to contact a rheumatologist and make the diagnosis more accurate. Arheumatologist specializes in treating arthritic conditions like gout.
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What Else Should I Ask My Healthcare Provider About Gout
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
Research And Statistics: How Prevalent Is Gout In The United States
Research published in the journal Arthritis & Rheumatology found that gout rates in the United States have been climbing steadily over the past 50 years, likely because of increases in obesity and high blood pressure.
Gout is the most common type of inflammatory arthritis among men. Its more common in men than women. About 6 percent of men in the United States have gout, while only about 2 percent of women have it. Women rarely develop gout before reaching menopause.
Gout is rare in children and young adults.
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Chronic Gout Signs And Symptoms
- 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.
Home Remedies To Treat Gout In Fingers
Medications are always the best option for treating gout in the fingers. However, patients may also try out some self-management strategies to reduce gout symptoms. A physician will start the treatment with NSAID drugs like ibuprofen. Other anti-inflammatory drugs, including colchicine, are also useful for pain management.
Self-management strategies include an adjustment to lifestyle and diet. They can lower the frequency and severity of gout flares. For instance, you can create a gout-friendly diet chart, do physical workouts, and maintain proper body weight. These are some ways to prevent complications from gout in the finger.
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Clinical And Public Health Implications
Our findings may have practical implications in the management of hypertension, particularly among those who are at a higher risk of developing gout. Our data suggest that calcium channel blockers or losartan would be preferred to other antihypertensive drugs if prevention of gout is relevant and other determining factors are comparable. Furthermore, from a public health perspective, using these urate lowering antihypertensive drugs could help reduce the high comorbidity burden of gout and hypertension.1 As our findings are based on the reference point of no use of each corresponding antihypertensive drug, the difference in risk of gout between urate lowering agents compared with urate raising agents would be even greater, which could in turn lead to noteworthy differences in risk-benefit ratios, particularly in populations at high risk for gout.
Can You Get Rid Of Gout
It ought to be fairly obvious why youd want to get rid of gout, but is it possible actually?
Sure can be, but theres not just a one-size suits all solution.
In the next section, well come to be going over whats worked greatest for us!
You wont want to lose out on this free video.
NOTICE: Id highly recommend going to your doctor or seeing a specialist about this situation, since we arent experts. See our medical disclaimer for more details.
We dont know what will work for you, but we know whats worked for us and others
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How And When To Take It
The usual dose of allopurinol is 100mg to 300mg a day. Follow your doctor’s advice on how many tablets to take, and how many times a day.
You’ll have regular blood tests to monitor your uric acid levels. If your uric acid level does not come down far enough, your doctor may increase your dose .
If you have kidney or liver disease, your doctor may prescribe a lower dose and will monitor you more closely.