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What Is Gout?

Gout is an umbrella term that describes several conditions with one common feature – a buildup of uric acid in the joints.

Most commonly, gout affects the joints of the feet, leading to pain, swelling, and reduced range of motion.

According to statistics, the prevalence of gout in the United States in 2016 was 3.9%, which translated to around 9.2 million people.

Numbers like these make gout extremely concerning, requiring a special focus to treat symptoms and prevent attacks.

What Causes Gout

As mentioned above, gout is the direct result of uric acid buildup in the bloodstream, which leads to the accumulation of this chemical inside the joint capsules. Consequently, an inflammatory/immune response gets triggered, causing all the classic symptoms of gout.

The abnormal accumulation of uric acid can be due to a variety of causes, including metabolic disorders, dehydration, and certain vascular conditions.

Moreover, kidney and thyroid ailments can interfere with your body’s ability to get rid of excess uric acid.

Risk factors of gout include:

  • Age – being a middle-aged man or postmenopausal woman
  • Family history – having relatives with gout increases your risk of this condition
  • Alcohol abuse – drinking alcohol excessively precipitates gout
  • Medication – diuretics, cyclosporine
  • Concurrent medical conditions – high blood pressure, kidney disease, thyroid disease, diabetes, obstructive sleep apnea
  • Dietary choices – foods rich in gout-producing purines (e.g., organ meats, game meats, some types of fish)

Different Forms Of Gout

Many people confuse gout with another condition referred to as pseudogout. As the name implies, pseudogout is a type of arthritis that resembles gout in the underlying mechanism. In other words, it is an inflammation of the joint that results from the accumulation of crystals in the synovial fluid.

The presentation of pseudogout is difficult to distinguish from gout since it leads to pain, swelling, warmth, and redness of the affected joints.

Unlike gout, however, pseudogout generally occurs in the knees and is more common in adults above the age of 60. Additionally, pseudogout is caused by the accumulation of calcium pyrophosphate crystals.

Other forms of gout result from the buildup of different crystals in the joint capsule.

Gout Symptoms & Signs

While high levels of uric acid correlate with gout attacks, this relationship is not linear. In other words, some people have excessive uric acid in their blood but do not manifest any symptoms. We refer to this form as asymptomatic gout.

Conversely, acute gout attacks present with a variety of symptoms related to joints, which last between 3 to 10 days.

Classic symptoms include pain, swelling, and warmth of the skin above the joint. Once the attack subsides, you will not have any symptoms.

Untreated gout can become chronic in nature, especially when the underlying mechanism is still present. Additionally, the hard lumps (i.e., tophi) can deposit around the skin, joints, and soft tissues, which permanently damages the structure of the articulations.

With all of that said, the prompt treatment of acute gout is primordial to prevent chronic disease.

Diagnosis Of Gout

The diagnosis of gout is similar to other medical conditions.

Your doctor will start by collecting information from your chief complaint (e.g., joint pain, swollen joints), medical history, physical examination, and additional tests (e.g., serum levels of uric acid, X-ray).

Once this step is over, the diagnosis of gout will be based on the following elements:

  • The typical description of pain (e.g., location, severity, triggers, sedative factors)
  • The frequency of symptoms (e.g., number of attacks)
  • Serum levels of uric acid
  • The concentration of uric acid inside the joint (taken by a sample)
  • Typical findings of joint inflammation on X-ray

In general, simple attacks of gout are addressed by your primary care physician. However, if your condition becomes severe, you may need to consult with a rheumatologist.

Gout Diet & Lifestyle Modifications

Your doctor will likely recommend lifestyle modifications to manage symptoms and reduce the subsequent gout attacks. These may include:

  • Lowering your intake of alcohol
  • Hydrating yourself with water and electrolytes
  • Losing weight
  • Exercising regularly
  • Quitting smoking

Since gout results from high levels of uric acid in the blood, avoiding certain foods can be quite consequential for this condition.

The foods in this category are high in purine, which is metabolized into uric acid. If you are genetically susceptible to developing gout (i.e., suboptimal excretion of uric acid), you may want to avoid the following food elements:

  • Red meats
  • Organ meats
  • Certain seafood
  • Alcohol
  • Sugar-sweetened beverages

Note that sugar-sweetened beverages do not contain purines but they seem to precipitate gout attacks.

Conversely, there are some foods that lower uric acid levels and prevent gout attacks. Examples include tart cherries, magnesium, ginger, apple cider vinegar, celery, nettle tea, dandelion, and milk thistle seeds. See "Natural Remedies For Gout" section below.

Medical Gout Treatment Options

Your doctor may recommend two types of medications:

The first category includes drugs, such as:

  • Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) – aspirin, ibuprofen, naproxen
  • Colchicine
  • Steroidal Anti-Inflammatory Drugs (SAIDs) – corticosteroids

The second category includes drugs, such as:

  • Xanthine oxidase inhibitors – allopurinol, febuxostat
  • Probenecid

Be cautious with these options, prescription and over-the-counter drugs typically have their own potential health problems and side-effects.

