Gout

In the Westerm world, at least one man in a hundred over the age of 40 has gout. Women can develop it, too, mainly after menopause. Sufferers feel fine much of the time, but an attack can occur without warning, bringing on agonising joint pain that demands fast-acting relief.

What is it?

Gout is a metabolic disorder linked to high levels of uric acid in the blood. Uric acid, a by-product of various body processes, is also formed after eating certain foods. The body rids itself of uric acid through the urine. But some people produce too much uric acid – or can’t dispose of it fast enough – and levels build up. Often, the excess uric acid is converted into needle-shaped crystals that settle in and around the joints and other tissues, triggering inflammation and the excruciating pain associated with gout.

What causes it?

It’s uncertain what precipitates a gout attack, although some factors may put you at risk. A quarter of those who suffer from gout have a family history of the illness and three-quarters have high triglyceride levels. Men who gain a lot of weight between the ages of 20 and 40 are particularly vulnerable. Excessive alcohol intake (including ‘binge’ drinking), high blood pressure, kidney disease, exposure to lead, crash diets and certain medications (including antibiotics, diuretics and cancer chemotherapy drugs) may also play a role. For a few people, eating foods high in chemicals called purines (such as liver or anchovies) can cause flare-ups.

What are the symptoms?

• Sudden and severe joint pain, usually involving the big toe, heel, ankle or instep first. Subsequent attacks may affect the knee, wrist, elbow, fingers or other areas.
• Redness and swelling in affected joint or joints.
• Kidney stones develop occasionally, causing fever, severe low back pain, nausea, vomiting or a swollen abdomen.

Are there any natural therapies?

Uric acid can accumulate in the blood for years with no symptoms. An acute attack often happens suddenly and is best treated with conventional drugs. The main supplement that seems to help during an acute attack is bromelain. The other, taken together, may prevent future attacks. All can be safely used for long periods, although celery seed extract, vitamin C and nettle may be the simplest regimen to follow for long-term maintenance.

Bromelain is a popular natural anti-inflammatory that may relieve gout pain. When not using it for acute flare-ups, decrease the dosage and add quercetin. This flavanoid reduces the uric acid levels and is better absorbed if taken with bromelain. Celery seed extract increases uric acid excretion. In incremental doses, vitamin C helps uric acid to free itself from the tissues and be excreted in the urine. (High initial doses may release so much uric acid that a kidney stone develops.)

Nettle can be helpful internally and externally: nettle capsules clear out excess uric acid and nettle tea compresses may relieve inflamed joints. Flaxseed oil may deter the production of leukotrienes, substances involved in the inflammatory reaction of gout. Other natural therapies including eating celery or avocadoes or drinking teas made from the herbs cat’s claw, devil’s claw or olive leaf. Cherries are rich in flavonoids and are often effective in lowering uric acid levels. Cherry or blueberry juice (half a cup a day) also works well.

What else can I do?

• Drink at least eight glasses of water a day to dilute the urine and help lower uric acid levels. Stay away from alcohol, which can trigger attacks.
• Keep your weight down. Obesity may play an important role in gout.
• Avoid fats, refined carbohydrates, excess protein and, if you’re sensitive to purines, foods containing them (including offal, anchovies, legumes, otameal, spinach, asparagus, cauliflower and mushrooms).

Did you know?

Although an estimated half and million Australians and New Zealanders have high uric acid levels, only a small percentage of them ever actually develop gout.