The Truth about Gout
Origins, Symptoms, and Natural Remedies
By Isaac Eliaz, MD, MS, LAc
While gout has been called “the disease of kings,” those afflicted feel anything but royal.
This debilitating arthritic condition comes on suddenly when excessive uric acid in the blood crystalizes in the feet, ankles, wrists, fingers, or other joints and tissues. Gout attacks—considered to be among the most excruciating conditions—cause severe pain that can last several days, weeks, or even months. It is the most common form of inflammatory arthritis in the United States, affecting more than three million people.
The Egyptians, Greeks, Romans, and most everyone since have associated gout with extravagant diets and lifestyles. Many rich foods—particularly animal fats, organ meats, red meat, poultry and fish, yeasts, and alcoholic beverages—are high in purines, the organic compounds that break down into uric acid. However, while high purine foods do contribute to the onset of gout attacks, the real issue lies in the body’s overproduction and/or inefficient processing of uric acid, leading to a buildup in joints and tissues.
Gout is no longer considered an aristocratic disease, as virtually anyone can take part in the dietary excesses associated with the condition. Asian populations were spared for centuries because their diets emphasized vegetables and rice with minimal meat and alcohol consumption. However, since many Asian cultures have adopted more Western diets and lifestyles in recent decades, they too are witnessing a rise in Western health afflictions with gout as a prime example.
Gout can be triggered by a number of factors, including: Excessive consumption of purine-rich foods, alcohol, illness, infection, injury, and side effects of some pharmaceutical drugs. A family history of gout can also be a contributing factor.
Who gets gout?
Gout tends to hit older people, mostly men, though postmenopausal women are also at a higher risk because declining estrogen levels may cause uric acid levels to increase. Estrogen is believed to help the kidneys process uric acid, which may also explain why men are up to nine times more likely to experience gout.
Gout also has a genetic component: some people simply don’t metabolize uric acid well, or they produce too much of it. People with joint injuries can also be more susceptible, as uric acid crystallizes at the injury site. Overall kidney function may also be a factor, allowing uric acid levels to increase.
Furthermore, many gout sufferers are also afflicted with metabolic syndrome—obesity, high blood pressure, and insulin resistance— which carries a major diet/lifestyle component. Early research has also linked gout to insulin resistance.
Gout flare-ups are most commonly seen in feet and ankle joints, particularly the big toe, causing acute, sudden pain and inflammation. Symptoms may include:
• Sudden onset of extreme joint tenderness, particularly at night
• Sudden swelling
• Redness on joints
• Extreme pain and swelling in the joints where the toes and foot meet
• Mild fever and flu-like symptoms
The pain is often treated with ibuprofen or other nonsteroidal anti-inflammatories. In some cases, steroids may be used to reduce the inflammation and pain. There are also drugs that reduce uric acid in the blood, however most people who go this route must remain on medication for life.
Leverage a Healthy Lifestyle
Though sometimes difficult to implement, an important component of gout management is the careful moderation of dietary and lifestyle habits. We can reduce the amount of uric acid in our blood in part by following a low-purine diet. It’s also critical to drink plenty of filtered water to help flush uric acid, to get regular exercise, and to maintain a healthy weight.
Again, it’s important to remember that foods are not the true underlying cause of gout: the real issue is excess uric acid in the blood which can be caused by kidney problems, hereditary factors, or other issues. Thus, specific foods that may influence uric acid levels can either contribute to, or help control the frequency and severity of, gout attacks.
A number of studies have illuminated the relationship between gout and foods. Among the findings: Gout patients who consume cherries lower their risk of an attack by 35 percent. Low-fat dairy products may help reduce uric acid levels. Red wine is easier on gout patients than other alcoholic beverages, perhaps due to its high antioxidant content. Coffee may help, but not caffeinated teas. Fructose worsens gout symptoms.
Targeted supplements can help reduce gout by addressing related issues. In particular, we should focus on three critical functions: metabolism, circulation, and inflammation.
As noted, gout shares a family tree with metabolic syndrome, so supporting a healthy, efficient metabolism should be a high priority. In my practice, I use a comprehensive metabolic formula that combines lipoic acid and alginates with medicinal mushrooms and traditional herbs, including cinnamon, American ginseng root, and other natural ingredients. This formula supports healthy glucose and fat metabolism, reduces insulin resistance, controls sugar cravings, and helps to promote healthy cholesterol.
Poor circulation may also contribute to gout, as it allows uric acid to build up in joints and tissues. A supplement that includes the potent natural enzyme nattokinase—as well as medicinal mushrooms and other botanicals (like hawthorn)—boosts circulation, reduces inflammation, and can help control gout. Such a formula can also support overall cardiovascular health.
Vitamin C may also reduce uric acid levels in the blood. We do know that it works to reduce inflammation and boost circulation.
While gout can be excruciatingly painful, it is also controllable. A side benefit from working to manage gout using targeted natural approaches is that we can improve our overall health at the same time. Remember, the underlying causes that increase uric acid in the body are also linked to chronic inflammation, cancer, diabetes, and heart disease. By addressing these issues with healthy diets, exercise, and supplementation, we can work to manage gout, prevent chronic disease, and increase our overall wellness and vitality—naturally.
Isaac Eliaz, MD, MS, Lac, is a licensed acupuncturist, physician, and homeopath, has a MS in traditional Chinese medicine, and has done graduate studies in herbology.