What Can You Do to Help Prevent Gout? by Dr. Mercola
What Can You Do to Help Prevent Gout?
July 27, 2016|32,280views
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By Dr. Mercola
Gout is one of the more than 100 different types of arthritis.1 Once called the “Disease of Kings” or “rich man’s disease,” the number of people suffering from gout is on the rise.
In England and New Zealand, the number of people evaluated at the
hospital for symptoms of gout rose by 80 percent in the past decade.2 In the past 50 years the incidence of gout has nearly doubled in the U.S.3
Like a window into your metabolic health, gout is an outward sign of
what’s happening on the inside of your body. Symptoms of the condition,
and long-term treatment, are related to your lifestyle choices and
nutritional habits. In other words, you have some degree of control over
your condition.
In 2011, gout affected 8.3 million, or 4 percent of Americans.4
Although the numbers of people diagnosed are rising, it may not be an
accurate representation of the number of people who experience the
condition each year.
Many people suffer from an episodic gout condition, experiencing several occurrences over their lifetime.5
However, according to Dr. Allen Anandarajah, an associate professor of
medicine and a rheumatologist at the University of Rochester Medical
Center, many don’t see their doctor for these periodic occurrences.6
This means the number of people who have gout each year could
actually be as high as 10 percent of the population. Symptoms include:7
Pain, often in the big toe, starting at night
Warmth, swelling and redness in the affected area
Both fingers and toes or feet may be affected
Extreme tenderness in the affected joint
Red or purple coloring on the skin over the joint
Joint may appear to be infected
Limited movement in the joint
Skin may itch or peel as the gout resolves
Symptoms Are Related to an End Product of Metabolism
These symptoms are the result of uric acid crystal deposits in the
joint space. There is evidence that these deposits are related to
metabolic syndrome,8
a constellation of health conditions characterized by insulin and
leptin resistance, central or abdominal obesity, high blood pressure,
and a fasting glucose greater than 100 milligram per deciliter (mg/dL).9
Purine, a compound found in certain foods, contributes to energy
metabolism and is a component in some co-enzymes. All cells require
purine for growth and survival. The final compound in the breakdown of
purine is uric acid.
Only humans don’t have the enzyme uricase that converts uric acid to a
compound easily excreted in the urine. It’s the buildup of serum uric
acid that is associated with the severity of your gout.10
When your metabolic processes controlling serum uric acid don’t
function effectively, it can result in an overproduction of uric acid
and crystalline deposits in a joint space.11
Drugs Are Not an Ideal Long-Term Solution
Conventional treatment for gout includes the use of medications such as:
Allopurinol, which reduces uric acid production
Colchicine, which blocks inflammation caused by uric acid crystals
and may be used for long-term prevention of recurring episodes
In the short-term, these medications may effectively treat your
symptoms. But gout may be a lifelong condition and the side effects from
these drugs make them dangerous for long-term use.
Allopurinol is used during an episode of gout. Common side effects
include nausea, diarrhea or drowsiness. Other side effects may include
increased bleeding, signs of infection, kidney problems, yellowing skin
or eyes, eye pain or vision changes and unexplained weight loss.12
Colchicine is used as a prophylaxis to prevent a recurrence. You may
experience diarrhea, nausea, cramping and vomiting when you begin the
medication.
Serious side effects include muscle weakness, numbness or tingling of
your hands or feet, pale color to your lips, tongue or palms of your
hands, unusual weakness, fast heart rate and shortness of breath.13
Side effects from long-term or consistent use of NSAIDs are well documented. Severe intestinal damage,14
increased risk of heart attack and stroke, increased risk of ulcers and
reduced blood flow to the kidneys are some of the risks of NSAID use.15
Lifestyle Choices That May Limit or Prevent Gout
Gout is more common among men than women, and more often between the ages of 40 and 50.16
Although you may not have symptoms of gout today, it’s never too early
to use a proactive approach to preventing illness. The preventive
lifestyle choices to reduce your risk of gout will also help reduce your
risk for other diseases.
Exercise Daily
Regular exercise and consistent movement may help to normalize your
insulin and leptin levels and reduce buildup of uric acid. If you suffer
symptoms of gout you may want to limit your exercise to reduce the
potential for permanent joint damage. For instance:
Don’t exercise a joint with active symptoms of gout
Choose another exercise if you feel pain in a joint an hour after finishing your workout
Enlist the help of a professional therapist to identify a safe range of workouts
If you don’t have symptoms of gout, consider high-intensity interval training combined with strength training.
Optimize Your Vitamin D Levels
Research has demonstrated the importance of vitamin D to your overall
health and the prevention of many diseases, including diabetes, cancer
and heart disease. Evidence also suggests it plays a preventive role in
the development of metabolic syndrome.17
Sensible sun exposure is the best way to raise your vitamin D levels.
This way your body naturally creates vitamin D3. You’ll know that you
have accomplished this when your skin turns to the lightest shade of
pink. Staying in the sun beyond this point will only promote burning and
skin damage.
