Natural Therapies for Gout

Age related illnesses | November 21, 2016 | Author: Naturopath

Natural Therapies for Gout

For many people, the first sign of gout is swelling and pain in the big toe. This form of arthritis typically affects more males than females and is the most common type of inflammatory joint disease diagnosed in men over the age of 40.
Diet plays a large role in preventing and treating gout, with certain foods high in purines and alcohol being a causative factor. Natural therapies aim to reduce joint pain and inflammation while increasing the body’s elimination of toxins and wastes.

Types of gout

The first attack of gout usually affects the big toe or another part of the foot causing pain, swelling and redness. After a few days or up to a few weeks (if left untreated) the symptoms can subside. Sometimes acute attacks can also include fever and malaise and an increase in white blood cells and inflammatory markers. Subacute gout typically involves more joints and may also include fever and fatigue. Chronic gout is a sign of unresolved attacks of gout which slowly leads to a crippling and destructive arthritis. Gouty tophi (small bumps around the affected joints) result from the monosodium urate crystals being deposited. These tophi mainly occur on the elbows, knees, wrists, toes and fingers.

What is uric acid?

Uric acid is formed in the liver from certain foods high in purines and is mainly eliminated via the kidneys. In people with gout, levels of urate are elevated for a period of time which allows the formation of crystals in joints, kidneys and soft tissue. Levels of uric acid elevate in people with gout as they usually have high dietary sources of purines and a reduced ability to eliminate them.

 

Risk factors

  1. Genetics: Enzyme defects that can cause an overproduction of uric acid
  2. Obesity: People who are overweight or obese are more likely to have high levels of uric acid and the reduced ability to remove it
  3. Age/sex: The risk of gout increases with a person’s age. Women after menopause are at a higher risk and in men the peak incidence occurs between 40-60 years of age. Men have a 4-9 fold increased risk in developing the condition compared to women.
  4. Medications: Certain medications such as diuretics and low-dose aspirin can inhibit uric acid excretion.
  5. Diet: Consuming alcohol (particularly beer), meat (especially red meat, wild game and organ meat), some seafood, fruit juice and beverages sweetened with high-fructose corn syrup increases the risk of gout.

Foods to include in the diet

Consuming optimal amounts of low-fat dairy has been associated with a lower risk of gout.
Include good quality sources with no additional sugar such as natural biodynamic yoghurt, cottage cheese and milk.

A diet rich in fruits and vegetables to reduce the frequency of gout, with foods rich in vitamin C being of particular benefit. Examples include berries, papaya, mangoes, kiwi fruit and chili.

Consuming cherries has also been shown to reduce uric acid levels and inflammation. Include nuts, seeds and legumes daily to reduce the comorbidities of gout and the incidence of insulin resistance.

Complex carbohydrates from wholegrains such as brown rice, oats, barley, rye and quinoa are good choices compared to refined, processed carbohydrates.

It is important to ensure sufficient hydration by drinking 2 litres or more of water daily.

Foods to avoid

Avoid foods high in animal derived purines such as seafood and red meat as this has shown to increase the risk of gout.

Foods high in purines include processed meats, organ meat/offal, red meat, shellfish/crustaceans, yeast (brewer’s and baker’s), red wine, port and oily fish (herring, sardines, mackerel and anchovies).

Moderate intake of purine-rich vegetables such as peas, mushrooms, spinach, lentils, beans and cauliflower do not appear to increase the risk of gout.

Avoid soft-drinks and products containing high-fructose corn syrup. Alcohol should be completely avoided in people with gout, especially beer as alcohol is associated with increased serum uric acid.

Avoid saturated and trans fatty acids as these promote inflammation in the body.

Eat vegetarian sources of omega 3 such as walnuts, chia seeds, flaxseed oil and linseeds.

Exercise and healthy lifestyle

Having a lower body mass index, maintaining an ideal body weight and regular physical activity is associated with a reduced risk of gout. Aim for 30 minutes of exercise each day and avoid exercise that exacerbates gout, especially during an attack.

Nutritionals and herbs

Bromelain is a proteolytic enzyme naturally found in pineapples but can also be taken as a supplement. It assists in reducing pain, swelling and inflammation in soft tissue injuries.

Vitamin C taken in moderate doses of 500-1500mg/day has been shown to reduce the risk of gout. It has also been proven to reduce uric acid levels in the blood. Avoid high doses as it may increase uric acid in a small number of people.

Omega-3 essential fatty acids have long been used in treating inflammation. Recent research has shown that low levels of omega 3’s in male’s increases the frequency of gout attacks, while high levels are associated with infrequent acute attacks.

Herbs that aim to reduce inflammation in gout include turmeric, boswellia, devil’s claw, willow bark and ginger. Diuretic herbs that help to increase elimination of uric acid and other waste products via the kidneys include dandelion leaf, nettle, juniper, celery and couch grass.

In conclusion, gout is an inflammatory joint disease caused by sodium urate crystals in the joints which causes pain and swelling. If left untreated it can lead to severe disability and deformity. Gout can be treated and prevented by adhering to strict dietary guidelines, reducing weight and exercising. Nutritionals and herbal medicine can help to further reduce uric acid levels and inflammation and offer a safe form of pain relief.

References

  • Hechtman L (2014). Clinical Naturopathic Medicine, Churchill Livingstone, Australia
  • Hainer BL, et al. Diagnosis, treatment and prevention of gout. Am Fam Physician. 2014 Dec 15;90(12):831-836
  • Choi H, et al. Purine-rich foods, dairy and protein intake, and the risk of gout in men. N Engl J Med 2004;51:1023-9
  • Jacob RA, et al. Consumption of cherries lowers plasma urate in healthy women. J Nutr 2003;133:1826-9
  • Huang HA, et al. The effects of vitamin C supplementation on serum concentrations of uric acid: results of a randomized controlled trial. Arthritis Rheum 2005;52:1843-7
  • Abhishek A, et al. Low omega-3 fatty acid levels associate with frequent gout attacks: a case control study. Ann Rheum Dis. 2016 Apr;75(4):784-5
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