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So you Have Gout!

What is gout?

Gout is a form of arthritis resulting from deposits of uric acid crystals formed in the bodies' joints. A gout attack will usually attack only one joint at a time, the big toe being the most common. Other joints that may also be impacted by gout are the feet, ankle, knee, hand, and wrist. The pain will typically last five to fourteen days, at which point the crystals will leave the joint.


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 What causes gout?

This question is still up in the air. The quick answer is that hyperuricemia, which is an elevated blood level of uric acid, is responsible for gout. With that said, not all patients with hyperuricemia develop gout, and some patients with gout do not have hyperuricemia. Although it is not clear how hyperuricemia relates to gout, one thing is clear; gout is associated with sudden changes in uric acid levels in the blood.

What is uric acid?

Uric acid helps protect blood vessel linings and serves as an antioxidant. Uric acid is created when purines are broken down by the body. Purines are found in all the cells of the body, and in virtually all food. Some food sources contain a much higher concentration of purines than all the others. Foods with very high purine levels include:

- Organ meats, such as brain, kidney, liver, and sweetbreads.

- Anchovies

- Mackerel

- Herring

- Sardines

- Gravies

- Dried beans and peas

Foods with high and moderately high purine levels include:

- All other meat

- Other beans, such as kidney, lima, navy, lentil

- Some vegetables, such as asparagus, cauliflower, mushrooms, and spinach

What are the risk factors?

- Alcohol. Excessive consumption of alcohol is believed to inhibit the bodies' ability to dispose of excess uric acid.

- Obesity. Body weight has an impact on the bodies' ability to process uric acid properly, and puts a greater load on your joints.

- Medical Conditions. High blood pressure, diabetes, high cholesterol and medicines used to treat such conditions increase the likelihood of developing gout.

- Genetics. A family history of gout increases the chance of developing gout by 20 percent.

 
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- Gender. Men are much more likely than women to develop gout.

- Age. Men are most likely to develop gout between the ages of forty and fifty. Women generally develop gout after menopause.

What can we do about gout?

There is no sure way to determine if you will have gout, until you have your first flare up. If you have already had a gout attack, you know that you never want to have another one. There are a number of prescription medications available to treat gout, and you should discuss with your physician what you should take.

Self help!

There are a number of things that you can do for yourself to decrease your chance of developing gout, or having a recurrence. I must state however that there is no guaranteed way to prevent a gout attack. Important Disclaimer; Many of the following suggestions are intended to decrease your blood uric acid level. Ultimately, this should be your goal, but a sudden drop in your blood uric acid level, may cause a gout attack. I suggest that all lifestyle changes be made at a moderate pace to decrease the risk.

- Drink plenty of water. Water helps to flush uric acid out of your body.

- Lose weight. If you are overweight, losing weight will decrease your uric acid levels. Do not fast, or engage in a rapid weight loss program, because this will actually cause a temporary raise in uric acid levels.

- Avoid Alcohol. As stated before, alcohol interferes with the body excreting uric acid. Definitely stay away from alcohol if you are experiencing a gout attack.

- Limit your purine intake. Uric acid is formed when your body breaks down purines.

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