The first sign is commonly an aching, throbbing, and exquisitely painful big toe. Usually the joint becomes swollen, red, and tender and, if the attack is ongoing, fever and chills may develop. Gout mostly affects men. In fact, nearly 90% are men over the age of thirty. However, women are not immune, particularly if they are taking medications, such as antihypertensives.
The main cause of gout is the formation of uric acid crystals in the joints, skin, and kidneys. Uric acid is an end-product of the body’s own chemical processes. Someone affected by gout will have a higher level of uric acid in the blood than normal, due either to excess production or reduced excretion by the kidneys. Uric acid usually remains dissolved in the blood. However, if the blood becomes saturated with it, the acid will start to form needle-shaped crystals in the joints.
Other causes of gout are heredity, excessive alcohol, regular eating of foods rich in protein and carbohydrate, lack of proper exercise, and stress.
It is also important to understand that uric acid is a major natural antioxidant in human blood that protects against aging and oxidative stress. Therefore, if uric acid is being produced in excessive amounts, it may be because that person is under too much oxidative stress from external sources (pollution, smoking, poor diet etc). This can be corrected by modifying lifestyle and increasing the intake of natural antioxidants.
Dietary modification
Foods that are high in compounds called purines will raise the level of uric acid in the body and increase the risk of gout. Restricting purine intake can reduce the risk of an attack in people, especially if they are susceptible to gout. Foods high in purines include:
- anchovies,
- bouillon,
- brains,
- broth,
- consommé,
- dried legumes,
- goose,
- gravy,
- heart,
- herring,
- kidneys,
- liver,
- mackerel,
- mince,
- mussels,
- partridge,
- fish roe,
- sardines,
- scallops,
- shrimp,
- sweetbreads,
- baker’s yeast,
- brewer’s yeast, and
- yeast extracts (e.g., Marmite, Vegemite).
As well as eliminating these foods, intake of fruit and vegetables should be increased as these will reduce the acidity of both tissue and urine and therefore reduce the likelihood of uric acid build-up. Avoiding alcohol, particularly beer, or limiting alcohol intake to one drink per day or less may reduce the number of gout attacks. It is also best to avoid refined sugars, including sucrose (white table sugar) and fructose (the sugar found in fruit juice), as they have been shown to raise uric acid levels.
Gout diet
Raw vegetable juices are commonly recommended for the treatment of gout. Carrot juice, in combination with the juices of beetroot and cucumber, is especially effective. Mix 100 ml of beetroot juice and 100 ml of cucumber juice with 300 ml of carrot juice and drink daily.
The juice of French or string beans has also proved effective in treating gout, with the target amount being 150ml daily. Bananas have been found beneficial in the treatment of gout. A diet of bananas only for three or four days has been shown to provide some relief from gout, consuming as many as eight or nine bananas daily and nothing else.
Current evidence indicates that regular consumption of cherries results in fewer gout flare-ups. Black, sweet yellow, and red sour cherries are all effective. A pilot study suggests that consuming cherry juice concentrate for 4 months or longer may reduce the number of acute gout flare-ups. It is believed that cherries are beneficial in part for their anti-inflammatory activity; and also by lowering the levels of uric acid in the body.
For an acute attack, the best remedy is a fast of orange juice and water for three days, then moving on to an all-fruit diet for another three or four days. This should be followed by a well-balanced diet of natural foods, with an emphasis on fresh fruits, raw vegetables, and sprouts. Epsom salts foot baths twice daily are also helpful. Add about 250 – 500 g of salts to tolerably hot water. Full Epsom salts baths are also recommended three times a week, reducing to twice weekly once the acute episode subsides.
Lifestyle modification
Obesity and high blood pressure both increase the risk of developing gout. However, any weight loss should be slow and controlled as restriction of calories can increase uric acid levels temporarily, which may aggravate the condition. Drinking adequate amounts of water is important. Water dilutes urine and lessens the chance of uric acid crystals forming, as well as helping to prevent the formation of kidney stones. About 10 to 20 % of gout victims develop kidney stones, so trying to prevent them before they form is important.
Stress can exacerbate gout. Stress control through exercise and stress-reduction techniques is an important aspect of controlling symptoms. Vitamin A in large amounts can exacerbate gout. Dosage should not exceed 5,000 I.U. daily. During an acute attack vitamin A intake should be excluded altogether.
Niacin can also raise uric acid levels and thus aggravate gout. Dosage should be restricted to no more than 100 mg daily.
Nutritional supplement treatment options
Folic Acid – Large amounts of supplemental folic acid have reduced uric acid levels in research studies.
Vitamin C – High levels of vitamin C (4 grams and above) can increase urinary excretion of uric acid within a few hours. However, this should always be undertaken under medical guidance as there is a risk that taking large amounts of vitamin C could actually trigger an acute attack of gout by abruptly changing uric acid levels in the body.
Taking 500mg of vitamin C daily for two months has been shown to significantly reduced blood levels of uric acid, especially in people whose initial uric acid levels were elevated.
Quercetin – Has been shown to inhibit an enzyme involved in the development of gout.
Botanical treatment options
Autumn crocus (Colchicum autumnale) is the herb from which colchicine was originally isolated. Colchicine, a strong anti-inflammatory compound, is used as a conventional treatment for gout. Both the herb and the drug have significant toxicity and should only be used under the guidance of a practitioner.
Devil’s Claw (Harpagophytum procumbens) is an herbaceous perennial used not only for its analgesic and anti-inflammatory properties; but has also been shown in research to reduce cholesterol and high uric acid levels.
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Article contributed by Dr Tracy S Gates, DO, DIBAK, L.C.P.H., Consultant, Pure Bio Ltd. Copyright © Pure Bio Ltd 2024. All rights reserved. Pure Bio Ltd are a leading UK supplier of the highest quality PURE nutritional supplements, based in Horsham, West Sussex. Proud Winners of Southern Enterprise Awards, Best Nationwide Hypoallergenic Nutritional Supplements Distributor 2022 and 2023. Visit www.purebio.co.uk for all your nutritional supplement needs