Gout Surgery

Chronic gout can lead to permanent damage of the joints, tendons, and ligaments.

Moreover, tophi build up in the joints and ears, wreaking havoc on the functional integrity of these structures.

Based on your specific case, your doctor may recommend one of the following surgical procedures:

  • Tophi removal surgery
  • Joint fusion surgery
  • Joint replacement surgery

Home Remedies for Gout

In this section, we will cover some home remedies that may improve symptoms of gout and prevent attacks.

Ginger

For centuries, people took ginger due to its anti-inflammatory and antimicrobial properties.

Researchers found that the topical application of ginger successfully relieved pain induced by uric acid in the joints.

Another laboratory study analyzed the effects of ginger supplementation on uricemia. The results showed that regular intake of ginger prevents hyperuricemia.

To apply ginger on the affected articulations, you need to turn it into a paste by boiling water with 1 tablespoon of grated fresh ginger root.

After that, soak a washcloth in the mixture. When it cools down, apply the washcloth to the affected joints for 15–30 minutes. This should be done at least once a day.

If you want the systemic benefits of ginger, you can also take it internally by steeping 2 teaspoons of ginger root in boiling water for 10 minutes.

Note that you may need to speak with your primary care physician before taking large amounts of ginger due to potential pharmacological interactions with other medications.

Cherries

According to one study, cherries (e.g., sour, sweet, red, black) are very effective in tempering down gout attacks.

Researchers believe that cherries exert their anti-inflammatory and antioxidative effects, which translates into pain relief and reduced swelling.

Magnesium

Magnesium deficiency is often an exacerbating factor of gout attacks and other inflammatory conditions.

In a 2015 study, researchers found a link between adequate magnesium consumption and lower levels of uric acid. Interestingly, this finding was only present in men and not women.

Warm water with apple cider vinegar

Apple cider vinegar is very commonly used to treat gout attacks.

Unfortunately, there is no reliable clinical research that supports the effects of this remedy on gout. However, some studies found that apple cider vinegar is good for the kidneys.

To add synergy to this mixture, you can also include turmeric and lemon juice.

Celery

Celery is a common food used to treat urinary tract conditions.

Dozens of clinical studies demonstrated the anti-inflammatory effects of celery; however, there is scarce evidence that supports its effects on gout.

Nevertheless, you can start by consuming celery many times a day. Also, make sure to read the label carefully before making a purchase.

Nettle tea

Stinging nettle (Urtica dioica) is an effective remedy that treats inflammation and pain.

According to one study, nettle tea showed potent nephroprotective (i.e., kidney protection) properties that enhance the clearance of uric acid and antibiotics.

You can take this tea by boiling water and steeping 2 tablespoons of dried nettle.

Milk thistle seeds

Milk thistle is beneficial for the liver and kidneys.

In one study, experts noted that this herb lowers uric acid when kidney clearance is compromised (e.g., kidney failure).

The study included rat subjects, hence the need for human clinical trials.

Hibiscus

Hibiscus is a traditional herb used as a garden flower, food, or tea.

Including hibiscus in a home remedy can improve symptoms of gout by reducing uric acid levels. Similar to the other remedies listed above, there is scarce evidence that supports the effectiveness of this herb on human subjects.

Summary

While there are many pharmaceutical treatments available for this distressing and painful condition, each has its own potential problems and side effects. Among the more effective natural gout treatments are gout home remedies such as sensible diet, losing weight and drinking plenty water to help flush the uric acid out of your system.

However, if you can reduce the level of acidosis in your body then that is one of the best gout treatments of all because it attacks the problem at the source. If you can reduce the levels of uric acid in your body, particularly in your blood plasma and in the synovial fluid that bathes and lubricates your joints, you will go a long way in preventing further attacks.  Not only that, but natural gout remedies are always preferred to synthetic pharmaceuticals with all their potential side-effects.

Frequently Asked Questions

Yes, gout is a specific form of arthritis that develops due to the accumulation of uric acid in the joints. Most commonly, the big toe is affected by gout, but other articulations can also develop gout attacks (e.g., knees, ankles, heels).

According to research, gout is several times more common in men relative to women.

Uric acid is a crystal that builds up in the joints, causing inflammation, swelling, and pain.

The body eliminates uric acid through renal filtration (i.e., through the urine). When this function is not working properly, uric acid builds up in the blood (i.e., hyperuricemia).

The classic symptoms of gout include the four pillars of inflammation: warmth, pain, swelling, and redness of the affected joint.

Abnormally high levels of uric acid can precipitate kidney stones and nephrolithiasis.

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