Gout is a form of arthritis caused by elevated levels of uric acid in the blood. When the uric acid reaches a certain level, the uric acid crystallises out (like little sharp needles) in the joints and tissues causing extreme pain. Uric acid is a breakdown product from the metabolism of a series of proteins called purines which are found in food such as liver, kidneys, sweetbreads, tongue, shellfish, peas, lentils, beans, red wine and port.
Acute gout - severe pain, swelling and heat, usually over one joint, although occasionally a number of joints can be involved.
Over time gout can cause destruction of joints, deformities and also lumps of uric acid called tophi. Persistent high uric acid and gout can also cause damage to the kidneys.
What doctors can do
There are two phases of treatment - pain relief during an attack and secondarily ways to reduce the uric acid level in the blood.
- Acute pain relief: The current recommendation is to start with a NSAID drug ( Naproxen, voltarin are) and continue for a couple of days after the pain has subsided (usually 5-7 days). If NSAIDs are not tolerated then Colchicine 0.5mg three times a day until the pain subsides, then half the dose till the pain has gone and then continue for a further 2 days. Direct injection of steroids into the inflamed joint is very effective too. Prednisone steroids 50mg daily is also an effective treatment and should continue and be tapered when the pain has gone for 2 days.
- Drugs to lower the uric acid in the blood - these are taken continually. Usually the drug used in most countries is Allopurinol, although probenecid is sometimes used.
What you can do
- A number of drugs can bring on gout, so it is important to avoid these, or if they are essential, have your treatment drugs available or be taking allopurinol. These drugs include
diuretics (frusemide and thiazides), some cancer and immunosuppressive drugs and aspirin.
- Avoiding the foods and drink which precipitate the attacks. This may seem like deprivation, but it is better than getting gout! You may find that once the uric acid level has fallen after taking allopurinol, you may be able to eat some of these foods again in moderation. Cut down on seafood, and red meat, beer, red wine and spirits,
- Avoid dehydration, and keep a water intake high, especially in warmer climates.
- Eat plenty of fibre in the diet, and use fibre drinks and shakes because these can help flush uric acid from the body
- Anti-inflammatory nutrients like high-dose grape seed extract and turmeric are helpful
- Omega 3 fish oils, 1–2 grams daily improve the elasticity and strength of the cartilage and tendons round the joint, and improve the quality of the synovial fluid which lines and lubricates the joints.
- Glucosamine is a complex sugar which forms a vital part of the cartilage tissue. Taking a high dose of glucosamine has actually been shown to repair cartilage tissue, as well as reduce pain.
- A good multivitamin/multimineral will ensure that the cartilage and tissues have all the nutrients and minerals they require to stay strong and to repair themselves.
- High dose vitamin C, 2-4 grams daily, may also help reduce the inflammation, pain, and help with tissue repair.
- Tumeric has a NSAID like action, and taking this regularly may help reduce the gout pain.
The Nutritional supplements I use and recommend to my patients
Supplements I recommend for Gout patients -
USANA - Cellsentials * , Biomega, Active Calcium plus, Proflavanol C, Procosa 2, -
Curcumin (tumeric) - Curcugel Obtain in NZ from from www.johnappleton.co.nz
Other therapiesThere are a number of other therapies which you might like to look at. They have not been specifically included with this disease because some are a form of treatment which is applicable to most diseases and many focus on the mind, body, spirit, and the universe. These include - acupuncture, Ayurvedic medicine, energy healing, homeopathy, naturopathy, prayer, visualisation and some people with this condition might like to look at these topics (I have described them more fully on another page on this website click here .) With my personal experience and reading, I do not think that I can comment of whether one or a number of these might help. They fit well with most conventional and complementary treatments and I suspect some or even all of them can be extremely powerful - if performed by an experienced practitioner. My only caveat is that if in the course of one of these therapies, you are given potions or herbs, do check with your health practitioner that they will not interfere with other treatments or drugs you are receiving.
Nutritional supplementsI believe in today's world that nutritional supplements are so necessary as to be an essential component of any form of both prevention and treatment. Not only is today's food lacking in nutrients because of the way it was grown and processed, but also most of us make the wrong choices in diet. It is virtually impossible to obtain optimal levels of most of the vitamins, minerals and other nutrients although many people try to do so, and even then fresh produce is not available all year round. *There are many quality supplements available on the market, including –Thorne, NFS, Douglas Labs, Xtend Life, True Star Health, USANA, and Metagenics. There are others, but do your due diligence before choosing one. USANA Health Sciences has added a new adjunct to its multivitamin and multi mineral called CellSentials. These are a patented blend of phyto-nutrients which they believe affects cell signaling and growth, and increases the production of preventative antioxidants within the cell. These should add to the value of the multi, so these are the multivitamin/mineral preparation I recommend.