by Diana Arundell
Gout occurs more commonly in males and is one of the most common inflammatory joint diseases in men over 40 years. If women do get it, it tends to be post menopause when estrogen levels decline resulting in a reduced excretion of uric acid and possibly exacerbated by lifestyle changes such as increased alcohol consumption and less activity.
Gout can occur as a primary inflammatory condition where excess uric acid levels in the blood is the underlying cause. It can also occur as a secondary inflammatory condition whereby it’s a result of another underlying condition such as kidney failure or a side effect of a pharmaceutical drug. Genetic predisposition can occur when certain genes are activated resulting in the overproduction of uric acid and other enzymatic pathways involved with purine metabolism. Majority of gout cases are due to an increase in uric acid production by the body and other cases are due to a reduced ability to eliminate uric acid or a combination of the two. It is also possible to have high uric acid levels in the blood and not have gout symptoms.A degree of kidney dysfunction is present in majority of people who experience gout.
The big toe and thumbs are the most common site for gout crystals to form and can to a lesser degree show up in the heel or ankle. The pain is extreme and has been likened to dislocation or feeling like shards of glass buried in the region. It is usually accompanied by redness, heat and swelling in the area. Gout is often experienced more than once with the subsequent attack most likely to occur within a year. Due to dietary intervention and medication that lowers uric acid levels, chronic gout is no longer a common issue.
It appears that obesity may increase uric acid and therefore increases the risk of gout and consequently fat loss in obese individuals may result in lowered uric acid levels reducing the risk. Conditions such as diabetes, high blood pressure and chronic kidney disease have been linked to an increased risk of gout. Some medications that may inhibit uric acid excretion include diuretics and aspirin. Trauma may also have a role to play in the formation of gout crystals.
Diet and lifestyle modifications are imperative for managing gout and preventing outbreaks. Weight loss is essential if overweight and regular exercise may also prevent gout attacks. Dietary considerations to reduce the incidence of gout revolve around reducing purine rich foods which can increase uric acid levels, maintaining a more alkaline environment in the body to reduce inflammation and supporting optimal kidney function and elimination.
Increase the intake of cherries and cherry juice; red or blue berries (250g minimum per day); fresh juice of celery, cucumber, ginger, turmeric, lemon and ginger; generally increase fresh fruit and vegetable consumption and optimal hydration is imperative to support elimination of uric acid.
Substances to decrease or minimise include alcohol; soft drink; high caffeine consumption; high purine containing foods such as meat, organ meat, poultry, yeast; avoid saturated fat including full fat dairy products; if very sensitive then moderate purine containing vegetables such as asparagus, spinach, mushrooms, cauliflower and peas may also need to be reduced.
Your naturopathic practitioner may also suggest specific herbal medicine formulas or therapeutic doses of nutritionals to reduce inflammation, increase circulation to the joints or to help support the elimination systems.
Diana Arundell is a university-qualified naturopath and consults from her Avoca Naturopath clinic. She has a special interest in fertility and pregnancy health, digestive health, immune function and family wellness programs. She was a nutrition lecturer at Macquarie University for 10 years, and is an accredited Journey Practitioner.
For further information or to make an appointment please contact Diana Arundell at Avoca Naturopath on 0410 465 900.