By Dr. Mercola
Often in past centuries, gout was laughingly passed off as an affliction of the rich, because it usually affected those who had easy access to fancy foods and plenty of liquor. However today we know better and this report will review these myths and help you understand the real cause of gout.
Anyone who has experienced the excruciating pain of a gout attack knows that it is no laughing matter. Some sufferers have described the intense pain of a gout attack as similar to being burned by a flame. Others say it feels like they were skewered by a hot poker.
A gout attack, or "flare," usually strikes suddenly, and generally at night. Mysteriously, it often targets the large joint of your big toe.1 Your skin becomes red, inflamed, and overly sensitive. Even the light pressure of a bed sheet can become unbearable. A fever may also be present.
What Exactly Is Gout?
Gout is a type of arthritis characterized by painful, stiff and inflamed joints. The stiffness and swelling are a result of excess uric acid forming crystals in your joints, and the pain associated with this disease is caused by your body's inflammatory response to the crystals.2
Gout is essentially a breakdown of the metabolic process that controls the amount of uric acid in your blood. Gout can occur in any joint of your body, but most commonly occurs in your big toe.
With or without treatment, gout symptoms will usually go away within three to 10 days, and the next attack may not occur for months, or even years, if at all. Nonetheless, if more attacks occur, they tend to increase in frequency, become more severe, and last longer.3 Over time, recurrent gout attacks can damage your joints and the surrounding areas.4
This is why it's important to treat your gout as soon as possible, before it begins damaging your body permanently. Natural treatments are kinder and gentler to your body than drugs, as well as being more effective overall. I'll discuss in an upcoming section natural treatments that can pack a real punch in helping your body get rid of gout.
The Real Cause of Gout
You may have wondered why you developed gout, while your spouse, neighbor, or co-worker didn't. The simple answer is typically quite straightforward once you understand how your body works and is generally related to your diet and lifestyle.
Your genetics also play a relatively minor role. If either or both of your parents had gout, you have a higher predisposition to getting it.5 That means your children also are at risk for gout. But simply reducing your intake of sugar-sweetened beverages during childhood could lessen the risk of gout as an adult, and I'll discuss why this may be in an upcoming section.6
At the most basic level, a gout attack usually results from years of having high levels of uric acid in your blood, a condition called hyperuricemia.7 While uric acid normally dissolves in your blood and passes harmlessly through your kidneys, it's possible for your body to either produce too much uric acid or excrete too little in your urine. The resulting buildup of uric acid forms needle-like crystals in your joints and surrounding tissues that causes the intense pain.
Hyperuricemia often has no symptoms, but as these uric acid levels increase in your blood, mainly due to poor dietary choices, your risk of an impending attack increases also. Besides gout, elevated uric acid is related to a variety of other health conditions, including:
- High cholesterol
- High blood pressure
- Kidney disease
- Heart disease
Just How Common Is Gout?
Between two million and five million Americans suffer from gout,8 about 90 percent of them being men in their 40s and older.9 In recent years, the prevalence of gout has been rising rapidly in the United States and in other developed countries. This comes as no surprise, because the principal reason for the increase of gout stems from the processed foods we consume, along with our devotion to other unhealthy lifestyle habits.
In developing nations, much of the food is harvested and eaten directly from the earth. There are no processing plants to remove the nutrients from their food. Their entire lifestyle is exceedingly healthy. Indigenous people live hardy, outdoor lives with plenty of exercise, non-processed, nutrient-rich foods, and little or no access to television, video games, or even liquor.
But in the United States and other Westernized countries, this is no longer true. America has for the most part shifted its dietary preferences to highly processed foods, and many are now suffering from diseases like gout as a result.
High-Fructose Corn Syrup Is a Major Risk Factor
Although gout is commonly blamed on eating too many high-purine foods, such as organ meats, anchovies, herring, asparagus and mushrooms, there is another clear culprit: high-fructose corn syrup (HFCS).10
Countless health problems have been linked to the consumption of HFCS, not the least of which is gout. A recent study showed that consumption of sugar-sweetened soft drinks is strongly associated with an increased risk of developing gout.11
The study, done by U.S. and Canadian researchers, indicated that men who drank two or more sugary soft drinks a day had an 85 percent higher risk of gout than those who drank less than one a month. In fact, the risk significantly increased among men who drank five to six servings of sugary soft drinks a week. Fruit juice and fructose-rich fruits, such as oranges and apples, also increased the risk.12
This makes sense on many levels, but first and foremost because fructose is known to inhibit the excretion of uric acid. Fructose also reduces the affinity of insulin for its receptor, which is the principle characteristic of type 2 diabetes.13 Further, HFCS has been implicated in elevated blood cholesterol levels, and it has been found to inhibit the action of white blood cells in your immune system.14
Many of the health conditions that HFCS causes, including high cholesterol and diabetes, also increase your risk of developing gout. Additionally, fructose converts more readily to fat than other sugars, making it a major risk factor for both diabetes and obesity -- another gout risk factor.
