Julia, age 65, woke with a start at 2 am with excruciating pain in her big toe (it felt like nothing she had experienced before). Even the light touch of the sheet was unbearable. The toe was not only extremely painful but red, swollen and stiff. Her diagnosis the next day at the doctor: Gout.
If you’ve ever had an attack of gout, you’d certainly remember it and want to do everything you can to dodge a future attack. On the other hand, if you’ve never experienced it, you will want to do what you can to avoid going down that painful road.
Caused by a buildup of uric acid, a first attack of gout tends to strike in the middle of the night, usually in the joint of the big toe. And risk for follow-up attacks is very high.
The dangers: While the initial flare-up may subside in about three to 10 days without treatment, long-term complications from repeated attacks can be serious. Gout can damage and deform your joints and bones…interfere with walking, driving and other day-to-day activities…and seriously harm your quality of life. It’s also been associated with greater risk for stroke, high blood pressure, heart attack and kidney stones.
Gout is on the rise, now affecting about 8.3 million Americans—most likely due to the increase of chronic disease and obesity in the US. It tends to run in families, occurs more often in people who suffer from chronic illness such as those mentioned above and is affecting more women than ever before.
But there are actions you can take to treat gout naturally. These have been proven to reduce the likelihood of having one of these painful episodes—whether you’re looking to ward off recurrent gout flare-ups or a first attack…*
• Lose weight. Extra weight reduces the ability of the kidneys to flush out uric acid, resulting in a greater possibility of a gout flare-up. One study in women found that obesity increased the risk for gout by 2.4 times. That number jumped to 2.8 for those who became obese in early or mid-adulthood.
What to do: Talk with your doctor about losing weight gradually through diet and exercise. Ironically, crash dieting (eating very little in order to lose weight quickly) and low-carb diets can increase the odds of a flare-up, as both cause uric acid levels to rise.
• Avoid high-purine foods. Purines are chemicals in food that lead to the production of uric acid. The list of foods with purine is very long. You don’t need to avoid all of these foods, but if you’re prone to gout, it’s best to moderate your consumption of purine-rich red meat, organ meats and seafood (particularly anchovies, herring, mackerel, sardines, tuna, haddock and scallops).
Foods that may offer protection against gout flare-ups: Low-fat dairy products and cherries. Vitamin C (from food or a supplement) may also help.
• Reevaluate aspirin and diuretics. Daily low-dose aspirin can trigger gout by increasing levels of uric acid in the blood. And diuretics, which are commonly used to treat high blood pressure and heart disease, may limit the kidneys’ ability to remove uric acid.
If you take one of these drugs and develop gout, ask your doctor if there are other medications (or dosages) that can be considered. Caution: Never stop taking a medication without your doctor’s approval.
• Stay well-hydrated. If you’re predisposed to gout, drinking too little liquid can increase the concentration of uric acid in the blood, resulting in an attack.
Best: Drink eight eight-ounce glasses of water a day (excess uric acid will then be excreted via urination). Also, avoid regular soda and many other sweetened drinks that contain high-fructose corn syrup, which has been shown to increase uric acid levels.
• Limit alcohol use. Overindulging in alcohol results in a damaging one-two punch to the body. It not only increases uric acid levels in the bloodstream and kidneys but also blocks the kidneys from excreting uric acid. While some studies have suggested that beer and hard liquor are worse than wine, the jury’s still out.
What to do: If you have gout or are looking to prevent it, play it safe—avoid beer and hard liquor and limit consumption of wine.
Most patients will have a significant reduction, if not complete resolution, of gout attacks with the prescription drug allopurinol, which can be taken indefinitely, unless there is a change in health that lowers uric acid levels in the body naturally.
It may take a few dosage adjustments to achieve the target uric acid level of 6 mg/dL or lower. Also, especially in the first two weeks of taking this drug, some patients experience a gout flare-up, so doctors often prescribe anti-inflammatory medications with this drug.
Allopurinol is generally very well-tolerated, but in rare cases, it can cause a severe rash. If this happens, contact your doctor.
*If your gout flares up more than twice a year, it’s important to see a doctor for treatment.
