Getting a grasp on gout
Despite the increasing prevalence of the affliction, "gout is one of the most preventable and treatable forms of arthritis," Hootman says. For other forms of arthritis, such as rheumatoid arthritis, smoking is the only major modifiable risk factor, she says. But with so many risk factors for gout being tied to lifestyle, "many more are modifiable than other types of arthritis. You can't change your genetics, but you can change your diet," Hootman notes.
Choi explains that keeping weight in check and limiting alcohol, fructose and fatty meat intake can help reduce the risk of getting gout. And when possible, switching to medications that are either neutral or reduce uric acid is best.
Doctors now also have a selection of new drugs that work more quickly and on a wider range of patients. Mueller notes that those who seem to most need medication are those patients who also have kidney problems, but existing pharmaceuticals can be problematic for that population.
Despite advances, plenty of unknowns surround gout, which tends not to draw as much research interest as other metabolic conditions. For instance, Anandarajah points out that it's unclear whether people who have disparate attacks of gout are suffering from joint damage between symptomatic episodes. Greater clarity could better help define a treatment strategy that, rather than always focusing on the immediate pain, works in the long term.
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21 Comments
Add CommentOnce more unto a proper diet, dear friends, once more;
Reply | Report Abuse | Link to thisOr close the wall up with our gout-ridden dead.
(Sorry, William)
Purely anecdotal but I'm very healthy and have gout ans so is my brother in-law. In my case my Doctor and I believe it is a hereditary ailment. In my case it only shows up when I stub my toe or over stretch it when Hiking.
Reply | Report Abuse | Link to thisSee this article about a unpublished chapter from Taubes' book that links excessive fructose consumption to gout. There is a lot of hidden fructose in the SAD. http://bit.ly/qgF4kz
Reply | Report Abuse | Link to thisI have a gout disease but it s genetic and I have a pain sometimes. We must patient and God help us!!!
Reply | Report Abuse | Link to this@drafter --- same thing with me. It all started when I was wearing a pair of wing tips that were narrower than usual for me. Incredible pain! then a couple of years later I banged the side of my big toe -- two weeks of pain. Bent the big toe back hiking up a hill -- two weeks of pain.
Reply | Report Abuse | Link to thisEverytime I've tested low on U acid but I definitely get the burning hot and fiery red toe joint -- can't even sleep with a cotton sheet on it. Some times I feel it coming on and try to treat it.
I too am prone to gout, as is my brother and (was) my maternal grandfather - none of us is obese. Fortunately, there is an effective prophylactic in the form of allopurinol which has (for most people) almost no side effects. My brother manages his gout through diet, but I prefer to medicate rather than risk the effects of chronically elevated uric acid levels, referred to in the article.
Reply | Report Abuse | Link to thisYou can suffer gout attacks even with normal serum uric acid levels, and there are other related diseases caused, for example, by calcium crystals. High uric acid levels have been shown to be a cardiovascular risk factor, but it wasn't shown that lowering blood uric acid reduces risk. The goal uric acid level for men is 6 mg/dl. When you start taking some uric acid lowering drugs, the uric acid pool inside your body mobilizes, and the first year on uric acid lowering drugs you may have an increase in the number of gout crisis. Diet is the cornerstone of gout therapy.
Reply | Report Abuse | Link to thisI meant goal uric acid level is less than 6 mg/dl, however, too low uric acid levels are linked to an increased cancer risk, although no cause-effect relationship was found.
Reply | Report Abuse | Link to thisVery low blood cholesterol levels are linked to increased cancer risk too.
Reply | Report Abuse | Link to thisClearly your "diet" does not include a serving of compassion. Even a cursory search reveals that gout has many triggers, only one of which is diet.
Reply | Report Abuse | Link to thisI have had intermittent gout attacks for the last 30 years. With the first such attack, I thought I had a stone bruise from my previous days 3 mile run(I was also doing some heavy power lifting). My body fat levels were under 20 in those days. I finally determined that the usual trigger for my gout was dehydration(I rarely notice being thirsty). These days I have to force myself to drink two to three liters of water every day and that usually takes care of the problem(except when I'm doing outside work and sweating).
Reply | Report Abuse | Link to thisIn reading comments, I see that there is a possibility that some self-diagnosis may have misdiagnosed hallux valgus, or bunions, as gout.