In a fructose metabolism study, it was noted that when two high-fructose breakfast drinks were consumed, the build-up of stored fat continued into the afternoon, during which time the quick conversion of fructose to fat remained active during digestion of the lunch meal.15 The study concluded that the higher the concentration of fructose in the diet, the higher the rate of fat conversion.
Frequently, fruit juices also have fructose added to them, and if you still believe that this is an acceptable form of sugar, think again. Fructose contains no beneficial enzymes, vitamins, minerals, or additional micronutrients. Instead, it actually leeches them from your body.16 Unbound fructose, found in large quantities in HFCS, can also interfere with your heart's use of vital minerals such as magnesium, copper, and chromium.
Hidden Fructose in Your Foods
You may think that avoiding fructose means just staying stay away from desserts and sweet drinks, but unfortunately there is more to it as fructose is hidden in many foods you would not even suspect.
According to biochemist Russ Bianchi, HFCS is "intentionally mislabeled, or (uses) deceptively legally noncompliant names like: 'chicory,' 'inulin,' 'iso glucose,' 'glucose-fructose syrup,' 'dahlia syrup,' 'tapioca syrup,' 'glucose syrup,' 'corn syrup,' 'crystalline fructose,' and flat-out fraud 'fruit fructose,' or… 'agave'…"17 Even processed meats and other foods you would never imagine contain HFCS.
Why? The commercial food industry embraces HFCS because it is easier to blend, and sweeter than table sugar. And it's also cheaper. Additionally, the food manufacturers can sell more products because they know that HFCS, like all sugar, has an addictive effect, and once your taste buds are stimulated, you will want more and more.18 Sugar, and added salt, can stabilize food ingredients, enabling food manufacturers to keep it on the shelves longer.19
The industry has also started to air deceptive ad campaigns claiming that HFCS is all natural to counteract this information.20 Fortunately you don't have to be deceived by them as you now know the truth. So, instead of drinking enormous amounts of sugar-laden sodas, fruit juice, and other sweet beverages that will only worsen or cause gout, your best choice will be to choose pure water, because the fluids will help to remove uric acid from your body.21
You can add small amounts (about a teaspoonful) of fresh-squeezed lemon or lime juice to your water for flavor. But use caution with higher quantities if you have issues with your insulin level, because too much added fruit juice can adversely affect that. Also, be sure to eliminate those cookies, cakes, pies, candy bars, and other sweets that can aggravate your gout just as badly as HFCS.22
Maintaining Ideal Body Weight Large Part of the Solution
Another risk factor for gout is obesity, or any excessive weight gain. Approximately half of all gout sufferers are overweight.23 Excess weight worsens gout because irritated nerve endings are further irritated by having to support and deal with extra weight.24 Of course, obesity can worsen any type of arthritis.
Furthermore, medical data shows a remarkably high prevalence of metabolic syndrome (heart disease and diabetes symptoms such as insulin resistance, abdominal obesity, hypertension, and high triglyceride levels) in gout sufferers.25
A 2002 study of obese women with metabolic syndrome found that weight gain, especially around the abdomen, led to increased levels of proteins from their immune systems called cytokines. Certain cytokines cause an inflammatory response, which can contribute to the formation of fatty deposits in arteries, otherwise known as atherosclerosis.
After a one-year program of diet, exercise, and behavioral counseling, each obese woman in the study lost at least 10 percent of their starting weight (about 22 pounds, on average). They also showed a significant reduction in their levels of cytokines and other potentially damaging proteins.26
Weight loss represents a safe method for reducing inflammatory states and ameliorating blood-vessel dysfunction in obese women. Cytokine levels returned toward normal even though women did not lose all their excess weight. Gout is an inflammatory condition, and it is clear from this study that losing weight, and keeping it off, will greatly improve your chances of avoiding further gout attacks.
You can do this most effectively by first determining your Nutritional Type.™ The next section will give you more details on this revolutionary system to better health and lasting weight loss. And if you didn't have enough reasons to avoid HCFS, remember that it also exacerbates obesity. Excess sugar in any form, particularly HFCS, also harms organs like your liver and pancreas, leading to bone loss, anemia, and heart problems.27
Eating Right for Your Nutritional Type™ Can Dramatically Help
The REAL underlying problem causing the inflammation associated with gout, and the subsequent damage, is likely due to having chronically elevated blood sugar. (The sugar molecule causes far more damage than any other molecule.) And, your number one way of normalizing your blood sugar and insulin levels is through your diet. But what constitutes an optimal diet?
