Signs and Symptoms
- Extreme pain in a single joint, usually the base of the big toe, but other joints can also be affected (such as the feet, fingers, wrists, elbows, knees, or ankles)
- Joint is shiny red-purple, swollen, hot, and stiff
- Fever as high as 39°C (102.2° F) with or without chills
- Symptoms can develop very quickly, with the first episode often occurring at night, then go away after 5
- 10 days only to come back later
- In later attacks, you may see lumps (called tophi) just under the skin in the outer ear, hands, feet, elbow, or
knee
The body either produces too much uric acid, doesn't excrete enough uric acid, or both, so that the acid accumulates
in tissues in the form of needle-like crystals that cause pain. Gout generally occurs because of a predisposition
to the condition, but it can result from blood disorders or cancers, such as leukemia, or the use of certain drugs. Risk factors include:
- Family history of gout
- High levels of triglycerides
- Drinking too much alcohol
- Eating foods rich in purines, such as meat, shellfish, and sweetbreads. Uric acid is formed when purines break down.
Complementary and Alternative Therapies
A combination of therapies can be very effective at decreasing both the length and frequency of attacks.
Lifestyle
- Improve body composition.
- Drink plenty of water to help the kidneys flush uric acid from the body. Dehydration often triggers a gout
attack.
- Restrict purines in your diet. Foods with a high purine content include beef, goose, organ meats, sweetbreads, mussels, anchovies, herring, mackerel, and yeast. Foods with a moderate amount of purines include meats, poultry, fish, and shellfish not listed above. Spinach, asparagus, beans, lentils, mushrooms, and dried peas also contain moderate amounts of purines.
- Do not drink alcohol, especially beer.
- Cherries -- One half pound of cherries per day (fresh or frozen) for 2 weeks lowers uric acid and prevents attacks. Cherries and other dark red berries (hawthorn berries and blueberries) contain anthocyanidins
that increase collagen integrity and decrease inflammation. You may prefer to take cherry fruit extract as
a pill (1,000 mg three times per day during an attack; 1,000 mg per day to prevent attacks).Cherry juice (8
- 16 oz. per day) is also helpful.
- Vitamin C, taken in high doses, can help decrease blood uric acid levels. Note that there is a small subset
of people with gout who will actually get worse with high levels of vitamin C.
- Folic acid -- 400-800 mcg per day inhibits xanthine oxidase, which is required for uric acid production.
- Bromelain, an enzyme found in pineapple, is an anti-inflammatory. Take 200 - 300 mg three times per day between meals. As the attack subsides, take two times per day to prevent future attacks.
- Quercetin, a bioflavonoid, is an anti-inflammatory that may also help reduce uric acid levels. It is usually taken with bromelain in the same amount (200 - 300 mg three times per day).
- EPA (eicosapentaenoic acid), found in fish oil, inhibits pro-inflammatory leukotrienes. Dose is 1,500 mg per
day.
- Avoid taking extra niacin and vitamin A. Both may play a role in some attacks of gout.
Suggested Nutritional Supplementation
- ActiFolate® - 1-2 tablets three times daily
ActiFolate is a proprietary blend of L-5 methyl tetrahydrofolate (L-5-MTHF), 5-formyl tetrahydrofolate (5- formyl THF), and folic acid.
- EPA-DHA 720TM - 2 softgels 2-3 times daily with meals
EPA-DHA 720 provides 720 mg of omega-3 essential fatty acids from cold water fish per softgel
- Inflavonoid Intensive Care® - 3-9 tablets daily with meals. Standardized Herbal Relief for Minor Pain
- Ultra Potent-C® Powder - 2 teaspoons in water or juice 3 times daily
Ultra Potent-C Powder is an exclusive, patented formula that is designed to enhance the utilization of
Vitamin C.
If Toxicity is a concern
- UltraClear PLUS 10-day Express Detox Program - see Detoxification section
Dietary Considerations
- FirstLine Therapy® Diet
- Avoid organ meats, meat, shellfish, herring, anchovies, sardines, lentils, dry peas, dry beans, seafood, mushrooms, alcohol (esp. beer which has a higher purine content than wine or spirits), coffee, tea, cocoa, cola, refined carbohydrates, fructose (increases urate production), and saturated fat
