GOUT – Symptoms, Causes and Prevention

Medically reviewed by Dr. Shunmukha Priya, Ph.D. in Food Science and Nutrition

Gout is a type of arthritis that is extremely painful. It has been around since ancient times and is a condition that occurs more often in men and in women after menopause. It is also common among people with kidney disease.

Gout is strongly associated with obesity, diabetes, high blood pressure, high cholesterol. It is also genetic, and you may inherit from ancestors. There have been hardly any cases of gout in children.[1]

Introduction

Gout is a potentially disabling form of arthritis that occurs when excess uric acid collects in the body forming a needle like urate crystals that is deposited in the joints.

This can be the result of two actions. First being if uric acid production increases; second being if the kidneys cannot remove uric acid from the body well enough. In case of consumption of certain foods and drugs that raises uric acid levels, it leads to gout attacks.[2]

So, what is Uric acid?

Uric acid is a waste product created during the conventional breakdown of purines. These purines are naturally present in the human body. You can also find purines in foods such as liver, mushrooms, anchovies, mackerel and dried beans etc. 

This uric acid produced is cleaned out of the blood by the kidneys; It is then passed out of the body along with urine.

Like most other diseases, gout can also be treated with certain diet therapy and medication. In simple terms, it is also one of the lifestyle diseases, which requires you to practice a healthy lifestyle in order to defeat gout.

Saying NO to alcohol and meat is the first thing that has to be done for lowering blood levels of uric acid. This can also reduce symptoms that come with elevated uric acid.

Loss of excess weight may also enhance treatment for gout by improving the kidney’s ability to clear uric acid from plasma.

Hyperuricemia is nothing but an excess amount of uric acid in the blood. Uric acid passes through the liver and enters your bloodstream. Most of it is excreted (removed from your body) in your urine or passes through your intestines to regulate “normal” levels.[3]

How to Decrease High uric?

There are some of the basic diet and lifestyle changes that helps you decrease uric acid in your body.

• Replacing meat with legumes and other plant proteins. 
• Avoidance of alcohol.
• Reduce Elevated lead levels. 
• Avoidance of sugar-sweetened beverages (Fructose rich). 
• Reduce Dairy intake except buttermilk.
• Reduce pungent, saline, sour and alkaline taste Items.
• Cut down on fat.

“None of One, Less of Two, More of Three” (One –Smoking, Two –Wrong Food intake and Alcohol, Three- Rest, Mild exercise and Enjoyable Activity.

Next Read: Lifestyle Modifications To Manage Uric Acid Levels

Signs and Symptoms of Gout

The signs and symptoms of gout occur suddenly; especially in the night. These are some of the initial observations on a person with gout:

1. Intense joint pain: It is common to have more pain in the large joint of your big toe when you have gout; but it is also true that it might occur in any joint. Gout also affects other joints in the ankles, knees, elbows, wrists, and fingers.
2. Lingering discomfort: Ones the most severe pain recedes, in some places the joint discomfort could last for a few days or even a few weeks. With time, the attacks become more often and also starts affecting all the joints.
3. Inflammation and redness: The affected joints start to swell. Gradually becomes tender, warm and red.
4. Body movement reduces: As gout the condition becomes severe, it becomes hard to move joints normally.[4]

Interesting facts about Gout

• Gout is rarely seen in men before adolescence.
• Estrogen protects women from developing gout prior to Menopause (the stage when estrogen levels decline).
• Uric acid levels can be normal during a gout attack.
• Many drugs can cause a gout attack including thiazide diuretics 
• Alcohol use increases the risk for gout.
• Besides causing arthritis (gouty arthritis), gout can damage the kidneys if left unchecked.

Causes of Gout

When the level of uric acid in your blood increases, urate crystals are formed. These urate crystals start to pile up in your joint. This causes inflammation and leads to intense pain. Hence results in gout attack.

Are you wondering how uric acids are produced in your body? So, uric acid is produced by the common breakdown of the purines. These purines are found naturally in the human body.

Purines can also be found in foods.  Steak, organ meats and seafood have large amounts of purines. Alcoholic beverages like beer, and drinks sweetened with fruit sugar also promote higher levels of uric acid.

As a normal activity, the uric acid produced in the body dissolves in your blood and is moved out of the body as urine. But in cases where the production of uric acid is more or if your kidney excretes too little uric acid, that is when it is dangerous.

The uric acid builds up and forms urate crystals in your joints. This causes pain in the tissues, inflammation and finally swelling.[5]

Risk Factors and Complications of Gout

If you have high levels of uric acid in your body, then you are more likely to develop gout. Basic elements that causes the uric acid level to shoot up in your body are:

• Food: Foods that are rich in meat and seafood levels up the uric acid in the body. Not just foods, drinking beverages that are added with fruit sugar can also increase the amount of uric acid. Alcohol, especially beer causes more damage than pleasure; it is known to bring up the uric acid levels. Hence elevates the risk of gout attacks.
• Obesity: Being overweight causes your body to produce more uric acid. This leads to difficulty in eliminating uric acid by the kidneys.
• Medical conditions: Conditions like high blood pressure, diabetes, digestive problems, and heart and kidney diseases can lead to the risk of gout in you.
• Some medications: Consumption of low dose aspirin can increase the uric acid level in your body. Not just this, medications like thiazide diuretics that are used to treat hypertension also induces the increase of uric acid level.
• Family history of gout: As per the studies gout is also a genetic disease. If at all anyone in your family has had gout, then you are more likely to get it.
• Age and sex: Women tend to have lower levels of uric acid when compared to that of men. Hence occurring of gout is more common among men. Once a woman approaches her menopause stage, her uric levels reach to the same as that of men. Usually gout occurs in a man when he reaches the age between 30 to 50. Whereas in women, the gout occurs after she approaches menopause.
• Recent surgery or trauma: In case of recent surgery or a trauma, there has been studies of increased risk of gout attacks.[6]