As I said earlier, it definitely includes limiting or eliminating your intake of HFCS, sugar, and grains (which are metabolized as sugar). For most people this means first eliminating soft drinks and fruit juices, along with sugary snacks. But there's more to it than just that. It is important to understand that there is no perfect diet for everyone. We each have our own unique individual and biochemical nutritional needs. The science of Nutritional Typing™28 was developed over three decades and customizes your food choices based on the way your body reacts to food. Nutritional Typing™ will classify you into one of three groups:
- High protein, high fat, low carbs (Protein type)
- Low protein, low fat, high carbs (Carb type)
- Mixture between the above (Mixed type)
When you eat based on your Nutritional Type™, you will resolve most health disorders, including gout, and achieve optimum health. Not only will cravings that have plagued you for years disappear, but your newfound energy will amaze you. You will also discover how much impact foods can have on your state of mind. Eating the wrong foods for your Nutritional Type™ will not only imbalance you on a physical level, but also on an emotional one. This can easily leave you feeling irritable, nervous, angry, hyper, depressed, or hopeless.
You see, foods and individual nutrients do not behave the same way in two people with different Nutritional Types™. This explains why some healthy foods that make other people energetic (and slim) might make you unhealthy, sluggish, bloated, heavier, or more prone to gout.29 And it also explains why, no matter how much you try to stick to foods you've been told are "healthy," or even organic, you may still not feel as good as you'd like to. There is a reason for this. It's the result of a giant factor outside your control -- your metabolism.
However, once you determine your Nutritional Type™ and understand your own unique characteristics, you will start choosing foods that will move you away from weight issues, disease, and accelerated aging, and toward optimal health and your naturally ideal weight! You can now take the Nutritional Typing test for free.
Limiting Alcohol Crucial for Succesful Gout Treatment
Gout is often seen in association with hypertension, excessive alcohol consumption,30 and coronary artery disease,31 so alcohol is a strong risk factor for this disease. In general, I believe alcohol should be reserved for people who have already achieved optimal wellness and therefore have their carbohydrates (sugars and grains) under control, and do not have disease conditions such as gout, diabetes, or other signs of ill health.32
Although wine has been shown to have some health benefits, it may also increase your insulin levels, which is not only a risk factor for diabetes, but increased insulin levels have been linked with a shorter life span, in general.33 So it needs to be used cautiously, especially if you have gout. Most importantly for those suffering with gout, alcohol may raise the levels of uric acid in your blood, and therefore could even initiate a gout attack, so it's wise to limit the alcohol you drink, or eliminate it altogether.
Avoid Drug Solutions for Gout Treatment Unless Absolutely Necessary
Over the years, medical science has used a number of pharmaceuticals in an attempt to treat gout. That list includes, among others, NSAIDs, Colchicine, corticosteroids, Corticotropin (adrenocorticotropic hormone),34 Febuxostat, Aloprim, and Zyloprim.35 But even if drugs like these could cure gout, and there is little, if any, evidence they can, you still would have to deal with some very nasty side effects.36 NSAIDS alone, for example, are known to have the following side effects:37
- Gastrointestinal upsets including nausea, vomiting, diarrhea, constipation, decreased appetite
- Rash, dizziness, headaches, drowsiness
- Fluid retention
- Shortness of breath
- Kidney failure, liver failure, ulcers, prolonged bleeding after an injury.
Additionally, NSAIDs may increase your risk of potentially fatal stomach and intestinal adverse reactions (for example, bleeding, ulcers, and perforation of the stomach or intestines). These events can occur at any time during treatment and without warning symptoms. NSAIDs (except low-dose aspirin) may also increase your risk of potentially fatal heart attacks, stroke, and related conditions.
Drugs such as Allopurinol and Colchicine, which work by either lowering your uric acid levels and decreasing crystal formation, or by simply blocking your body's natural inflammatory response, are also very commonly prescribed for gout. But these drugs also have very dangerous, long-term side effects, and gout is frequently regarded as a lifelong condition, so you may end up staying on these drugs for very long periods of time, which can wreak havoc on your health.
On the other hand, natural remedies will end up helping not only the problem they were meant for, but also other body issues as well, because they work holistically within your entire system. That said, because of the intense pain of a gout attack, you may still need some type of pain medication initially, typically an anti-inflammatory, until you can get the symptoms under control.38 If you're looking for immediate relief in a natural form, try cayenne cream. Also called capsaicin cream, this spice comes from dried hot peppers. It alleviates pain by depleting your body's supply of substance P, a chemical component of nerve cells that transmits pain signals to your brain.