Reply | Report Abuse | Link to thisHallux valgus does have hereditary component, but it might not occur if one is careful not to wear footwear that constricts the toes.
(I made the mistake of wearing shoes too narrow while performing, jumping and flexing the toe over an extreme range of flexibility for years.)
Hallux valgus symptoms include swelling, enlargement of the first metatarsal pharyngeal joint, big toe turned toward the other toes, rather than in line with the flexor tendon.
It is painful, and essentially a specific form of arthritis (which merely translates as joint inflammation.
Gout, as was pointed out, is uric acid crystallization, especially at that joint.
The x-ray photo show a significantly bunioned foot. The shadowy surround of the joint may be uric acid crystals. There may be pain from both conditions.
I have been working at a part-time job that exposes me to a lot of "average" suburban Americans lately. Sadly, I've observed that at least a third of these people are morbidly obese; another sixth are very overweight; another sixth just overweight; and only about a third of average weight. I myself am slightly overweight.
Reply | Report Abuse | Link to thisHaving written about medical issues for some time myself, I am deeply suspicious that at least half the blame for this epidemic can be placed on the food industry. The other half can be blamed on the pharmaceutical industry. These are gross overstatements, but with the latter's overriding interests in keeping Americans just a hair shy of death's door and the former's interests in getting us sugar and fat addicted, my points are certainly valid.
Sadly, the average joe in the US works very hard so he doesn't have time at the end of the day to discern what he sees in front of him: the barrage of commercials for fatty prepackaged foods or for the bevy of drugs that can make him combat the high cholesterol, high blood pressure and insomnia that the aforementioned items create.
Gout is one part of the equation, and not at all surprising.
I did a post a while back on Emotions for engineers about gout. It referenced Taubes work, Cordain's as well as others.
Reply | Report Abuse | Link to thishttp://bit.ly/k6T8Gd
Regards,
Tony
By the way, fatty meat is not a cause of gout in any case. The author was off on that.
Reply | Report Abuse | Link to thisGot a good laugh reading the posts by people that injured a toe and foolishly labelled it gout. If you seriously impact a joint in your foot (or elsewhere in the body) it will naturally hurt. This has nothing to do with uric acid crystals building up. What kind of idiot thinks that for thousands of years only royalty stubbed their toes. Apparently they didn't actually read the article.
Reply | Report Abuse | Link to thisThank You 'Old Salt 72' for the info about Gary Taubes and the chapter left out of "Good Calories, Bad Calories". If you read this article, then one has to assume that in addition to an interest in gout you may have an interest in nutrition and health in general. In which case I would urge you to read Taubes' 'Good Calories, Bad Calories. If your interest is merely about gout and/or you suffer from gout then do yourself an enormous service and go to the web site that Old Salt 72 referred to (or just Google: 'Gary Taubes gout'). 'Good Calories, Bad Calories' is a rather imposing work (640 pages)but well worth the read. If your not inclined to take an introductory course in endocrinology which is what 'GC,BC' essentially is, then read 'Why We Get Fat' by Taubes which the author says he wrote because people pointed out to him that 'GC,BC' was JUST TOO LONG. Either book will absolutely change the way you think about what you're eating. You'll never look at a bagel again the same way.
Reply | Report Abuse | Link to thisYou're quite right, but your assertion needs fine-tuning: I have zero compassion for all those who incur such problems as a result of irresponsible self-indulgence.
Reply | Report Abuse | Link to thisThe portion of compassion that would normally go to those people is instead aimed at those who bear the problem through no guilt of their own. They have my full sympathy and my best wishes.
(sigh) My previous post was a reply to comment #10.
Reply | Report Abuse | Link to thisIt would have been nice if a little biochemistry had been included. What exactly causes gout?
Reply | Report Abuse | Link to thisIt's alimentary- whether we like it or not!
Reply | Report Abuse | Link to thisAcid-causing food,mainly meats, and eggs and cheeses, are they worth the pangs of gout?
Try a vegetarian approach; with a fruit-and salad menu before ingesting those animal cadavers....
And feel the difference it makes.
It's evolutionary; we are chimps de luxe by design.
How about caring about our own pH values as much as those of our swimming pools?
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