Gout
Overview
Gout is an inflammatory condition that is caused by the deposit of urate crystals in joints (most famously the big toe) as well as other tissues. Typically, attacks of fierce pain, redness, swelling, and heat punctuate pain-free intervals.
Gout usually occurs in the big toes of individuals, but may also occur in the ankles, knees, wrists, and hands. Gout is most common in men who are middle-aged and older, but it also affects women. About one-fifth of people with gout develop kidney damage.
Causes of Gout
Gout is caused by an excess of uric acid in the body, with uric acid itself being produced when the body breaks down protein and other compounds. This excess happens when the kidneys are unable to eliminate enough uric acid through urine or when the body’s metabolism produces too much uric acid. When there is an excess of uric acid, it crystallizes around joints in the body, which in turn causes joint pain and inflammation (gout).
Certain factors increase the risk that an individual may suffer from gout. Consumption of foods high in the nucleic acids called purines (chemicals that the body converts to make uric acid) may lead to an increased risk of gout. Foods high in purines include organ meat, brains, anchovies, shellfish, baker’s yeast, brewer’s yeast, asparagus, and mushrooms. Additionally, alcohol consumption increases the risk of gout as it increases production of uric acid and decreases the functions of the kidneys. Gout may also be cause by certain illnesses, including obesity, hypothyroidism, diabetes, leukemia, and kidney failure. Certain medications may also increase the risk of gout, such as radiation treatments and medications that slow the functioning of the kidney (such as diuretics for high blood pressure and warfarin for stroke).
Gout tends to run in families, with some theorizing that individuals may have a genetic disposition toward developing gout.
Prevention of Gout
Avoiding obesity and foods high in purines, and moderating alcohol consumption can help prevent gout from developing or recurring. Drinking six to eight glasses of water a day can dilute uric acid, possibly preventing attacks of gout.
Symptoms of Gout
Individuals suffering from gout experience swelling, redness, heat, and severe joint pain that appears suddenly and usually lasts for about a week. Gout symptoms may also be accompanied by a fever and a general feeling of malaise.
How Gout is Diagnosed
Doctors can usually diagnose gout by examining a patient’s symptoms and looking for swelling in the joints, as well as their range of motion. Blood test may also be ordered, but only about 50% of gout sufferers exhibit higher levels of uric acid than normal. Other diagnostic tactics include taking a fluid sample from a joint and testing it for crystals, or using X-rays to examine joints for damage caused by gout.
Gout Possible Treatments
Medical treatment consists of anti-inflammatory drugs for acute attacks and urate-lowering drugs for prevention.
Gout may be prevented through smart management of an individual’s diet and lifestyle in combination with medication. Pain caused by gout may be reduced by taking non-steroidal anti-inflammatory and acetaminophen. Colchicine may be used to decrease inflammation in the joints and prevent further gout. Other drugs may be taken to reduce the amount of uric acid in a person’s blood, increase the excretion of uric acid, or reduce the production of uric acid.
A 2004 study found that individuals suffering from gout who underwent one month of acupuncture treatment had lower levels of uric acid than those who did not. The study, published in the Journal of Traditional Chinese Medicine, concluded that acupuncture may help prevent gout from damaging the kidneys.
Folic acid supplements may help prevent gout, but may also cause a vitamin B12 deficiency and high doses may lead to digestive issues and exacerbate seizures in epileptics. A doctor should be consulted before taking folic acid supplements. Cherry extract may also help to detoxify the body and eliminate uric acid.
Celery (Apium graveolens) extract may help eliminate uric acid. Chiso (Perilla frutescens) is a weedy mint that is often used in the East for medicinal purposes. Chiso has compounds that act as xanthine oxide inhibitors, preventing uric acid from ever being formed in the body. Chiso may be added to teas, and the Japanese often add a little chiso to their sushi. Licorice (Glycyrrhiza glabra) also contains xanthine oxide inhibitors, but not at the same level as chiso.
Turmeric (Curcuma longa) contains a compound called curcumin that inhibits prostaglandins from being synthesize in the body, reducing pain. The effect of curcumin is similar to that of aspirin or ibuprofen, but not as strong. Additionally, high doses of curcumin stimulate the adrenal glands, releasing cortisone, which prevents inflammation and the pain caused by inflammation. Turmeric may be absorbed in curries, through tea, or may be taken in capsule form. Avocado (Persea Americana) also purportedly lowers the levels of uric acid in the blood.
Cat’s claw (Uncaria) may serve to alleviate the inflammation caused by gout, and may be bought in health and herb shops. Cherries (Prunus) may help to prevent attacks of gout, though they must be eaten in large amounts. Strawberries may also serve the same purpose.
Devil’s claw (Harpagophytum procumbens) is reported to lower levels of uric acid in the body as well as relieve inflammation in joints. Devil’s claw is used to treat a number of arthritic conditions like gout. However, these reports rely on direct injections of devil’s claw. If taken through a pill or in a tea, the herb may lose its effectiveness when it is digested through the stomach.
Oat (Avena sativa) teas, made from the silica-rich tops of the plant, may have a diuretic effect which lowers the levels of uric acid in the blood. Olives (Olea europea) have been used as diuretics for thousands of years. Research has shown that four cups of olive leaf tea per day lowered uric acid levels in the blood and increased the outflow of uric acid in the urine.
Pineapple (Ananas comosus) contains an enzyme called bromelain that helps break down proteins, and can reduce inflammation and swelling in joints. Pure bromelain is available at natural food stores, but drinking pineapple juice or eating pineapples may have the same effect.
References
- Bratman, S. The Alternative Medicine Ratings Guide: an expert panel rates the best treatments for over 80 conditions, Prima Health A Division of Prima Publishing (1998)
- Brown, L. Alternative Medicine, NTC/Contemporary Publishing (1999)
- Deepak Chopra, M.D. Alternative Medicine: The Definitive Guide, Celestial Arts (2002)
- Duke, J. The Green Pharmacy: Herbal remedies for common diseases and conditions from the world's foremost authority on healing herbs,Rodale Limited (2003)
- Nancy Allison. The Illustrated Encyclopedia of Body-Mind Disciplines, The Rosen Publishing Group (1999)
- Servan-Schreiber, D. The Encyclopedia of New Medicine: Conventional & Alternative Medicine For All Ages, Rodale International Limited (2006)
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