Exercise Can Dramatically Help
While exercise is not recommended while your joints are in pain or when it might cause further injury, once your gout is under control, exercise is needed as a necessary adjunct to a healthier lifestyle. Exercise will even help prevent further attacks by increasing circulation and normalizing your uric acids levels, which it does primarily by normalizing your insulin levels.39 An exercise routine has other advantages as well. Studies have shown that it works as an effective antidepressant,40 strengthens your immune system so it can fight off diseases like cancer,41 and it can even improve insulin resistance and reverse pre-diabetic conditions.42
Fight Inflammation with Cherries and Strawberries
Tart cherries contain two powerful compounds, anthocyanins and bioflavonoids. Both of these compounds slow down the enzymes Cyclo-oxyygenase-1 and -2, which helps to relieve and prevent arthritis and gout in your body.43 Cherries, along with strawberries and other berries, are also a rich source of antioxidants. This means they help prevent or repair damage done to your body's cells by free radicals. The antioxidants replace the free radicals in your body before they can cause any damage. Dr. Wei, a nationally known, board-certified rheumatologist, recalled this story about the powerful effect of cherries on gout:
"Dr. Ludwig W. Blau, relating how eating a bowl of cherries one day led to complete relief from pain, sparked off the interest in cherries in the treatment of gout. Dr. Blau's gout had been so severe that he had been confined to a wheelchair. One day, quite by accident, he polished off a large bowl of cherries, and the following day the pain in his foot was gone. "(Dr. Blau) continued eating a minimum of six cherries every day, and he was free from pain and able to get out of his wheelchair. Dr. Blau's research led to many other people suffering from gout who reported being helped by cherries."
Dr. Wei said that good results have also been reported with strawberries, which may be due to the fact that this food helps your body eliminate uric acid.44 There are a number of ways you can enjoy your berries while they go to work benefiting your gout. If fresh cherries are out of season, or if you just want more variety, try concentrated cherry juice.45
Cherry juice concentrate can contain about 55 to 60 tart cherries in every ounce. That's a single recommended serving, so in other words, you'd have to eat 55 to 60 cherries to get the same health benefit (and I don't recommend eating 55 to 60 cherries, as that is too much sugar... but with a concentrate, you can get the health benefit of the cherries without all the sugar).
While it may not be as easy to find organic, un-pasteurized tart cherry or strawberry juice, you can find it if you search on the Web, and local health food stores should be able to order it for you also. Just make sure any juice you buy is, ideally, organic, un-pasteurized, and has no added HFCS or other sugars.
Another option is to purchase frozen or canned tart cherries or strawberries. Organic is best, but if you can't locate any, you can use regular varieties in a pinch. Normally it's best to avoid non-organic canned or frozen goods, since they often have residual pesticides and additives, along with HFCS and other sweeteners and preservatives.
A Recap: The Top Steps to Prevent and Treat Gout
If left untreated, gout can become increasingly painful and lead to joint damage. So if you experience sudden, intense pain in your joints, especially your big toe, it's important to seek help. Here is a recap of the essential steps to addressing gout:
- Find out your nutritional type. This will tell you what foods your body needs to thrive, including whether you should be eating more fats and protein, or less.
- Avoid drinking soda, fruit juice, and other sweet beverages. Instead, drink plenty of pure water, as the fluids will help to remove uric acid from your body. Cutting back on all forms of sugar and grain in your diet is also important.
- Limit the alcohol you drink (or eliminate it altogether). Alcohol may raise the levels of uric acid in your blood.
- Exercise. Being overweight increases your risk of gout, and regular exercise will help you to maintain a healthy weight and improve your overall health.
- Try tart cherries or concentrated tart cherry juice. Tart cherries contain two powerful compounds, anthocyanins and bioflavonoids. Both of these compounds slow down the enzymes Cyclo-oxyygenase-1 and -2, which helps to relieve and prevent arthritis and gout in your body.
Interestingly, we have had many readers state that alfalfa tablets have provided a fair measure of relief and improvement from gout as well. I have no experience with this, but it would certainly seem another avenue to explore since it is a natural product with virtually no downside or side effects. Nutmeg has also shown promise for relieving gout symptoms, so if you enjoy this spice feel free to add it liberally to your diet. So, please remember that you don't need to take a dangerous drug to deal with this painful condition. You CAN address the underlying cause of gout and excess uric acid formation via all-natural means.