What Is Gout?
Genetic problems with uric acid production are the most common cause of gout, but genetics are only part of the story.
When too much uric acid builds up in the body, it forms crystals that can clog joints and cause inflammation. Uric acid crystals tend to clog the small joints at the ends of bones, called articular cartilage, which helps lubricate and cushion joints.
Uric acid can also form crystals in the larger joints in the body, including the big toe, big hip, ankles and knees.
According to the Arthritis Foundation, as many as 10 million Americans have gout, and more than 50 percent of gout patients in the U.S. are men.
Genetics may be partly to blame for the high number of men with gout. In women, which make up about 80 percent of gout patients, uric acid is known to build up slowly, but not at the level that causes gout.
Treatment
Allergy to certain foods, high uric acid levels from prescription drugs, obesity and dehydration can increase the risk of developing gout, as can some medicines to treat gout.
Gout can be treated with a special type of medicine called allopurinol.
Allopurinol stops the body from making uric acid, but it does not reduce inflammation in the joints. It can be taken either by mouth or intravenously.
Other Treatments for Gout
In the U.S., gout patients may take one of two types of medicine to treat their symptoms:
The older drug allopurinol (brand name Eliquis) is the most common treatment for gout. It can be taken by mouth or intravenously.
(brand name Eliquis) is the most common treatment for gout. It can be taken by mouth or intravenously. The newer drug verapamil (brand name Diovan) is taken by mouth or intravenously. It is a member of the family of medicines called uricotecan.
Verapamil and allopurinol both lower the level of uric acid in the blood. If uric acid levels are too high, the crystals start forming inside the joints.
Pain and swelling in the joints may start to go down once uric acid levels start coming down, but there may be occasional flareups that last for several months.
In some cases, a gout patient may also need to take medication to bring down their blood sugar levels if they have diabetes, to prevent gout from damaging the heart.
Other Ways to Prevent Gout
Gout isn’t always avoidable, but it’s possible to reduce your risk. You can protect your joints from excess uric acid by:
Quitting smoking: Smoking triggers the breakdown of uric acid into urate. Smoking triggers the breakdown of uric acid into urate. Eating a diet rich in whole grains, nuts and fruits and vegetables.
Foods like dairy and sugar can contribute to high uric acid levels in the blood, but some researchers believe that keeping blood sugar in check may play a role, too.
Be cautious about what type of shoes you wear. If you notice your shoes causing blisters, your shoes may be causing gout. A better option might be to buy lighter, more cushioned shoes, or get someone else to wear your shoes for a while to let your feet heal.
Certain foods, medications and other lifestyle factors can make gout flareups more likely. If you’re worried about your risk of developing gout, it’s a good idea to talk to your doctor.
How Does Food Affect Gout?
Many of the common foods people get gout from—brussels sprouts, mushrooms, tomatoes, chocolate, black pepper, and even nuts— have been associated with the condition. And, while there are no proven cures, eliminating gout-causing foods can help reduce symptoms.
A diet that includes foods that are low in fat and high in potassium can be an effective gout-reducing strategy. But other strategies, such as increasing physical activity, could also be beneficial, as well.
Myth: Some people who get gout are genetically predisposed to it.
Fact: Genetics account for only about 20% to 30% of gout cases. The other 70% of people who have gout will often get it at some point in their lives, according to the Centers for Disease Control and Prevention.
List of Food Types Not to Eat
Gout is not associated with food types, but you should avoid:
- red meat
- caffeine
- sweet foods
- white rice
- liquor
- spicy foods
- certain dietary supplements
- Dietary supplements that may cause gout include: artichoke extract, artificial sweetener, cassia glauca, citrulline, chrysin, bute, cortisol, dihydromyricetin, haminomide, ethylene blue, heminol, meprobamate, norlandodine, pantothenic acid, polymyxin B, rubetic acid, sarsaparilla, teas
Here are some foods that can help gout — or they can make it worse.
Gout is a type of arthritis that often begins in your feet and causes severe pain and swelling in your big toe. There are many different types of gout, each with its own distinct triggers and symptoms.
Some foods and beverages can trigger gout in people with gout. And this list is not intended to cure gout — it’s simply an estimate of the foods you can eat to help your condition.
