Gout usually affects men over age 30 with a family history of gout, but it
can occur at any time and also affects women, especially after menopause. Recent
food and alcohol excess, surgery, infection, physical or emotional stress, or
the use of certain drugs can lead to the development of gout
|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
- Attack develops over a matter of hours and may get better over a few
days or weeks
- In later attacks, you may see lumps (called tophi) just under the
skin in the outer ear, hands, feet, elbow, or
|What Causes It?|
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.
|What to Expect at Your Provider's Office|
Your health care provider will examine the affected joint, evaluate how
painful it is, and may ask if there is any history of gout in your family. Your
provider may take a sample of fluid from the affected joint, draw blood for a
blood test, or take X rays to rule out other possibilities.
Your health care provider may give you ibuprofen or another nonsteroidal
anti-inflammatory drug (NSAID) to help with the pain and swelling. You must
avoid drinking alcoholic beverages and avoid the foods that trigger your
attacks. Besides NSAIDs, you may be given other drugs.
|Complementary and Alternative Therapies|
A combination of therapies can be very effective at decreasing both the
length and frequency of attacks.
- Maintain a healthy weight. However, it is important to avoid crash
dieting and rapid weight loss.
- Drink plenty of water because dehydration may make gout
- Restrict purines in your diet. Purines increase lactate production,
which competes with uric acid for excretion. 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
- Do not drink alcohol, especially beer.
- Cherries—One half pound of cherries per day
(fresh or frozen) for two 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.
Cherry juice (8 to 16 oz. per day) is also helpful.
- Vitamin C—8 g per day can lead to decreased
blood uric acid levels. Note that there is a small subset of people with gout
who will actually get worse with this level of vitamin C.
- Folic acid—10 to 75 mg per day inhibits
xanthine oxidase, which is required for uric acid production.
- EPA (eicosapentaenoic acid) inhibits pro-inflammatory leukotrienes.
Dose is 1,500 mg per day.
- Niacin—Avoid niacin in doses greater than 50
mg per day. Nicotinic acid may bring on an attack of gout.
- Vitamin A—There is some concern that
elevated retinol levels may play a role in some attacks of gouty
Herbs may be used as dried extracts (capsules, powders, teas), glycerites
(glycerine extracts), or tinctures (alcohol extracts). Unless otherwise
indicated, teas should be made with 1 tsp. herb per cup of hot water. Steep
covered 5 to 10 minutes for leaf or flowers, and 10 to 20 minutes for roots.
Drink 2 to 4 cups per day.
- Devil's claw (Harpagophytum procumbens) reduces pain and
inflammation. Dose is 1 to 2 g three times per day of dried powdered root, 4 to
5 ml three times per day of tincture, or 400 mg three times per day of dry solid
extract during attacks.
- Bromelain (Ananas
comosus)—proteolytic enzyme (anti-inflammatory)
when taken on an empty stomach. Dose is 125 to 250 mg three times per day during
Some of the most common remedies used for gout are listed below. Usually, the
dose is 3 to 5 pellets of a 12X to 30C remedy every one to four hours until your
symptoms get better.
- Aconite for sudden onset of burning pain, anxiety,
restlessness, and attacks that come after a shock or injury
- Belladonna for intense pain that may be throbbing; pain is made
worse by any motion and better by pressure; joint is very hot
- Bryonia for pain made much worse by any kind of motion; pain is
better with pressure and with heat
- Colchicum for pains made worse by motion and changes of
weather, especially if there is any nausea associated with the
- Ledum when joints become mottled, purple and swollen; pain is
much better with cold applications and is worse when
- Hot and cold compresses—three minutes hot
alternated with 30 seconds cold provide pain relief and increase
- Bed rest for 24 hours after acute attack. However, prolonged bed rest
may make the condition
If you have had several attacks and the joint has suffered damage, your
provider may refer you to an orthopedist.
People who have had gout have an increased risk of developing kidney stones,
high blood pressure, kidney disease, diabetes mellitus, high levels of
triglycerides, and atherosclerosis.
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|Review Date: August 1999|
|Reviewed By: Participants in the review process include: Shiva Barton, ND, Wellspace,
Cambridge, MA; Terry Yochum, DC, Rocky Mountain Chiropractic Center, Arvada,
Copyright © 2004 A.D.A.M., Inc
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