What is gout?
Gout (podagra) is a form of acute inflammatory arthritis. It is characterised by sudden sharp, unexpected pains in joints, and swelling, redness, warmness and stiffness around the affected joint. Low-grade fever can also occur.
An elevated level of uric acid in the blood seems to be part of the mechanism of gout. The uric acid crystallises and is deposited in joints and tendons. These deposits provoke an inflammatory reaction in surrounding tissues.
The patient usually suffers from two sources of pain. The crystals in the joints cause intense pain when the affected area is moved. The inflammation of the tissues around the joint causes the skin to be swollen, tender and sore if it is even lightly touched. For example, a sheet or blanket covering the affected area can cause extreme pain.
Gout affects about 1% of the Western population at some point in their lives. It is most common in the toes of men (particularly the big toe), but affects other parts of the body, and occurs in both sexes. Gout was historically known as "the disease of kings" or "rich man's disease".
Causes of gout
- Abnormally high level of uric acid in the blood (hyperuricemia) is the underlying cause of gout. This can occur for dietary, genetic, or metabolic reasons.
- Gout frequently occurs in combination with other medical problems, particularly metabolic syndrome. A combination of obesity, insulin resistance, hypertension (high blood pressure) and abnormal lipid levels occurs in nearly 75% of cases. Lack of physical fitness is a high risk factor.
- Deficiency and imbalance in a range of minerals. This is both an effect of, and cause of inefficient metabolism of sugars, alcohol and protein.
- Fructose. High levels of fructose consumption are associated with gout (1,2), especially if you have a weak liver causing impaired fructose metabolism.
- Diet. In addition to the fructose sugar mentioned above, sweetened foods, meat and seafood consumption are
associated with gout.
Foods high in purines cause gout, so try to avoid asparagus, cauliflower, green peas, legumes (beans\lentils\split peas), mushrooms, parsley, rhubarb and sweet potato and see if this makes a difference.
A pseudo gout may be caused by the accumulation of calcium oxylate crystals in joints. High oxylate foods include beans and lentils, particularly peanut and soy products (tofu, grits, soy milk etc), wheat germ, tea & coffee, dandelion root & greens, cranberry juice, cocoa & chocolate, beets, blueberries, carrots, grapes & wine, nuts, oranges, strawberries, sweet potato, spinach and cauliflower. Did you start eating any of the above, or eat larger quantities, prior to the onset of the gout? Again, experiment with removing them to see whether it makes a difference.
- Alcohol consumption is associated with gout.
- Exposure to lead is a risk factor due to the harmful effect of lead on kidney function.
Remedies for gout
- Exercise (aerobic exercise) and physical fitness.
- Alkaline-forming diet.
- Correction of mineral imbalance, particularly boron.
- Hydration. Drink sufficient pure water.
- Moderate coffee consumption decreases the risk of gout.
1. Underwood M.
Sugary drinks, fruit, and increased risk of gout.
BMJ 2008 Feb 9, 336(7639):285-6.
2. Seegmiller JE et al. Fructose-induced aberration of metabolism in familial gout identified by 31P magnetic resonance spectroscopy. Proc Natl Acad Sci USA. Nov 1990, 87(21):8326-30.