There can be more severe risks for people with gout, such as:

• Recurrent gout: Most people may never experience the signs and symptoms of gout again. But some may experience it frequently every year. Certain medicines may help prevent gout attacks; especially in people experiencing frequent attacks. Hence it is very important to get treated; if not, gout attacks can get very serious causing severe actions on the joints.
• Advanced gout: If you leave the gout untreated, the urate crystals start depositing under the skin in nodules called tophi (TOE-fie). The development of tophi can be seen in several areas; especially in the fingers, hands, feet and elbows. Tophi can get swollen and become tender during gout attacks; although it is not usually painful.
• Kidney stones: Urate crystals formed by the uric acid gets collected in the urinary tract of people with gout. This causes kidney stones. There are many medications and surgeries that can help reduce the risk of kidney stones.[7]

Nutritional Management Of Gout

Studies have shown that certain nutrients tend to improve gout condition .

Nutrients Required

• Vitamin C: This particular nutrient is water soluble and is known for its antioxidants and also its benefit over immune function. Spinach, Broccoli, cauliflower, green leafy veggies, tomatoes etc are some of the major foods rich in vitamin C.
• Vitamin B6: Beneficial in maintaining blood sugar levels, vitamin B6 is also an essential nutrient for proper brain development among toddlers and children. Foods such as chicken, turkey, fish, pork, oats, brown rice etc are rich in this particular vitamin.
• Vitamin D: It is found in very few foods and is a fat soluble vitamin. Fatty fishes, diary products, cereals etc are some of the foods that provide vitamin D.

Kidney cleansing foods

• Beet juice
• Watermelon
• Lemon juice
• Cranberry juice
• Pumpkin seeds
• Smoothies
• Ginger
• Turmeric

Must Try: Everyday Drink Health Smoothies Recipe

Gout and Body Weight

It must be surprising for most of you to know that Gout and weight loss are interrelated. Yes! Hence it becomes important to take heed and efforts towards losing weight and improving metabolism.

A 2015 Arthritis Research and Therapy study found that people with high levels of visceral fat (abdominal fat), were more likely to have gout than their smaller-bellied counterparts.

The reason for body weight being a savior for gout is loss of excess weight may enhance treatment by improving the kidney’s ability to clear uric acid from plasma.[8]

Values

Hyperuricemia is usually 6.8mg/dl and above for Male and female. The normal upper limit is 6.8mg/dL, and anything over 7 mg/dL is considered saturated. Gout has a male predominance in a 4:1 ratio of men to women.[9]

Prevention before it worsens

In the initial period, you hardly experience any symptoms of gout. Hence with certain dietary and lifestyle changes, you can prevent the risks gout attacks in the future:

• Drink more liquids: Again! This is important. It is necessary to stay well-hydrated. Avoid beverages that are highly sweetened; especially the ones sweetened with high-fructose corn syrup. Stick to water.
• Limit or avoid alcohol: We know it is not easy to give up on alcohol at once. Hence talk to your doctor; ask them if there is any type of alcohol that is safe for you or maybe any prescribed amount of alcohol that best suits you. But it is true that beer especially increases the uric acid levels in the body, mostly in men.
• Get your protein from low-fat dairy products: Looking for the best protein? Hold on to dairy products that are low fat. They are known to have a protective effect against gout symptoms.
• Limit your intake of meat, fish and poultry: Maybe not completely, but limit the consumption of meat or fish or poultry into as less as possible. Keep a check on what is better for you.
• Maintain a desirable body weight: Your body weight is everything here. Divide your meals into small portions. The level of uric acid in your body may even decline if you lose weight. But do not go overboard.[10]

Home remedies for Gout

1. Ginger Tea: Take ginger internally by boiling water and steeping 2 teaspoons of ginger root for 10 minutes. Drink 3 cups per day.
2. Lemon-turmeric liquid: Mix juice from one squeezed half lemon into warm water. Combine with 2 teaspoons turmeric and 1 teaspoon apple cider vinegar. Adjust to taste. Drink two times per day.
3. Soak painful joint in Epsom salt with warm water 

Herbs for Gout

• Patola 
• Guduchi 
• Madhuka 
• Ginger 
• Punarnava (not for longer duration)
• Gokshura (not for longer duration)

Possible products for reducing high uric acid levels:

• Trudrink
• Red rice poha
• Trufibre
• Amla drink
• Pumpkin cranberry seeds
• Quinoa dosa

Conclusion

Gout is one of the most painful and dangerous diseases of all. It comes with a lot of pain and the pain lasts long causing mental illnesses too. Now that you have read all about gout, it is inhumane to not take a precaution right away.

Healthy living has led to the longevity and increase in quality of life. Why not develop the right habit instead of the several unnecessary ones? The decision is up-to to you and we are here for you!