Gout is a common type of arthritis caused by an increased concentration of uric acid (the final breakdown product of purine-one of the units of DNA and RNA) in biological fluids. In gout, uric acid crystals are deposited in joints, tendons, kidneys, and other tissues, where they cause considerable inflammation and damage. Gout may lead to debilitation from the uric acid deposits around the joints and tendons, and kidney involvement may result in kidney failure.
What are the signs and symptoms of Gout?
The first attack of gout is characterized by intense pain, usually involving only one joint. The first joint of the big toe is affected in nearly half of the first attacks, and is at some time involved in over ninety percent of individuals with gout. If the attack progresses, fever and chills will appear. The first attacks usually occur at night and are usually preceded by a specific event, such as dietary excess, alcohol ingestion, trauma, certain drugs (mainly chemotherapy drugs, certain diuretics, and high dosages of niacin), or surgery.
What causes Gout?
Gout is the result of either increased synthesis of uric acid; reduced ability to excrete uric acid; or both over production and under excretion of uric acid. Several dietary factors are known to be trigger gout, including consumption of alcohol, high-purine-content foods (organ meats, meat, yeast, poultry, etc.), fats, refined carbohydrates, and excessive calories.
What dietary factors are important in Gout?
Alcohol increases uric acid production by accelerating purine breakdown. It also reduces uric acid excretion by increasing lactate production, which impairs kidney function. Elimination of alcohol is all that is needed to reduce uric acid levels and prevent gouty arthritis in many individuals.
A low-purine diet has long been the mainstay of dietary therapy for gout. Foods with high purine levels should be entirely omitted. These include: organ meats, meats, shellfish, yeast (brewer’s and baker’s), herring, sardines, mackerel, and anchovies. Intake of foods with moderate levels of protein should be reduced as well. These include: dried legumes, spinach, asparagus, fish, poultry, and mushrooms.
Obesity is associated with an increased rate of gout. Weight reduction in obese individuals significantly reduces serum uric acid levels. Weight reduction should involve the use of a high-fiber, low-fat diet, as this type of diet will help manage the elevated cholesterol and triglyceride levels that are also common in obesity.
Refined carbohydrates, fructose, and saturated fat intake should be kept to a minimum. Simple sugars (refined sugar, honey, maple syrup, corn syrup, fructose, etc.) increase uric acid production, while saturated fats decrease uric acid excretion. The diet should focus on complex carbohydrates such as legumes, whole grains, and vegetables rather than on simple sugars.
Liberal fluid intake keeps the urine diluted and promotes the excretion of uric acid. Furthermore, dilution of the urine reduces the risk of kidney stones. Drink at least 48 ounces of water each day.
Cherries, hawthorn berries, blueberries, and other dark red-blue berries are rich sources of anthocyanidins and proanthocyanidins. Consuming one-half pound of fresh or canned cherries per day has been shown to be very effective in lowering uric acid levels and preventing attacks of gout. In addition to consuming anthocyanidin- and proanthocyanidin-rich berries, extracts of cherries, bilberry (Vaccinium myrtillus), grape seed (Vitis vinifera), or pine bark (Pinus maritima) can be used. The typical dosage recommendation for these flavonoid rich extracts is 150 to 300 mg daily.
What nutritional supplements should I take for Gout?
Foundation Supplements. High potency multiple vitamin and mineral formula; Vitamin D3 2,000-5,000 IU/day; Fish oil, EPA+DHA 1,000 to 3,000 mg/day.
Celery Extract standardized to contain 85% 3nB (3-n-butylpthalide) – a compound unique to celery that is responsible for the characteristic flavor and odor of celery as well as its medicinal effects – has been shown to produce significant benefits in the treatment of gout. The recommended dosage is 75 to 150 mg twice daily.
Celadrin® is an all-natural matrix of special cetylated, esterifed fatty acids that reduce inflammation. The unique features of Celadrin® as a natural product include an ability to reduce inflammation and pain quickly with no side effects as demonstrated in clinical trials published in the internationally acclaimed Journal of Rheumatology. Available in cream and capsule form, Celadrin® is clinically proven to produce results. Celadrin® cream can be applied to affected areas on an as needed basis. The dosage with oral preparations is three soft gelatin capsules daily.
How do I know if the recommendations are working?
The goal is a reduction is the frequency and severity of gout attacks.