Scientists estimate that 6 million adults age 20 and older report having had gout at some time in their lives.
. . [It] may be difficult for doctors to diagnose because the symptoms can be vague, and gout often mimics other conditions. . . . [H]yperuricemia may not be present during an acute attack. In addition, having hyperuricemia alone does not mean that a person will get gout.
~ National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)(http://www.niams.nih.gov)
If you suffer occasional or reoccurring sudden, excruciating pain in one of your big toes, ankles, heels, knees, insteps, wrists, fingers, or elbows, you may have gout. Although gout is a common arthritic condition for which there is no known cure, certain natural remedies can provide relief.
The Symptoms & Causes of Gout
Gout often causes debilitating joint pain and swelling. The affected area may be hot to the touch and the surrounding skin can appear red or purple. Gout symptoms generally subside in 3-10 days, and the next attack may not occur for months or years, if at all. Untreated gout can become a lifelong health issue and flares can occur with increasing frequency and severity. Long-term gout can: (1) cause damaging nodules to develop near the affected joints, (2) damage the kidneys, and (3) cause kidney stones. Moreover, gout is often associated with metabolic syndrome and an increased risk for cardiovascular disease and mortality.
Elevated blood levels of uric acid (hyperuricemia) (upper limits: men = 8.6 mg/dL; women = 7.1 mg/dL), resulting from the metabolism of the subclass of proteins called purines, is the primary cause of gout. The rate of uric acid: (1) excretion from the kidneys (inadequate excretion accounts for 90% of hyperuricemia cases), and (2) synthesis in the liver to support important metabolic functions, determine uric acid blood levels.
Uric acid isn’t all bad. It is one of the most important antioxidants in body fluids, and low blood levels have been associated with the progression or increased risk of various neurological disorders. The risk of gout increases with age and is more common in men. Diet/lifestyle, environmental factors, and genetics also determine whether an individual will suffer gout. Joint trauma, dehydration, certain serious infections, surgery, acidosis, lower body temperature, and rapid weight loss or certain diets, can trigger gout attacks. In those who are genetically susceptible, excess alcohol consumption, obesity, and lead exposure can cause gout.
Certain prescription drugs can increase blood levels of uric acid, including aspirin, diuretics, cyclosporine, and Levodopa. Since it competes with the excretion of uric acid, vitamin B3 (niacin) in high doses (beyond what is found in food or a multivitamin), can also contribute to higher uric acid blood levels and its crystallization in the joints.
The Disadvantages of Conventional Drug Approaches
All conventional drug approaches to reduce the pain and inflammation of gout [i.e., NSAIDS and corticosteroids (prednisone/cortisone)] introduce risks of significant side effects. Physicians also recommend xanthine oxidase inhibitors that can lower levels of uric acid. Allopurinol, among the most prescribed of this drug class, can cause muscle pain, drowsiness, headaches, and digestive ailments.
Natural, Safe Gout Support
Various natural remedies and the beneficial dietary changes outlined below have proven to combat gout symptoms safely.
Apple Cider Vinegar (Organic – Raw- Unfiltered ) (ACV)
Apple cider vinegar is a long-used folk remedy for short- and long-term gout relief. Therapeutic ACV should be organic, unfiltered, and raw/unprocessed, and should contain the “mother,” the murky brown substance that usually floats at the bottom of the bottle (e.g., Bragg’s or Eden ACV). To obtain relief within two days, slowly drink an ACV cocktail 3 times per day with meals that consists of: (1) 8 oz of water (some recommend distilled), (2) 2 tsp raw honey or stevia (optional); and (3) 2 tsp organic apple cider vinegar.
Unless diluted and/or rinsed after consumption, ACV’s acidity can damage tooth enamel or mouth/throat tissues. Also, ACV could interact with diuretics, laxatives, and diabetes and cardiovascular medications, and its long-term excessive use could lower bone density and cause a potassium deficiency.
Vitamin C
Following a 20-year study of over 46,000 men, researchers concluded that “higher vitamin C intake is independently associated with a lower risk of gout” and that “supplemental vitamin C intake may be beneficial in the prevention of gout. Patients should take higher amounts in divided doses.
Cherry Extract (Tart/Black/Sweet)
Evidence of the benefits of cherries is growing and thought to have long-term effects. The mechanism by which cherries and cherry extract impact gout is unclear, but their benefits are thought to derive in part from the presence of high levels of anthocyanins, flavonoids that are antioxidants and anti-inflammatory. In fact, one rat study found that tart cherry juice actually functioned as a natural xanthine oxidase inhibitor.
While it is true that cherry consumption is associated with a lower risk of gout attacks, large quantities as whole fruit or juice are high in inflammatory fructose. A sugar-free cherry extract as a dietary supplement is thus ideal. The cell-protective freeze-drying of cherries in supplements best preserves their antioxidants, enzyme activity, and general nutritional value.
Celery Seed Extract
The most powerful healing component of celery, 3-nbutylphthalide (3nB), appears to lower uric acid production by inhibiting xanthine oxidase and reducing inflammation.
In one study, gouty rats treated with celery seed extract experienced a 56% reduction of uric acid levels. In an earlier study, 70 rheumatic patients, including those with gout, received 75 mg of phthalides from celery seed twice/day for 3 weeks. Significant reductions were noted in pain scores, mobility, and quality of life.
Curcumin from Turmeric
While studies have not specifically explored the role of curcumin in the treatment of gout, researchers have examined its impact on its cousins, osteo- and rheumatoid arthritis (OA and RA). In multiple OA and RA studies, curcumin has proven to
- significantly reduce CRP levels and disease, pain, and swelling/tenderness scores
- decrease patient use of NSAIDs/ painkillers
- increase treadmill walking distance
Diet to Reduce Gout Risk
Most practitioners would agree that maintaining a low-purine, anti-inflammatory diet can reduce the risk of gout flare-ups. A healthy gout diet requires these dietary modifications: (
- Eliminate/ Greatly Reduce Foods High In Purines/Saturated Fat: beef, pork, lamb, organ and game meats, and seafood
- Eliminate/Greatly Reduce Pro-Inflammatory Sugar, Gluten & Dairy
- Eliminate Alcohol Intake
- Consume:
- vegetable proteins
- complex carbohydrates
- eight 8oz glasses/day of high pH water
- nuts/nut butters
- eggs and egg whites
- coffee/tea
- modest amounts of lower-purine foods (max 1 serving/day with 8 oz water) (e.g., cruciferous vegetables, beans/peas/lentils, mushrooms, oats/oatmeal).
For any gout patient who wishes to avoid prescription or OTC drugs, it makes sense to address the condition’s symptoms by following a gout-friendly diet and/or trying proven study- or testimonial-based natural remedies. Experimenting with various combinations may produce the best results.
The statements in this article have not been evaluated by the Food and Drug Administration (FDA) and are not intended to take the place of a physician’s advice. Unless otherwise supported by specific research and stated herein, the natural remedies discussed herein are not intended to diagnose, treat, cure or prevent any disease.
Submitted by Michael Dworkin, PD, CCN, a Registered Pharmacist and State Certified Clinical Nutritionist (CT Cert. No. 232), with J. Erika Dworkin, Certified Lifestyle Educator and Board Cert. Holistic Nutrition (Cand.). Owner of the Manchester Parkade Health Shoppe (860.646.8178, 378 Middle Turnpike West, Manchester, CT, www.cthealthshop.com), Pharmacist Dworkin has been guiding patients since 1956 and is available for consultation by appointment. Erika is available to speak to groups. All statements in this article are research-based and references are available upon request.