Embedded Files
What's Gout?
What's Gout?
Gout is a crystal deposition disease hallmarked by elevated levels of uric acid (hyperuricemia) in the bloodstream. If you suspect yourself of having gout after reading this article, ask your healthcare professional about including a simple blood test to measure your uric acid level during your next office visit. In [32], it says that your serum uric acid levels should be less than 6 mg/dL for females and 7 mg/dL for males.
In humans and higher primates, uric acid is the final oxidation (breakdown) product of purine metabolism and is excreted in urine. When the level of uric acid in the bloodstream becomes too high for the body to process, it crystallizes in the joint, causing pain and swelling. MRI reveals that gout affects the joints, bones, and tendons[15].
Humans suffer from gout because we lack an enzyme called uricase that in animals converts uric acid into a more soluble substance[10]. In fact, humans don't need this enzyme. As long as normal levels of uric acid are maintained it's easily excreted from the urine. It is only when blood uric acid levels go so high that they endanger the stability of the blood's acid-alkaline balance that the excess uric acid is removed from the blood and deposited as far away from the major blood supplies as possible—in the toes, wrists, or earlobes[9].
Gout is an inflammatory arthritis (the most common type in men and the most painful forms of arthritis) that has been recognized since ancient times. Once common among the wealthy of ancient Rome and the landed gentry of England, gout became known as the "disease of kings" and was associated with a diet of meat and wine. About 3 million Americans have gout, and that number is growing, says Dr. Ernesto Zatarain, medical director of the Mills-Peninsula Arthritis Center [1]. Despite these facts, little advances have been made in the diagnosis and treatment of gout for the past 50 years.
Symptoms of Gout
Symptoms of Gout
The symptoms normally appear overnight—a red, swollen and extremely tender joint which is often the big toe, but can also be the mid foot, ankle, knee, or wrist. You can see the pictures of gout here.
Gout particularly happens in men after the age of 50 and women after menopause. In this condition, crystals of monosodium urate (MSU) or uric acid are deposited on the articular cartilage of joints, tendons and surrounding tissues. It is marked by transient painful attacks of acute arthritis initiated by crystallization of urates within and about the joints and eventually leads to chronic gouty arthritis and the deposition of masses of urates in joints and other sites, creating tophi. Tophi are a strong indication that your gout is serious, and hasn't been managed very well so far.
Tophi usually occur around 10 years after the onset of gout, but can occur earlier, particularly for older people. With treatment, acute attacks can be quickly stopped. Tophi and tissue stores of monosodium urate crystals can also be reversed (but a slow process) and may take 1 to 3 years by maintaining a low level of uric acid in the blood.
Causes of Gout
Causes of Gout
Gout results from a combination of prolonged elevation of uric acid and overall acidity in the bloodstream. In isolation, neither elevated uric acid nor acidity is sufficient to cause gout [4]. Elevated serum uric acid can result from high intake of purine-rich foods, high fructose intake (regardless of fructose's low glycemic index value) and/or impaired excretion by the kidneys [6, 13]. Especially pay attention to the fact that fructose is a poison: High consumption of fructose (from most soft drinks and processed food) increases risks for gout (also hypertension) in adults[13, 16-20]. As a matter of fact, fructose is the only carbohydrate known to increase uric acid levels. However, when God creates a poison (i.e., fructose), he also provides an antidote (i.e., fiber). Therefore, eating fruit (i.e., fructose + fiber) for healthy people is OK.
Gout and obesity have been linked for centuries. Body mass is only one of the causes of gout, and it can exist with other factors. It is important to consult a rheumatologist to investigate the cause of gout in your particular case. Once the causes are known, you can plan a diet for gout patients that suits your particular circumstances (see [26] for the gout diet recommended by Mayo Clinic).
While eating meat can contribute, alcohol is more of a problem—beer being the beverage that most affects uric acid levels, Dr. Zatarain said [1]. People with risk factors such as metabolic syndrome, kidney insufficiency, use of diuretics[23], osteoarthritis and history of high uric acid might want to limit themselves to one drink a day.
Moreover, elevated uric acid levels have recently been identified as a marker for heart disease[21], so gout is more than episodic painful arthritis.
