Gout Sufferers - Ease Your Pain

A swollen big toe and a hobbled gait - finally, excruciating pain sends you to fill a prescription for allopurinol, the standard drug for treating gout. Are there natural remedies you can use to ease gout suffering in addition to or instead of the pharmaceutical?

While gout cannot be cured, it can be controlled with medication, herbs, diet and nutritional supplements. Since ancient times people have suffered from the pain and swelling caused by a precipitation of uric acid crystals (monosodium urate) in joints, tendons, kidneys and other tissues. Diet was always blamed - particularly rich foods such as gravies, organ meats and other proteins - but we now know gout can result from a number of genetic disorders that cause overproduction or impaired excretion of uric acid. Gout affects between three and five adults per thousand in the general population, but more than 95 percent of cases occur in men older than 30. This means roughly one in 100 adult men have gout. Some 70 percent of gout patients have an overproduction of uric acid, while about 30 percent have problems eliminating it from their bodies. The result of either situation is excess uric acid that crystallizes in joints and causes painful inflammation and severe arthritic symptoms. It is not clear what makes the uric acid precipitate in the joints, but it is not simply because there is too much present. Some patients can have chronically elevated uric acid levels with no other gout symptoms. Interestingly, the first joint of the big toe is affected in almost half of all first attacks, and there is a 90 percent chance that gout patients will have an attack in their toe at some time.

Why the toe? Uric acid has a lower saturation point at lower temperatures, which may explain why deposits tend to form in the cooler extremities including the toe, or the top of the ear. Uric acid is the normal form in which biochemicals called purines are excreted after they are digested and metabolized. Purines are components of the nucleic acids DNA and RNA. In fact, uric acid is not all bad. It has antioxidant activity nearly equivalent to vitamin C, prompting some researchers to speculate that genes causing high levels of uric acid were not selected against because the uric acid helps protect against oxidative damage to cells. Dietary Management of Uric Acid It is impossible to completely eliminate purine metabolism, nor would anyone want to, because a large percentage of purines are generated as the body recycles its own tissue proteins. But dietary recommendations for gout management limit purine intake, and eliminate nearly all protein, especially meat.

The high-purine foods to limit or avoid are organ meats, which are rich in nucleic acids, as well as anchovies, baker's and brewer's yeast, herring, mackerel, red meat, sardines and shellfish. Poultry and white fish--which also contain purines but have less dense muscle fibers, a different protein composition and more water per unit weight than red meat and dark fish - are better choices but should not be eaten in excess either. Legumes, especially peanuts, should also be limited or avoided because of their purines content. Nutritional yeast, supplements with DNA, RNA or organ tissue extracts such as thyroid or thymus can also pose a risk if taken regularly. Alcohol consumption exacerbates gout by reducing uric acid elimination from the body and slightly increasing uric acid production. Beer and wine are higher in purines than other alcoholic beverages because of their yeast residues. Heavy drinkers are more likely to have gout than those who drink less. Very high intakes of fructose - 25 to 30 percent of calories - can also elevate uric acid, so those with gout should minimize fructose intake, namely high fructose corn syrup, which is present in many processed foods and beverages.

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