By Dr. Loretta Lanphier, ND, CN, HHP, CH

Imagine waking up in the middle of the night with your big toe throbbing and aching so badly that you can’t even bear to have the bed covers touching it. It is red, swollen, and warm to the touch, and it hurts so badly that standing up to walk is simply out of the question. Chances are you are having an attack of gout. This condition can be very painful, and often strikes with out warning. What can we do to protect ourselves from such a scenario? Let’s see if we can find out.

What is Gout?

Gout is a form of acute arthritis that is the result of increased uric acid levels in body. Uric acid crystals are deposited in the joints, tendons, and other tissues, causing swelling and severe pain. The pain usually lasts for 5-10 days.  The attacks may recur intermittently, and eventually may cause permanent damage to joints and other body parts, especially the kidneys.

The first attack of gout often involves only one joint, and 50% of the time that joint is the first one of the big toe. That same big toe joint is involved at some point in over 90% of all gout attacks, initial and subsequent. Gout may also affect the hand, wrist, elbow, ankle, or heel. Most of these initial bouts with gout occur during the night while sleeping. The uric acid accumulates in the joints in needle-like formations, which may be present for years before causing any problems. It seems that often there may be a triggering event, some kind of trauma that sets off the gout attack. This can be an infection, stress, surgery, chemotherapy drugs, a stubbed toe, overeating (especially of rich foods), or even a heavy drinking binge. The targeted joint may be so inflamed that the skin is shiny and purple. Many patients experience a fever and chills as well.

What Causes Gout?

Uric acid is a natural byproduct produced in the bloodstream during the breakdown of waste products. Most uric acid is formed in conjunction with a substance called purine, which is a component of DNA and RNA. Purine is also found in many foods. Uric acid is normally filtered out by the kidneys and passed through the urine. Gout is caused by either by over production of uric acid by the body, or reduced capability of the kidneys to excrete uric acid into the urine and out of the body, or a combination of both. This accumulation of excess uric acid in the body is called hyperuricemia, and it may take up to 20 years of hyperuricemia in order for symptoms to show themselves. The uric acid has difficulty remaining dissolved in the bloodstream, and eventually will begin to deposit itself in certain parts of the body. This most often happens in the joints, tendons, ear tips, and kidneys. The initial attack of gout is actually the body’s immune system reacting to the urate crystals as invaders, and sending out white blood cells to combat them. This causes the inflammation and pain.

It is estimated that as many as one million Americans suffer from gout. Approximately 80-90% of all gout patients are males. Uric acid production increases in males at puberty. Most men experience their first attack in their late 30’s or early 40’s. When women do develop gout, it is usually later in life, often after the age of 60. Researchers believe this is due to the fact that estrogen functions to protect women from hyperuricemia. As estrogen levels fall during menopause, the risk of gout increases.

Hyperuricemia does not always result in gout. Lifestyle has a lot to do with it. Gout is often nicknamed “The Rich Man’s Disease” because obesity and over consumption of rich foods and alcohol can increase the risk of the onset of gout. Studies have associated elevated levels of cholesterol and triglycerides with increased risk as well. Other factors include inherited traits that encourage urate crystal accumulation, use of certain drugs such as diuretics (often prescribed to lower blood pressure), and some illnesses such as leukemia or lymphoma. But the vast majority of gout cases can be prevented with changes in diet and lifestyle.

What is the Allopathic Approach to Treatment?

Drugs is the byword, to no surprise. As with most prescription drugs, there are some serious side effects that we must be aware of. Colchicine has a particularly impressive list of things to watch out for. Elderly folks and/or those with other health conditions such as heart disease, kidney disease, cancer, and diabetes should be especially careful when using any of these medications.  Some examples of possible side effects are jaundice, fever, vomiting, and joint pain. (Wait a minute, aren’t these drugs supposed to help with joint pain, not cause it??)

There are three main types of drugs prescribed to treat gout.

  • Those that reduce inflammation (Colchicine)
  • Those that reduce uric acid production (Allopurinol,Lopurin,Zyloprim)
  • Those thatincrease excretion of uric acid (Probenecid, Benemid, Probalan, Anturane)

As we will see below, all of these can be accomplished by diet and herbal/natural remedies. In fact, most cases of gout can be prevented by these natural approaches. The most important thing to remember when managing any disease is that alternative therapies focus on staying healthy, while allopathic therapies focus on treating an illness after it has developed. Isn’t it better to prevent an illness by staying well through healthy living?

What Alternative Measures Can be Taken to Avoid Gout?

Diet is by far the most important factor to both prevent the onset of gout and to minimize the chances of a recurring attack.