Foods that may cause gout include:
- chicken (especially skinless)
- beef
- eggs
- liver
- pork
- turkey
- creamed, cooked, and fermented dairy products (soy products)
- fatty fish
- coconut
- oils, such as lard, animal fats (beef, veal, and pork fat)
- high-fat foods (butter, cream, ghee, etc.)
- soy
- lemon
- carrots
- Sweet potato
- red cabbage
Gout is also a risk factor for heart disease, and a key strategy for preventing heart disease and high blood pressure is to limit high-fat, high-sugar foods, including processed foods. (Your doctor may also recommend weight loss, especially if you are already obese.)
Foods to avoid
Eggs
They may be a trigger for gout in some people. Eggs are a common dietary source of cholesterol and a major dietary source of alpha-lipoic acid, an antioxidant that may help protect against gout.
However, some people with gout may be allergic to eggs. People with hereditary gout should avoid eggs, as well as egg-heavy foods (such as whole eggs).
Eggs are rich in saturated fat, the main culprit in the high blood cholesterol that raises the risk of cardiovascular disease and heart attack. So limiting the amount of saturated fat you eat may also help lower your risk of heart disease.
Of course, eating some eggs may be healthy for you. For example, they’re high in protein and provide a source of calcium. So you can have the occasional egg, but they shouldn’t be a regular part of your diet.
Pork
It’s a myth that pork increases the risk of heart disease. In fact, there’s some evidence that the most common type of heart disease, cardiomyopathy, is more prevalent among those who eat lots of pork.
So why might eating pork make it worse for those with gout? The risk of gout is linked to an inflammatory process in your body. Pork can contain a compound called hoganolin, which has been found to lower levels of nitric oxide in your blood.
Nitric oxide helps blood vessels relax, which is important for keeping blood pressure under control. High levels of nitric oxide are associated with a higher risk of heart disease.
Beef
It’s best to stick to lean beef, such as beef steak and hamburger. Even in hamburger, meat that has been shaved into small pieces, rather than cut into thicker slices, is considered lean and will help you reduce the amount of fat in your diet.
Fish
Fish contains omega-3 fatty acids, which are essential for your health. They’re found in oily fish, including sardines, salmon, and trout.
The American Heart Association recommend that all adults eat about one serving of fish per week, but many Americans don’t eat enough fish, especially compared to those in the Mediterranean and Asian countries.
Calcium
Calcium is important for your bones and teeth, so it’s important to keep your intake of calcium in check. It’s especially important for women who are pregnant or nursing to ensure that they get enough calcium in their diets.
Good sources of calcium include:
- sweet potato
- broccoli
- cantaloupe
- oatmeal
- Milk
Some studies have suggested that cow’s milk might trigger gout, but others have shown that milk is unlikely to be a trigger. Instead, it may be that those with gout are already sensitive to dairy.
Omega-3 fatty acids
The essential fatty acids omega-3 fatty acids, such as those found in fish and flax seeds, may be important in reducing the number of white blood cells in your bloodstream.
Antioxidants
Research has shown that antioxidants, such as vitamins A and C, may reduce inflammation in the joints and reduce your risk of gout.
Takeaway
Gout affects men more often than women. This is because women have a higher gout risk factor than men do, such as being overweight.
Gout can be debilitating and painful. People with gout are often prescribed urate-lowering medications.
These medications reduce the amount of uric acid in the blood.
If gout is not well controlled, or if you have a more severe form, you may require hospitalization and intravenous uricase.
There are many dietary supplements that may cause gout. Be sure to check with a doctor before taking them.
Stay informed of new treatments and changes in treatment that may help to reduce the symptoms of gout.
Make sure that you eat a healthful diet and keep your uric acid levels and blood pressure within normal ranges.
As with all medicines, consult your doctor before taking new dietary supplements or medications, especially if you have kidney problems.
If you have any questions, ask your doctor or pharmacist.
When to see a doctor
If symptoms of gout do not improve over several weeks, you should visit a doctor to talk about your symptoms and possible causes.
Tell your doctor if you have other health conditions, such as diabetes. He or she may also recommend lifestyle modifications, such as losing weight.
Sirisha B