While in Montreal for a recent trade show, I came across a man suffering from gout. He’s a middle-aged, well-built man who appears to be someone who spends a lot of time in the gym, not someone living with gout. But he limped when he walked and he was in pain. When I mentioned my work and interest in natural health he practically begged me to give him advice on how to deal with his pain. So I’m writing this article and sending him the link.
WHAT IS GOUT?
Gout is the build-up in joints of a substance called uric acid. Uric acid is formed as a by-product of purine breakdown. Purines are chemical molecules which make up the backbone of our genetic code, i.e., our DNA. As cells divide and old ones are replaced by new ones, the DNA of old cells is broken down to individual units before being used again to form new DNA. The by-product of this process is uric acid. Most people have no problem with uric acid, but some individuals (due to genetic predisposition, diet or lifestyle) have a predisposition to having uric acid deposited in the joints. When this happens, the uric acid takes the form of sharply pointed needle-like structures, visible under a microscope. These needles cause excruciating, persistent pain and inflammation — described as the worst pain of all rheumatic conditions. For some unknown reason, this usually occurs in the big toe, but any joint can be affected. The worst thing about this condition, other than the excruciating pain and incapacity, is that the pain is continuous — even at night —and the flare-ups can last for weeks. If not properly treated or prevented, this condition can eventually cause permanent joint damage as well as serious kidney damage.
WHY DO WE GET IT?
What are the predisposing factors and how should one’s lifestyle be modified to decrease the chances of gout? Firstly, there is genetic predisposition. Some individuals are just more prone to develop gout. But just because you are predisposed, does not mean that you will get gout. This is because diet and lifestyle play a large role as well. The biggest gout triggers are: fatty red meats, organ meats (like liver), shellfish, herring, anchovies, sardines, mackerel, asparagus, mushrooms, all caffeinated beverages, high fructose corn syrup, sugary soft drinks, fruit juices (because of the high fructose content), sweets and alcohol (especially beer). With respect to alcohol and gout, wine is better than liquor and liquor is better than beer. But all three impact gout.
Other predisposing factors are heart disease, kidney disease, diabetes, high cholesterol & high blood pressure, obesity and lack of exercise (especially cardiovascular exercise).
NATURAL TREATMENTS FOR GOUT
With respect to natural supplements and diet to prevent and treat gout, the most important are anti-inflammatory compounds, as the pain in gout is due to inflammation. Here are the best examples:
Fish oils high in EPA at a dose of 2000-3000 mg of EPA per day.
Flaxseed oil, added generously in its raw form to salads or in smoothies. You can also take it with a spoon.
Turmeric, Devil’s Claw and Boswelia: These are powerful natural anti-inflammatory gifts of nature. They decrease inflammation by affecting multiple points in the inflammatory cascade. Interestingly, these are the same agents used to treat arthritis and other types of pain.
Bromelain is a plant enzyme found most commonly in pineapples. When taken with food, it works like a digestive enzyme. When taken on an empty stomach, it is a powerful anti-inflammatory agent.
Alfalfa apparently can dissolve the uric acid crystals responsible for gout. I recommend alfalfa sprouts, as sprouts are usually the richest in enzymes, nutrition and medicine.
Milk Thistle for liver support metabolizes the purines and uric acid efficiently as well protecting the liver from ongoing inflammation.
Antioxidants in the form of bioflavonoids reduce inflammation and oxidative damage. My favorite in this category is Bioflavia, which is organic grape skin powder.
Plant proteins, especially fermented ones like my favourite, Genuine Health, are important because most animal proteins (from meats, fish and shellfish) predispose us to gout. Supplement with plant proteins so you don’t become protein deficient.
Water: Drink at least 3 liters of fluids (mostly water) per day. This is especially important during gout attacks. The water will help flush out the excess uric acid.
B Complex vitamins efficiently metabolize purines, uric acid, proteins and carbohydrates.
Finally, tart cherries, tart cherry juice and other berries, preferably organic and fresh, are said to work miraculously. The reason for this is their very high level of bioflavonoids and anthocyanins. Both are powerful antioxidants with anti-inflammatory properties.
MAINSTREAM MEDICAL APPROACH
Your doctor will most likely first prescribe NSAIDs like Ibuprofen for the pain of gout. This brings only temporary partial relief and will not solve the underlying problem. NSAIDs also cause stomach ulcers, kidney damage (which is already taxed by the uric acid) and potentially intestinal and stomach bleeding. They also predispose to heart attacks and strokes. If NSAIDs are not enough, doctors recommend steroids (prednisone etc.). These are either injected into the excruciatingly painful and inflamed joint, or are taken orally. In either case, they are highly toxic. They cause hypertension, fluid retention in the body (causing swelling), mood swings (which can be quite serious), and obesity. Also, you cannot stop them abruptly when taken over longer periods of time because this can lead to shock. You must slowly taper your dose.
Your doctor may also run some tests to determine if you are over-producing or under-secreting uric acid through your kidneys. For over-production, a drug called Allopurinol is prescribed. It does not work for flare-ups but is rather used to prevent attacks. The problem is that in some cases, it can cause potentially fatal inflammatory skin conditions (Stevens Johnson Syndrome, etc.). It can also cause serious kidney damage as well as inhibition of bone marrow, leading to problems with blood formation. With respect to under-secretion of uric acid, the commonly prescribed drug is Probenecid. It increases uric acid secretion in urine. It is also used for prevention and not for flare-ups. Its potential side effects are headaches, joint pain, swelling, nausea and vomiting.
For flare-ups, in addition to NSAIDs, Colchicine is used. It can cause serious stomach upset, bone marrow depression as well as problems with sensory nerves. Although not all patients experience these side effects, many do. By taking them, you risk being one of them. Natural treatment are not only risk-free but the compounds listed above are powerful gifts of nature that benefit our overall health and well-being.
Take care and good luck preventing and treating your gout in a natural, healthy way.
Dr. Karol M.D