  • Some foods are high in purine and should be completely avoided. These include:

Ø       Organ meats, such as kidney,  brains, and liver

Ø       Red meat

Ø       Saturated fats: these lessen the body’s ability to excrete uric acid

Ø       Shellfish

Ø       Herring

Ø       Sardines

Ø       Anchovies

Ø       Mackerel

Ø       Yeast (brewer’s and baker’s)

Ø       Dried beans and peas

Ø       Gravies

  • Foods that are high in protein should be consumed in moderation:

Ø       Fish

Ø       Poultry

Ø       Mushrooms

Ø       Spinach

Ø       Asparagus

  • Alcohol should be completely eliminated or used in great moderation. Beer is especially troublesome due to high amounts of yeast. But all types of alcohol stimulate uric acid production by speeding up the breakdown of purine in the body. Alcohol also increases lactate levels. This decreases the efficiency of the kidneys and leads to less excretion of uric acid into the urine.
  • Gout patients (and all of us) would do well to follow diets recommended for healthy hearts.  Elevated cholesterol and triglyceride levels increase the risk of gout. Staying with a low-fat, high-fiber diet is an excellent choice. Animal fats are especially to be avoided. Other general recommendations include eating whole foods, lots of fresh fruits and vegetables (organic and locally-grown if possible), and avoiding processed and junk foods. Load up on complex carbohydrates. Simple sugars like refined sugar, corn syrup, and fructose encourage the body to increase uric acid production.
  • Drink at least 48 ounces of pure clean water every day. This helps to keep the urine diluted and increase uric acid excretion, and also lessens the chances of kidney stones.
  • One family of foods that is very beneficial is composed of dark red-blue berries such as cherries, blueberries, hawthorn berries, blackberries, and elderberries. These are high in flavonoids which lower uric acid levels, help to fight inflammation, and both prevent and restore joint tissue damage. Fresh organic berries are best.  Eat about half a pound (1 cup) per day.

What About Herbal Remedies?

There are many recommended herbal treatments to experiment with:

  • Celery extract has been very helpful to many gout patients. Buy a quality supplement with at least 85% 3nB (3-n-butylpthalide). 3nB is what makes celery taste and smell like celery, and it also provides its healing properties.
  • Devil’s claw is useful. It both lowers uric acid levels and can help reduce joint pain.
  • Nettles can be brewed as a tea and consumed liberally to help improve kidney function. Be careful though, as some folks are allergic to nettles.
  • Aloe vera performs many helpful tasks. It aids digestion, alkalizes excess stomach acid, and supports circulatory and kidney function. It is also composed of at least three amino acids that act as inflammatory agents.
  • Angelica provides nutritional support to the digestive system.
  • Bdellium gum reduces tissue inflammation, lowers cholesterol, aids in weight loss, and promotes thyroid health.
  • Bissy nut (cola acuminate) is specifically recommended for reducing pain and inflammation in gout patients.
  • Blue vervain nourishes the digestive system.
  • Burdock purifies the blood and helps eliminate deposits around the joints.
  • Catnip nourishes the stomach and aids digestion.
  • Chamomile acts to soothe the stomach.
  • Cayenne pepper nourishes the digestive tract and acts as a catalyst to improve the efficiency of other herbs.
  • Cranberry is a great fighter against kidney stones.
  • Elderberry flowers purify the blood and boost circulation.
  • Flax seed oil is a terrific source of fatty acids
  • Garlic nourishes the stomach and helps stabilize blood pressure.
  • Gentian root nourishes the kidneys.
  • Ginger nourishes the gastrointestinal system. It also acts as a catalyst to increase the effectiveness of other herbs.
  • Hops are known to promote healthy urine functions.
  • Hydrangea is an anti-inflammatory and cleanses the joints. It also soothes the urinary tract including the kidneys.
  • Irish moss boosts kidney and thyroid functions.
  • Juniper berries strengthen the urinary system and aid in the elimination of water and toxins.
  • Marshmallow nourishes the gastrointestinal system.
  • Noni aids the digestive system.
  • Pan pien lien helps remove obstructions in the body, as well as relieve joint pain.
  • Papaya contains an enzyme called papain which is especially helpful to gout patients, as it aids with protein breakdown.
  • Pippali fruit is a pepper that helps with digestive disorders and obesity.
  • Queen of the meadow supports ligament and tendon health, and restores damaged tissues. It also clears deposits from joints. Sounds like a great combination to fight gout.
  • Slippery elm helps to soothe irritated tissues.
  • Uva ursi nourishes the urinary system.
  • White willow is good for the stomach and kidneys.
  • Pineapple contains an enzyme called bromelain which is an excellent anti-inflammatory.

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