Myths About Gout Are Hampering Its Treatment

Content

• Gout Topics
• Treatment & Diagnosis
• Get Rid Of Gout Now: a Nutritional Approach For Getting Rid Of Your Gout
• Do Podiatrists Treat Gout?
• Health Essentials

If the tophi are not prevented or treated, they can damage joints . High fructose intake was linked to gout in a Choi-led study published in 2008. Uric acid is one of the products of fructose metabolism, and there's good evidence from controlled feeding studies that fructose increases uric acid levels in the blood. Much of the fructose in today's American diet comes from the high-fructose corn syrup that's used to sweeten soft drinks and many other foods and drinks. Adopting healthy lifestyle habits is a key part of an effective gout treatment plan. Eat a healthy diet, avoid or limit high-purine foods, do regular exercise and lose excess weight to lower your risk of repeated gout attacks.

Like osteoarthritis , gout may respond well to getting up and moving. Engaging in gentle, yet routine exercise helps to keep your joints functioning well and flushes uric acid crystallization from them. Exercise, along with a healthy diet, can also help you lose weight, which reduces your risk of gout flare-ups. Although exercise is important, it’s necessary to remember that your joints are arthritic; keep your routine gentle and don’t go overboard. Patients who continue to have high levels of uric acid in the blood may benefit from medications that control uric acid levels.

Gout Topics

If needed, fluid from the joint can be removed with a needle to confirm the gout diagnosis. Blood tests may be ordered to check for infection as well to check your uric acid levels. At first, probenecid or sulfinpyrazone may increase your risk for kidney stones by increasing the uric acid content of the urine. To prevent this problem, keep your urine diluted by drinking eight ounce glasses of fluid every day. They last only a week or so and then everything seems to go back to normal with no symptoms between episodes. If the disease is not controlled by medication, attacks may occur more often and may last longer.

Treatment & Diagnosis

Many of our Mission Viejo, California patients tell us that even the pressure of their sheets and blankets is enough to cause sharp pain. Simple sugars (refined sugar, honey, maple syrup, corn syrup, fructose, etc.) increase uric acid production while saturated fats decrease uric acid excretion. This sets up a situation similar to drinking alcohol where more uric acid is being created but less is being removed from the body. If you’re unsure what qualifies as a saturated fat, they’re fats that are solid at room temperature. It may wake you up at night with intense pain in your big toe — so intense that you cannot stand to have it touched, even by the sheets. If you have one of these medicines but have not been taking it, do not start taking the medicine during an attack.

Gout is the term to describe this condition whether it is acutely or chronically present. In people with kidney and liver problems, colchicine can cause a life-threatening interaction when taken with certain other medicines. People with kidney and liver problems should talk with their health care professional before taking colchicine. Febuxostat decreases the formation of uric acid by the body and is a very reliable way to lower the blood uric acid level. Patients who are overweight and have high blood pressure can also be at risk for gout.

Talk with your doctor about all the drugs you're taking. This includes over-the-counter drugs such as aspirin or diuretics. Some of the gout medications will not work properly if you are taking other drugs at the same time. Don't start any new drugs without being sure they will work properly with the ones you're already taking.

Low‐fat dairy products may help lower uric acid levels. The “gold standard” to diagnose an acute attack of gout is to remove some fluid from the joint with a needle and syringe, and examine this under a microscope for uric acid crystals. If this cannot be done, certain typical symptoms and signs seen together are highly suggestive of gout, and a diagnosis can be made. Joint ultrasound or dual energy CT scan images show gout very well. Rather, foods high in purines can increase the risk of gout, particularly in someone who is secreting too little uric acid. These include seafoods such as mussels, lobster, sardines and salmon, as well as beer, bacon, liver, sweetbreads, turkey, veal, and high fructose corn syrup.

The joint most often affected is the big toe, but gout can happen in any joint . The first symptom of gouty arthritis is typically the sudden onset of a hot, red, swollen, stiff, painful joint. The most common joint involved is in the foot at the base of the big toe where swelling can be associated with severe tenderness, but almost any joint can be involved . In some people, the acute pain is so intense that even a bed sheet on the toe causes severe pain. Acute gouty arthritis at the base of the big toe is referred to as podagra. Tophi occur when the person’s blood uric acid level remains high over a long period of time.

