Gout conjures up images of a hefty King Henry VIII with copious jowls, lolling around in an ermine coat, tucking into a pie of roast swan washed down with a few pints of ale. However, gout can strike even the most humble of folk. An arthritic condition affecting mainly men, gout is caused by a higher than normal concentration of uric acid in the blood. Often the first attack hits the big toe, although uric acid crystals may deposit in other joints and tendons. The pain can be so intense that even the weight of a bed sheet can bring on a cold sweat.
Behind the scenes
Uric acid is a derivative of purines in food. Purines, namely adenine and guanine, are found in certain protein foods and are the nitrogen-containing structures called bases found in our DNA.
- Pain in one or more joints, often the big toe, but may also affect the ankle and knee.
- Pain appears very suddenly.
- The affected joint can be warm and red.
- The pain can be throbbing or crushing and is often excruciating.
- Tophi is not the collective noun for coagulated bean curd, but are the harmless lumps below the skin around joints that can occur in long-term sufferers of gout.
What causes it?
- If you suffer from gout, there is a 25 per cent chance someone else in your family has it, too.
- Triggers include excess alcohol (particularly beer and spirits), purine-rich foods (see below) and cold weather.
- Some medications can be triggers for an attack of gout.
- Conditions that increase the risk of gout include obesity, diabetes, heart and kidney disease.
What to do
- Reduce foods high in purines, including offal or organ meats (liver, heart, spleen, intestines) and sweetbreads (thymus, pancreas), red meat, poultry, deli meats, shellfish, crustaceans, yeast, herring, sardines, mackerel, anchovies, asparagus, mushrooms and spinach.
- A juice made of 2/3 carrot, 1/3 celery, a knob of ginger and several sprigs of parsley can help the kidneys to excrete uric acid and reduce inflammation.
- Naturopathically, gout is thought of as an acidic condition. Reduce acid-forming foods (ie sugar, grains and meat) and increase fruits and vegetables
- Reduce alcohol. It increases uric acid levels and inhibits excretion. Moderate amounts of wine are acceptable, however beer and spirits are to be avoided.
- Drink 2 litres of water daily to dilute uric acid as much as possible.
- A popular remedy is the cherry cure. Cherries contain anthocyanidins that help lower uric acid. Eat 250–500 g of cherries (fresh, frozen or canned) each day or drink a cup of pure cherry juice. Strawberries and blueberries also contain anthocyanidins, so if cherries are not available, eat these berries instead.
- Turmeric and ginger are anti-inflammatory. Add them to your food.
- Drinking soft drinks is associated with gout. Switch to water.
- Taking 10 ml of fish oil daily is excellent for any inflammatory arthritic condition, including gout. Once inflammation has eased, reduce to 5 ml daily. (Fish oil is OK, but oily fish are not, and are mentioned in the purine list above. The purines are a protein derivative, so don’t appear in the oil.)
- Folic acid works on gout in the same way as the commonly prescribed medicine allopuprinol (a xanthine oxidase inhibitor). Take 400 mcg of folic acid along with a B complex each day. The evidence for folic acid is controversial, however, the recommended dose is not exceptionally high and is worth a trial.
- The bioflavonoids, especially quercetin, are effective anti-inflammatories. Take in large doses until pain subsides. (Note that in supplements, often the bioflavonoids are combined with vitamin C. In this instance, vitamin C is to be avoided, so find a supplement with the bioflavonoids alone.)
- Herbs that are helpful for gout include nettle leaf, dandelion leaf, boswellia, couch grass, juniper, willow bark, gravel root, parsley, celery seed, birch, turmeric and ginger. Take in tincture, tablet or tea form.
- Vitamin C in large doses should be avoided. The vitamin C competes with uric acid excretion, causing a sudden spike in uric acid and symptoms. Doses under 250 mg should pose no threat, but over 3 g a day is likely to trigger an attack. Food that is rich in vitamin C, such as berries and citrus, do not pose any threat as they do not contain the megadoses of vitamin C that you can only obtain by supplementation.
- Gout is an arthritic condition. The traditional apple cider vinegar and honey in hot water each morning is a nice way to start the day.
- The tissue salts silicea and natrum phosphoricum (nat. phos.) help remove and neutralise uric acid in the tissues.
- Lose weight if necessary. Overweight is associated with diabetes and heart disease, both risk factors for gout.
- Regular exercise has been associated with the reduced risk of gout.
- Rub affected joints with juniper oil.
- Acupuncture is a good adjunctive treatment.
Add 6–8 drops of this detoxifying blend to a warm bath with Epsom salts or blend with Arnica, St John’s wort and sweet almond oil and massage into the affected area.
- 4 drops of coriander seed – analgesic, antioxidant, soothing
- 3 drops of carrot seed – diuretic, depurative
- 4 drops of grapefruit – diuretic, cleansing, stimulating
- 3 drops of juniper – diuretic, purifying
At a glance
- Avoid or reduce foods containing purines, which may trigger an attack.
- Drink plenty of water to dilute the uric acid.
- Drink vegetable juice daily (especially the carrot, celery, parsley and ginger juice recommended above).
- Increase fruits and vegetables; decrease meat, sugar and grains.
- Cherries, blueberries and strawberries contain anthocyanins, which can be very good for gout. Eat them daily.
- Folic acid is a very effective remedy for relieving and preventing gout.
- Take fish oil daily. It contains the anti-inflammatory omega-3 fatty acids.
- Take quercetin, an anti-inflammatory bioflavonoid, as directed above.
- Being overweight may contribute to gout.
- If not too painful, rub the affected joint with juniper oil.