Gout is an acute form of inflammatory arthritis where excess uric acid (in the form of monosodium urate) is present in blood, tissue and urine, causing accumulation of crystals of uric acid (tophi) around the joints. Gout typically attacks the smaller joints of the fingers and toes, especially the big toe. Deposits of urate crystals cause joint swelling, redness and heat along with extreme pain (often in the morning).
Uric acid is the product of purine (protein) metabolism in the liver. Gout is therefore a problem with digestion of protein and metabolism. It can be triggered by excess alcohol or protein and rich food. Fruit (fructose increases production of uric acid) consumption and excess purines (from protein foods) can be a problem.
Gout afflicts 0.3-0.4 per cent of the population of the Western world and can be hereditary. Ninety-five per cent of gout patients are men 30 and over. It's 20 times more prevalent in men than women. Seventy per cent have over-production of uric acid and 30 per cent of sufferers have defective elimination of uric acid.
Pharmaceutical diuretics can also trigger gout (by increasing uric acid production) in those susceptible. Methylxanthines such as caffeine (coffee), nicotine (cigarettes) and theobromine (chocolate) are easily oxidised to uric acid. Lead exposure can also trigger gout in susceptible individuals. The nicotinic acid form of vitamin B3 increases production of uric acid.
Dietary changes to relieve gout
To reduce the symptoms of gout, a low-purine diet is essential. Purines are formed by the metabolism of proteins, so moderate protein, more carbohydrate and low fat diets work well. Tofu (soy protein) is the preferable source of protein, as it increases uric acid clearance and excretion. Uric acid excretion is reduced by fats and increased by carbs. Excessive dieting will increase the risk of a gout attack. Dieting raises levels of ketones in your body and ketones increase uric acid production. It's important to drink at least two liters of water per day.
Cherries should be a part of every gout sufferer's diet. This is because 250g per day fresh or canned cherries is particularly effective in lowering uric acid levels. Other red-blue berries prevent joint destruction and are powerful antioxidant and anti-inflammatory foods.
Alex Strande, ND, Ph.D., a naturopath and microbiologist out of Houston, Texas recommends the following diet.
Avoid foods high in purines
Anchovies, brains, meat broths, goose, heart, herring, liver, kidney mackerel, meat extracts, mince, mussels, roe, sardines, scallops, sweetbreads, yeast
Moderate purine foods - eat in moderation
Fish, poultry, meat, asparagus, dried beans, lentils, mushrooms, peas, spinach
Low purine foods - can be consumed regularly
Wholegrain cereals, rice, dairy products such as yoghurt, nuts and seeds, a wide range of vegetables and herbs, olives, oils (olive oil is best)
Supplements to relieve gout
Folic acid lowers uric acid levels in gout sufferers by inhibiting the xanthine oxidase enzyme that catalyses the production of uric acid.
Vitamin C facilitates the excretion of excessive uric acid, but too high a dose may increase uric acid production through oxalic acid.
Quercetin inhibits the xanthine oxidase enzyme, which subsequently causes a reduction in uric acid production (works like the drug allopurinol - Zyloprim, Capurate). Quercetin also reduces the inflammatory response and should be taken with bromelain to improve absorption.
Fish oils reduce the inflammation in inflammatory arthritis (including gout) and should be taken with vitamin E.
Celery seeds increases uric acid excretion, thereby assisting relieving crystals that can build up in the joints. Their anti-inflammatory effect will also reduce joint swelling.
Alfalfa(and celery) are excellent for alkalising the system to balance uric acid and increase excretion.
Alex Strande, ND, Ph.D., is a naturopath and microbiologist. His primary location is in Houston, Texas. If you have any issues concerning your health, please visit us at www.simplyhealingclinic.com or call us to set up a consultation on 713.660.1420. We do long distance phone/Skype consultations with people from all around the world.
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