Are eggs bad for gout?

The pain during a gout flare is so excruciating that many visit the emergency room for care. On a typical pain scale, most people with gout will rank their pain as a nine or a 10 – with even the slightest touch causing agony.

If tophi are causing infection, pain, pressure, and deformed joints, your doctor may be able to treat them with medicine. If this doesn't work, your doctor may recommend surgery to remove them. If the blood uric acid is high but a person has never had an attack of gout, treatment is rarely needed. But people with extremely elevated levels may need regular testing for signs of kidney damage. And they may need long-term treatment to lower their uric acid levels. Your blood uric acid level may be watched by your doctor until it is lowered to normal levels.

Anti-inflammatory steroids are very different in action and side-effects as compared to male hormone steroids. Anti-inflammatory steroids have long-term risks, such as bone thinning and infection, but their risk for short-term (for example, 3-7 days) therapy is relatively low. These agents can raise blood pressure and blood sugar, so can be a problem for those with uncontrolled hypertension or uncontrolled diabetes mellitus. Uric acid does not show up on x-rays, but some bone changes can be visible with gout .

How do you dissolve gout?

Two long-term medications for gout are allopurinol and febuxostat. This is the most commonly used drug. It is usually taken once a day, and works by lowering the amount of uric acid produced by the body. After uric acid levels are measured, people are usually prescribed a low dose to start with.

The amount of medications you take will depend upon your symptoms and laboratory test results. On the other hand, it may be necessary to take a combination of the drugs listed here. Whether you take these drugs depends on your doctor's judgment and your willingness to make a lifelong commitment to taking daily medications.

Drinking an organic, cherry concentrate at night will not only help with pain, but it will also help you sleep with the natural melatonin. While the treatments listed above all have proven effectiveness, consulting a physician for an accurate diagnosis before using home treatment is usually the best course of action. If you or a loved one are experiencing gout-like symptoms, you can make an appointment with your primary care physician or visit an urgent care center in order to be properly diagnosed. Hydrate – not only will staying well hydrated help to flush uric acid from your system, it will also help to prevent the development of kidney stones. If you choose to use cold packs for pain relief, be aware that you may be exchanging long term benefits for temporary relief. When the gout episodes are infrequent, an NSAID or colchicine can be used as needed.

Local injection of crystalline preparations of corticosteroid can be an excellent option if a person has a single joint gout attack. Formulations injected include methylprednisolone acetate (Depo-Medrol®), triamcinolone (Aristospan®), and betamethasone (Celestone®). The advantage of betamethasone is a decreased likelihood of temporarily worsened flares the day after the injection, which is the most common adverse reaction to local steroid injections. Non-steroidal anti-inflammatory agents and COX-2 inhibitors are the mainstay of therapy of acute attacks of gout in patients who have no contra-indication to them. These medications include such agents as naproxen (Naprosyn®), ibuprofen (Motrin®), celecoxib (Celebrex®), indomethacin (Indocin®) and many others.

Oxalates also cause a condition in women called vulvodynia, which leads to painful sex because of oxalic acid crystals in the labia. Poor sugar regulation is highly associated with gout, and a sugar-heavy diet can drastically worsen both. In fact, insulin resistance is known to raise uric acid levels, and high uric acid can also contribute to insulin resistance, which is why roughly 95% of gout patients also suffer hyperinsulinemia. Chronically high insulin, such as with insulin resistance, prediabetes or type 2 diabetes, reduces your body’s ability to excrete uric acid.

Whatever the mechanism of the elevated uric acid, the key event in gout is the movement of uric acid crystals into the joint fluid. This cycle also recruits more white blood cells to the joint, which accelerates the inflammatory process. About 10% of cases of gout are due to overproduction of uric acid.

Health Essentials

Some people have high uric acid levels, but never experience gout. And some people have signs and symptoms of gout, but don't have unusual levels of uric acid in their blood. Reduced uric acid levels could lower the risk of gout attacks. Research has not conclusively proven that vitamin C treats or prevents gout, however — only that it lowers uric acid levels. Reaching a healthy body weight may help reduce the risk of gout flares. Obesity increases the risk of gout, especially in people of a younger age.