As we age, the potential for a flare up of gout, a painful and potentially disabling condition, increases for both men and women. Gout is a form of inflammatory arthritis caused by an abnormal metabolism of uric acid, that results in a buildup of uric acid in the blood and tissues. Uric acid is a waste product that is formed when the body breaks down purines, byproducts of protein and fructose metabolism. Purines are also found in dietary foods and drinks, such as organ meats, some seafoods, certain vegetables, legumes, high fructose corn syrup (HFCS) and alcoholic beverages, particularly beer. Most of the time, uric acid dissolves in the blood and is filtered through the kidneys and excreted in urine. When the body makes too much uric acid, or we eat too many foods high in purines, or the kidneys fail to remove enough uric acid, needle-like uric acid crystals can form in the body, often settling in and around the joints, resulting in intense pain, stiffness and inflammation, or in the kidneys, where they can develop into stones.
Gout attacks are generally acute, appearing without warning and lasting from a few hours to several weeks. A majority of the time symptoms subside within 5-10 days, after which people may remain pain free for a period of time. Some people may experience another attack within a few months, while others may go several years between episodes. Flare-ups most often occur in the big toe, but the condition can affect any joint including knees, elbows, wrists and fingers. While a high blood level of uric acid is considered the first stage of gout, not everyone with high levels will develop gout symptoms. The development of gout is strongly linked to genetics and lifestyle factors, including diet and excess alcohol consumption, and with symptoms of metabolic syndrome, including obesity, hypertension, diabetes, and high cholesterol and triglycerides. Stressful events, dehydration, injury, chemotherapy, diuretics and other medications may also trigger this painful condition.
As there is no known cure for gout, medications, such as corticosteroids and nonsteroidal anti-inflammatory drugs (NSAIDS), are often prescribed to reduce pain and inflammation. Other medications, such as those designed to block uric acid production or those that help the kidneys remove uric acid, may also be prescribed. Left untreated, gout can develop into a painful and disabling chronic disorder that can destroy bone and cartilage and result in loss of mobility. While many people may prefer to manage their condition without side effect inducing medications, a combination of medications and lifestyle changes may be necessary to prevent future attacks. Keeping uric acid levels low is extremely important for a lifelong management of gout flare-ups.
While gout is a lifelong disease, lifestyle choices can make a difference in keeping future attacks at bay. Avoid triggers, monitor uric acid levels, maintain a healthy weight and follow a well balanced anti-inflammatory, high antioxidant, low-fructose diet. When flare-ups occur, elevate the painful joint as often as possible and, if tolerable, apply ice packs or cold compresses several times per day to help relieve pain and reduce swelling and inflammation. Lifestyle recommendations that focus on the underlying cause of gout and other painful inflammatory conditions include:
- Be aware that treatment starts with your diet. A heart healthy, anti-inflammatory eating strategy includes foods low in uric acid, such as low-fat dairy, whole grains and vegetables. Enjoy small amounts of fruits and limited amounts of red and organ meats and shellfish. Totally avoid or severely limit processed foods and, most importantly, sugary drinks and HFCS.
- Reach and maintain a proper weight. Gradual weight loss helps to reduce blood levels of uric acid and can lessen the risks of heart disease and stroke, commonly seen in those who have gout. Rapid weight loss can actually trigger a gout attack.
- Hydration is key to minimizing the frequency and intensity of flare-up. Water is a necessary agent for detoxification and helps the blood, liver and kidneys to eliminate toxins and waste products, including uric acid.
- Derived from hot peppers, cayenne or capsaicin cream applied to the inflamed area helps to alleviate pain. At first use, capsaicin may stimulate pain. However, with continued use, capsaicin decreases the intensity of pain signals in the body.
- Fresh tart cherries, tart cherry juice and tart cherry supplements and extracts have been shown to support healthy uric acid levels. Tart cherries contain high levels of bioflavonoids and anthocyanins, which inhibit the same inflammation contributing enzymes targeted by anti-inflammatory medications.
- Limit alcohol consumption as much as possible. Alcohol promotes dehydration and can raise blood levels of uric acid enough to initiate a flare-up. Studies show that men who drink alcohol daily have double the risk of developing gout as compared to non-drinkers.
- Bromelain, found naturally in pineapple, has been shown to cause uric acid crystals to decompose, helping to relieve pain associated with gout. Taken regularly as a supplement, bromelain can help reduce swelling, pain and tenderness and may also help prevent future attacks.
- Chronic stress can increase uric acid levels and contribute to a gout attack. Stress management helps to keep cortisol levels down and chronic inflammation at bay.
- Along with obesity, sleep apnea has been linked to an increased risk of developing gout. Studies suggest that sleep apnea triggers an overproduction of uric acid, creating a more ideal environment for a flare-up. Treating sleep apnea and losing weight may help to reduce gout risks.
Products that may help relieve gout symptoms include:
Uric Acid Formula by Pure Encapsulations – This vitamin and herbal extract formula is designed to support healthy uric acid metabolism. The formula includes antioxidant vitamin C, plus black cherry and bromelain for support of healthy liver enzyme activity, immune activity and alkalization. Gluten and soy free, Non-GMO vegetarian formula.
Uric-gen by Genestra – This liquid herbal remedy is specifically formulated to aid the elimination of uric acids from the body and to aid in the management of crystallized toxins associated with gout and rheumatism. Soy and dairy free, vegan formulation.
M.F. Bromelain® by Thorne Research – This formula contains a mixture of potent proteolytic enzymes derived from pineapple. Each serving provides 1 g of bromelain. Gluten, soy and dairy free, Non-GMO vegetarian formulation.
Tart Cherry Ultra by Enzymatic Therapy – One serving contains 1.2 g of tart cherry concentrate, which provides anthocyanins, beneficial antioxidants that support healthy uric acid levels. Gluten, soy and dairy free vegetarian formula.
What Is Uric Acid? http://www.livescience.com/45148-what-is-uric-acid.html
Gout Causes. http://www.arthritis.org/about-arthritis/types/gout/causes.php
What Is Gout? http://www.niams.nih.gov/Health_Info/Gout/gout_ff.asp
10 Foods That Cause Gout Flare-Ups. http://www.symptomfind.com/nutrition-supplements/foods-that-cause-gout-flare-ups/
Alcohol Increases the Risk of Gout. http://www.health.harvard.edu/family_health_guide/alcohol-increases-the-risk-of-gout