Prevention Tactics
Prevention Tactics
Prevention tactics involve careful diagnosis of the factors contributing to the gout, followed by appropriate use of medication[22], diet,[26] and over the counter remedies:
Reducing alcohol intake
It is best to restrict all kinds of alcohol, because it can increase the level of uric acid in the body
Losing weight gradually
It should includes regular meals, avoiding periods of starvation or overeating because rapid fluctuations during the day can trigger gout attacks.
Limiting protein and purine content in diet
Which can increase uric acid levels in blood
Several studies have shown that people suffering from gout should avoid the following foods and beverages: Anchovies, bacon, goose, heart, liver, mussels, mutton, pheasant, sardine, sweet breads, salmon, scallops, trout, turkey, veal, and yeast [34]
Most of foods of animal source are high in purine especially organs (such as spleen, liver, heart, kidney, lungs, etc.)
Brewer's yeast and baker's yeast are high in purine
Studies have shown that vegetables high in purines do not increase the risk of gout or recurring gout attacks[26]
Drinking plenty of water throughout the day
An increase in water consumption has been linked to fewer gout attacks[26]
Moderate coffee consumption may be associated with a reduced risk of gout, particularly with regular caffeinated coffee
Always keeping hands and feet well covered and warm in cold months
Gout attacks are very common during the cold months
Try more cherries
Cherries remove the sodium urate crystals in and around the bone joints by dissolving them. Once dissolved, they are easily eliminated.[8,9]
More importantly, people digest foods differently—a food that causes gout in one person might be tolerated by another, and different food combination have significantly different effects.
References
References
Healthpoint Magazine published by Mills-Peninsula Health Services, Spring 2009
Powerpoint on Gout and Septic arthritis Sreejith P.N,M.D
Purine-Rich Foods, Dairy and Protein Intake, and the Risk of Gout in Men
M. V. and L. K. Mahan, Food, Nutrition, and Diet Therapy, 8th ed. (Philadelphia: W. B. Saunders, 1992)
Dr. Ludwig E. Blau, "Can Eating Cherries Cure Gout?" Texas Reports on Biology and Medicine 8, no. 3 (Fall 1950).
The Acid alkaline Balance Diet by Felicia Drury Kliment.
J.P. Seegmitten, Gout (New York: Grune & Stratton, 1967).
尿酸不控制 積成痛風石 (in Chinese)
YIH JIA POH, et al. Magnetic Resonance Imaging Bone Edema Is Not a Major Feature of Gout Unless There Is Concomitant Osteomyelitis: 10-year Findings from a High-prevalence Population, J Rheumatol, Nov 2011; 38: 2475 - 2481.
Hyon K. Choi, Walter Willett, and Gary Curhan. Fructose-Rich Beverages and Risk of Gout in Women. JAMA, Nov 2010; 304: 2270 - 2278.
Stirpe F, et al. Fructose-induced hyperuricaemia. Lancet. 1970;2(7686):1310–1311, pmid:4098798.
Emmerson BT. Effect of oral fructose on urate production. Ann Rheum Dis. 1974;33(3):276–280, pmid:4843132.
Perheentupa J, Raivio K. Fructose-induced hyperuricaemia. Lancet. 1967;2(7515):528–531, pmid:4166890.
Choi HK, Curhan G. Soft drinks, fructose consumption, and the risk of gout in men: prospective cohort study. BMJ. 2008;336(7639):309–312, pmid:18244959.
Choi HK, Curhan G. Independent impact of gout on mortality and risk for coronary heart disease. Circulation. 2007;116(8):894–900, pmid:17698728.
Men with gout have a higher risk of death from all causes.
Diuretic (Wikipedia)
The main adverse effects of diuretics include hyperuricemia.
Young People Report Worse Fibromyalgia Than Older Patients, Mayo Clinic Study Shows
Hospitalization is a significant risk factor for gout flares in people already diagnosed with gout.
Gout and the risk of Alzheimer's disease: a population-based, BMI-matched cohort study
Gout is inversely associated with the risk of developing AD, supporting the purported potential neuroprotective role of uric acid.
Gout diet: What's allowed, what's not (Mayo Clinic)
How to quickly remove uric acid crystallization from your body to prevent gout & joint pain
Treating Gout with Cherry Juice (Dr. Michael Greger)
Slide show: Hand exercises for people with arthritis (Mayo Clinic)
Page updated
Google Sites
Report abuse