What is gout?
Causes of gout
Remedies for gout
What is gout?
Gout (podagra) is a form of acute inflammatory rheumatoid 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.
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. Uric acid is an antioxidant so at first this result may appear incongruous. However, uric acid can act both as an oxidant and an antioxidant.(7) Uric acid inhibits the production of nitric oxide, another antioxidant which is essential for good health. (8) It is likely that people with gout are deficient in nitric oxide. Some of the other causes of gout listed on this GrowYouthful page also lower your level of nitric oxide.
- Fructose. High levels of fructose consumption are associated with gout (1, 2), especially if you have a weak liver causing impaired fructose metabolism. Fructose inhibits the production of nitric oxide.
- Gout frequently occurs in combination with other medical problems, particularly those associated with high levels of uric acid. The following ailments occur in nearly 75% of cases of gout:
Hypertension (high blood pressure). People with gout usually have high blood pressure. One of the causes of hypertension is a high intake of refined sodium chloride salt, with a high level of sodium in the blood. Sodium inhibits the production of nitric oxide, whereas potassium increases nitric oxide production.
Metabolic syndrome, insulin resistance, diabetes.
Abnormal lipid levels.
- 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. The worst offenders are brewer's yeast, bacon, game meat, beef and lamb.
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 (apparent) gout? Again, experiment with removing them to see whether it makes a difference.
- Calcium deposits, hypercalcemia.
- Deficiency and imbalance in a range of minerals. This is both an effect of, and cause of inefficient metabolism of sugars, alcohol and protein.
- Lack of physical fitness, movement and exercise.
- Alcohol consumption is associated with gout. Try to avoid alcohol, especially sweet yeasty alcoholic drinks, port and beer.
- Exposure to lead is a risk factor due to the harmful effect of lead on kidney function.
Remedies for gout
- Avoid fructose. Avoid sweets (candy), sweetened drinks, fruit juice and processed foods which have high fructose corn syrup added - unfortunately, this is the majority of processed foods in the USA today. Even better is the total avoidance of all sugar in any form.
- Avoid high-purine foods like brewer's yeast, baker's yeast, bacon, game meat, beef and lamb. Other foods also have some level of purines, such as asparagus, cauliflower, chocolate/cacao/cocoa, green peas, legumes (beans\lentils\split peas), mushrooms, offal, parsley, rhubarb and sweet potato. Purine-containing foods from the ocean include anchovies, herrings, mackerel, sardines, sprats, mackerel, scallops and other shellfish. However it is difficult to avoid all of them in a healthy diet so stick to keeping them in balance and having them fresh and home-prepared rather than processed, sweetened and packaged products from a store.
- Exercise (aerobic exercise) and physical fitness.
- Correction of mineral imbalance, particularly boron.
- Hydration. Drink sufficient pure water.
- Moderate coffee consumption decreases the risk of gout.
- Sour cherries. Various berries and sour dark red plums are also beneficial, but tart sour cherries are the most effective.
- Vitamin C, best from food sources such as the berries above, and from sour fruits.
- Alkaline-forming diet.
- Omega-3 fatty acids, which act as an anti-inflammatory and inhibits the production of uric acid. (3, 4)
- Probiotics, particularly sauerkraut. A good gut biome is important to prevent gout, and also produces butyric acid. (5)
- Celery leaves, celery juice, celery seeds. Leafy green vegetables. Artichokes. Fresh sage and thyme.
- Cassia, also known as Chinese cinnamon, which helps with insulin resistance.
- Devil's claw (cat's claw), a general anti-inflammatory.
- White Chinese mulberry, which inhibits the production of uric acid. (6)
1. Underwood M.
Sugary drinks, fruit, and increased risk of gout.
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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.
3. Zou H, Wang H, Liu T, Li X, Zhu X, Wang Z. Protective role of α-lipoic acid in hyperuricemia-induced endothelial dysfunction. Exp Ther Med. Jun 2017;13(6):3047-3054. doi: 10.3892/etm.2017.4345. Epub 18 April 2017. PMID: 28587378; PMCID: PMC5450557.
4. Saito H, Toyoda Y, Takada T, Hirata H, Ota-Kontani A, Miyata H, Kobayashi N, Tsuchiya Y, Suzuki H. Omega-3 Polyunsaturated Fatty Acids Inhibit the Function of Human URAT1, a Renal Urate Re-Absorber. Nutrients. 29 May 2020. 12(6):1601. doi: 10.3390/nu12061601. PMID: 32486008; PMCID: PMC7353071.
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6. Hunyadi A, Liktor-Busa E, Marki A, Martins A, Jedlinszki N, Hsieh TJ, Bathori M, Hohmann J, Zupko I. Metabolic effects of mulberry leaves: exploring potential benefits in type 2 diabetes and hyperuricemia. Evid Based Complement Alternat Med. 2013;2013:948627. doi: 10.1155/2013/948627. Epub 5 Dec 2013. PMID: 24381639; PMCID: PMC3870074.
7. Kang DH, Ha SK. Uric Acid Puzzle: Dual Role as Anti-oxidantand Pro-oxidant. Electrolyte Blood Press. 2014 Jun;12(1):1-6. doi: 10.5049/EBP.2014.12.1.1. Epub 2014 Jun 30. PMID: 25061467; PMCID: PMC4105384.
8. Kobayashi J, Ohtake K, Uchida H. NO-Rich Diet for Lifestyle-Related Diseases. Nutrients. 2015 Jun 17;7(6):4911-37. doi: 10.3390/nu7064911. PMID: 26091235; PMCID: PMC4488823.
9. Wang Y, Chu C, Wang KK et al. Effect of Salt Intake on Plasma and Urinary Uric Acid Levels in Chinese Adults: An Interventional Trial. Sci Rep 8, 1434 (2018). doi.org/10.1038/s41598-018-20048-2.
10. Oberleithner H, Callies C, Kusche-Vihrog K, Schillers H, Shahin V, Riethmuller C, Macgregor GA, de Wardener HE. Potassium softens vascular endothelium and increases nitric oxide release. Proc Natl Acad Sci U S A. 2009 Feb 24;106(8):2829-34. doi: 10.1073/pnas.0813069106. Epub 2009 Feb 6. PMID: 19202069; PMCID: PMC2637279.