If you live in an area where sunlight isn’t abundant, you can take a
vitamin D3 (25-hydroxyvitamin D3) supplement along with a vitamin K2
MK-7 supplement. Your ideal dosage is one that will help you reach and
maintain a healthy vitamin D level of 40 to 60 nanograms per milliliter
(ng/ml).
Enough Sleep
Quality sleep each night benefits your overall health and reduces
your risk of abdominal fat deposits. Sleep deprivation suppresses your
immune system, increases your appetite and leads to premature aging.
How much sleep you need depends on several medical and physical
factors unique to you. According to the National Sleep Foundation, young
adults between 18 and 64 years need between seven and nine hours of
sleep each night.18
Practice Grounding
Grounding or earthing is the process of walking or standing barefoot on bare earth, permitting free electrons from the earth to enter your body. These powerful antioxidants combat free radicals in your system.
Grounding may reduce your risk of cardiovascular disease and may thin
your blood, both good things when you want to reduce your risk for
gout. If you want to try grounding, start by walking in a dewy, grassy
area barefoot.
If you live near a large body of water, that’s a great location for walking barefoot, as seawater is a good conductor.
Reduce Your Stress
Stress is almost inevitable in a fast-paced life. It may increase
your release of cortisol, reducing your body’s sensitivity to the
hormone and increasing the amount of inflammation in your system.
Inflammation reduces your ability to fight infections and is one factor in the development of several different diseases.
If you aren’t sure where to start reducing your stress, try the Emotional Freedom Techniques
(EFT). This process works much the same as acupuncture, but using
pressure and tapping to stimulate the energy meridian points in your
head and chest.
Limiting Fructose Is Critical if You Have Gout
Uric acid is a byproduct of fructose metabolism.
In fact, fructose is the ONLY type of sugar that will raise your uric
acid levels and will typically generate uric acid within minutes of
ingestion. The ideal range for uric acid is between 3 to 5.5 mg/dL. The
connection between fructose consumption and increased uric acid is so
reliable that a uric acid level taken from your blood can actually be
used as a marker for fructose toxicity.
I became fully aware of the dramatic and devastating impact fructose
has on your uric acid levels when I interviewed Dr. Richard Johnson on
this topic. You can watch that interview above.
Sensible food choices are important to your overall health and
wellness. Your cells produce energy and replicate based on the nutrition
you feed them. The choices you make can increase or reduce your risk of
experiencing a bout of gout. Fructose is at the very top of the list of
foods to avoid if you have gout.
As a general rule, I recommend limiting your total fructose to 25
grams (g) per day. If you’re insulin resistant or have gout, you would
be wise to limit fructose to 15 g per day or even less, until your
symptoms have resolved.
Dietary Considerations
Other dietary considerations that may be helpful include the following:
Limit Fructose
According to Johnson's research, a quarter of the U.S. population
consumes a whopping 134 g of fructose a day. This is a staggering amount
of fructose when you consider the fact that you need to restrict your
fructose intake to below 25 g a day in order to maintain good health.
If you have gout, this is extremely important, and you must take into account the fructose
you consume from fruit and other foods. For instance, if you eat
cherries for their therapeutic value, 10 sweet cherries or 1 cup of sour
cherries contain about 4 g of fructose.
Cherries
One of the oldest folk remedies for gout
was eating cherries. Research has also demonstrated that eating
approximately 10 cherries can reduce your risk for gout by almost 35
percent.19
However, cherries are also high in fructose, one of the primary means
of increasing your uric acid production and therefore your risk of
gout. The key is to eat them in moderation and include the grams of
fructose from your cherries in your daily allotment of fructose.
Celery Seed Extract
Unique to celery is compound 3-n-butylphthalide, which gives celery
a distinctive flavor. While still in early stages, research has found a
positive association between 3-n-butylphthalide and a reduction in pain
and inflammation.20 The results were statistically significant, with some participants achieving 100 percent pain relief.
Eat Potassium-Rich Foods
Potassium citrate helps alkalize your urine and improves the
excretion of uric acid. Potassium is widely available in fruits and
vegetables. The most beneficial sources include broccoli, celery,
avocado, spinach and romaine lettuce. If you want to supplement,
consider using potassium bicarbonate, which is probably the best
potassium source to use as a supplement.
Avoid Soy
There has been research associating the use of soy milk with a 10 percent increase in serum urate concentrations, increasing your risk of developing gout.21
Limit Alcohol
Regular alcohol use has a demonstrable association with the development of gout.22 Beer appears to have a slightly higher risk than hard liquor, while wine has very little effect on the development of gout.23
Drink Enough Fluid
Liberal intake of water helps to reduce the concentration and promote
the excretion of waste products in your urine. Diluting your urine also
reduces the risk of kidney stones. Drink enough each day to keep your
urine a light straw color, which indicates you’re well hydrated. When
the color is darker you aren’t drinking enough and if your urine doesn’t
have any color you may be drinking too much.
Avoid Foods High in Purines
Organ meats, brewer’s yeast, sardines and tuna packed in oil, chicken
livers and beef fillet all have over 100 mg of purine per 100 g of
product.24 Foods high in purine will breakdown to uric acid.
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