The pain of a gout attack can feel like tiny shards of glass piercing your big toe. Even the slightest brush of a bedsheet on your skin can be excruciating. Sufferers limp with agony and are simultaneously plagued by fever and chills. 

Once called the “disease of kings” because only the wealthy had the means to overindulge in the rich foods that are commonly associated with gout, the disease has since reached mass proportions. Incidence has more than doubled in the last 20 years to more than eight million people according to a study published in The Journal of Rheumatology. Gout is caused by a buildup of uric acid, which congeals into sharp crystals causing pain and destroying joints. 

Doctors commonly suggest that you lower levels of uric acid and prevent ­future attacks with medications such as allopurinol (Zyloprim, Aloprim). Beware—newer anti-gout drugs such as lesinurad (Zurampic) and pegloticase (Krystexxa) do not have proven safety records and do not provide more therapeutic benefit than allopurinol. 

You can avoid dependence on medication and prevent gout flare-ups with successful natural treatments that can get to the root of the problem—excess uric acid and the inflammation that it causes. Since flare-ups are mainly diet-related, treatment also centers around changes in your diet. 

Here’s what works best for preventing and treating this disease… 

Eat plain yogurt. You may already love yogurt because it is high in protein, calcium and vitamins, but now it has also been associated with lowering gout attack risk. In new research published in Modern Rheumatology, Japanese scientists studied 25 people with high uric acid (hyperuricemia) and/or gout. Half the patients consumed daily yogurt drinks rich in the probiotic lactobacillus gasseri, and half did not. After eight weeks, patients who ate yogurt had lower levels of uric acid. Even though it was a small study, the results were significant. If you don’t like yogurt, a probiotic supplement may help.

Avoid high-fructose corn syrup. It may not surprise you to learn that uric acid levels have risen along with the skyrocketing consumption of high-fructose corn syrup (HFCS). In a landmark study published in Diabetes, scientists from University of Colorado specifically blame rising uric acid levels on the HFCS found in sodas, juice drinks, candy, ice cream, baked goods (including breads), commercial salad dressings and many other processed foods. Although HFCS consumption seems to have peaked and is starting to fall, Americans still consume ­unhealthy amounts. 

Beware of other sugars as well. Fructose-rich fruit is OK to eat, but commercial fruit juices deliver too much fructose—even if they don’t contain HFCS. 

For sweetness, consider using stevia. You’re probably already familiar with the sweetener stevia—made from the leaves of the stevia plant and typically available as a powder or liquid extract. It is a safe, healthy and calorie-free natural sweetener. But now there’s a new benefit to using stevia—recent scientific research shows stevia lowers uric acid. There are hundreds of stevia-sweetened products on the market, including sodas, chocolate bars, candies, puddings, jams, etc. 

Latest research finding: In an animal study conducted by Chinese scientists and published in Journal of Food Biochemistry, a stevia extract lowered fructose-caused high uric acid levels and inflammation. And it worked even better when combined with the prescription drug allopurinol.

Add more fatty fish to your diet. The omega-3 fatty acids in fatty fish such as salmon, trout, mackerel, sardines and anchovies are powerfully ­anti-inflammatory and can help prevent gout attacks. Important new finding: Researchers at Harvard Medical School looked at more than 700 people with gout. Those who ate omega-3–rich servings of fish were 26% less likely to have a gout attack. 

Note: Many doctors and organizations such as the Mayo Clinic and the Arthritis Foundation routinely recommend that patients with gout avoid purine-rich foods, including seafood, organ meats and wild game. But this recommendation is becoming outdated. The most recent scientific research shows that avoiding purines is unlikely to help you avoid gout attacks and only serves to remove potentially healthful foods from your diet. Try this: It’s better to add anti-gout foods to your diet rather than eliminate healthy foods for a questionable benefit. 

Take the powerful anti-inflammatory curcumin—the active ingredient in the spice turmeric. New research finding: In a study published in ­Arthritis Research and Therapy, Chinese scientists successfully used curcumin to stop inflammation caused by uric acid crystals. Researchers concluded that curcumin is so effective, it could be considered a new “drug” for the treatment of gout. Gout attacks often can be stopped with the curcumin-­containing supplement Curamin* from Terry Naturally, which contains a highly absorbable form of the same compound. Directions: Take two or three capsules two to three times daily until you feel better. For a maintenance dose that can help prevent future attacks, take three capsules daily. 

Take a tart cherry supplement. You also can treat gout attacks with the supplement End Pain* from Enzymatic Therapy, which contains an extract of tart cherry (as well as boswellia and willow bark, two anti-inflammatory herbs). During a gout attack, take two tablets of End Pain three times daily. For maintenance to prevent gout attacks, take one tablet three times daily. 

New research finding: In a study published in Current Developments in ­Nutrition, researchers had 26 overweight people drink either tart cherry juice or a placebo beverage over a four-week period and then switch—so that each group tried both tart cherry juice and the placebo. Tart cherry juice lowered both uric acid and C-reactive protein (an inflammatory biomarker) by 19%. Caution: Regular intake of tart cherry juice to prevent or control gout is not recommended because it delivers too much fructose, so it is better to use a supplement such as End Pain instead. 

Note: Drinking a lot of water every day can dilute uric acid levels by helping you stay hydrated but will not stop an acute gout attack. You also can take supplements of omega-3s and antioxidants—these essential fatty acids are crucial for your body’s health, but they won’t do as much for gout as actual changes in your diet and lifestyle. 

*Dr. Teitelbaum works on the scientific advisory board of the company that makes Curamin, and he designed and sells End Pain. He donates all financial compensation for both products to charity.