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Gout is a form of arthritis that is a painful inflammation and swelling of the joints caused by the buildup of uric acid in the body. Certain foods cause gout so diet plays a role. Treatment of gout can be acheived through medication and proper diet.
At least one male in a hundred over age 40 suffers from gout. Women can develop it too, mainly after menopause. Though people with gout feel fine much of the time, an attack can occur without warning, bringing on breath-catching joint pain that demands fast-acting, effective relief.
The most common gout symptom is sudden, severe attacks of pain, tenderness, redness, warmth and swelling in some joints. It usually affects one joint at a time, especially the joint of the big toe, but can also affect the knee, ankle, foot, hand, wrist and elbow. Redness and swelling in affected joint or joints.
Kidney stones develop occasionally, causing fever, severe low back pain, nausea, vomiting, or a swollen abdomen. Deposits of uric acid, called tophi, can appear as lumps under the skin around the joints and at the rim of the ear. In addition, uric acid crystals can also collect in the kidneys and cause kidney stones.
What It Is
Gout is a metabolic disorder linked to high levels of uric acid in the blood. Uric acid, a by-product of various body processes, is also formed after eating certain foods. The body rids itself of uric acid through the urine. But some people produce too much uric acid — or can’t dispose of it fast enough — and levels build up. Often, the excess uric acid is converted into needle-shaped crystals that settle in and around joints and other tissues, triggering inflammation and the excruciating pain associated with gout.
Causes of Gout
This is one of the few types of arthritis where the cause is known. It results from deposits of needle-like crystals of uric acid in the connective tissue, joint spaces, or both. Normally this is a byproduct of the breakdown of purines or waste products in the body. Normally uric acid breaks down in the blood and is eliminated in urine. When the body increases its production of uric acid or if the kidneys do not eliminate enough of it from the body, levels build up. This is called hyperuricemia. Hyperuricemia is not a disease and is not dangerous. However, if excess uric acid crystals form as a result of hyperuricemia, gout can develop.
Gout does have a genetic basis in 20 per cent of cases, and does tend to cluster in families. It is inherited through the X chromosome. Women are carriers of the defective gene, but seldom develop the disease as they have two X chromosomes. The normal chromosome suppresses the defective one. Men develop the disease.
Environment and diet also play an important role. Not everyone with a high uric acid level develops joint pain. Also, not everyone with the gene develops gout.
Foods that Cause Gout
Some people may benefit from a reduction of purine rich foods. These include beer and other alcoholic beverages, anchovies, sardines (in oil), fish roes, herring, yeast, organ meats (e.g., liver, kidneys), legumes (e.g., dried beans, peas, and soybeans), meat extracts, consommÃ©, gravies, mushrooms, spinach, asparagus, cauliflower, and poultry. Weight loss can help reduce uric acid levels in those people that are overweight.
Modern Gout Treatment
Although there is no cure, most people with gout can keep it under control and lead normal lives. Treatment may consist of one treatment or a combination of treatments.
Nonsteroidal anti-inflammatory drugs (NSAIDs) block prostaglandins, the substances that dilate blood vessels and cause inflammation and pain. They are taken orally at their highest safe dosage as long as symptoms persist and for three or four days after. There are dozens of NSAIDs. Indomethacin (Indocin) is the usual choice.
Colchicine, a derivative of the autumn crocus, has been used to treat gout for thousands of years. This drug relieves the pain and swelling and can help prevent future attacks. Although highly effective, it is no longer the first treatment choice due to the potential for unpleasant side effects.
Corticosteroids may be used if NSAIDs are not tolerated.
Allopurinol (Lopurin, Zyloprim) blocks uric acid production and is the drug most often used in long-term treatment for older patients and those with high levels of excreted uric acid.
How is it diagnosed?
Standard diagnostic tools for gout may include a medical history and physical examination, a blood test for hyperuricemia, and urine sample. For a definitive diagnosis, a sample of synovial fluid from the affected joint is required. X-rays can provide helpful information in some cases.
What research is being done?
Scientists are studying whether other NSAIDs are effective in treating gout and are analyzing new compounds to develop safe, effective medicines to treat gout and other rheumatic diseases. For example, researchers are testing to determine whether fish oil supplements reduce the risk of gout. They are also studying the structure of the enzymes that break down purines in the body, in hopes of achieving a better understanding of the enzyme defects that can cause gout.
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When to Call Your Doctor :If you experience symptoms of an acute gout attack — your doctor can prescribe medications to ease the initial pain.If you suffer the severe pain of passing a kidney stone.
Reminder: If you have a medical condition, talk to your doctor before taking supplements.
How Supplements Can Help
Uric acid can accumulate in the blood for years with no symptoms. An acute attack often happens suddenly and is best treated with conventional drugs. The main supplement that seems to help during an acute attack is bromelain. The others, taken together, may prevent future attacks. All can be safely used for long periods, though cherry extract, vitamin C, and nettle may be the simplest regimen to follow for long-term maintenance.
What Else You Can Do
Drink at least eight glasses of water a day to dilute the urine and help lower uric acid levels. Stay away from alcohol, which can trigger attacks.
Keep weight down. Obesity may play an important role in gout attacks.
Avoid fats, refined carbohydrates, excess protein, and, if you’re sensitive to purines, foods containing them (including organ meats, anchovies, legumes, oatmeal, spinach, asparagus, cauliflower, and mushrooms).
One of the oldest known remedies for gout — a drug called colchicine — is derived from the autumn crocus, also known as meadow saffron. Unfortunately, colchicine in pill form causes severe cramping and diarrhea in up to 80% of those who take it in the high doses needed to combat gout attacks. An injectable form of colchicine administered by your doctor, however, appears to work quickly and without side effects.
Eating fresh or canned cherries (a half pound a day) may help keep gout at bay by reducing levels of uric acid. Some people swear by them; and a small study conducted many years ago found that eating cherries may indeed lower uric acid levels. An easier way to get the benefits of cherries is to take 1,000 mg daily of cherry fruit extract pills (available at health-food stores). Strawberries, blueberries, celery, or celery seed extracts may have a similar beneficial effect.
Cherry Fruit Extract
Dosage: 500 mg every 3 hours during an attack; reduce to twice a day to help prevent further attacks.
Comments: Each dose should provide 2,000 GDU or 3,000 MCU.
Dosage: 500 mg twice a day between meals.
Comments: Take with bromelain to help prevent gout attacks.
Cherry Fruit Extract
Dosage: 1,000 mg 3 times a day following an acute attack.
Comments: Reduce dosage to 1,000 mg a day for maintenance.
Dosage: 500 mg a day.
Comments: Add 500 mg every 5 days until you reach 1,000 mg twice a day. Reduce dose if diarrhea develops.
Dosage: 250 mg standardized extract 3 times a day.
Comments: Also effective as a nettle tea compress applied to sore joints. (Use 1 or 2 tsp. dried herb per cup of hot water.)
Dosage: 1 tbsp. (14 grams) a day.
Comments: Can be mixed with food; take in the morning.
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Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.
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