Gout Taking control of your - A practical guide to treatments, services and lifestyle choices
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Taking control of your
Gout
A practical guide to treatments,
services and lifestyle choices
How can this booklet help you
This booklet is designed for people
who have gout.
It will help you understand your • m
ake healthy choices for your
condition so that you can better general health and wellbeing
manage your symptoms and continue
• fi
nd support and additional
to lead an active and healthy life.
information to cope with the
This booklet offers information and impact of gout.
practical advice to help you:
The information inside is based
• u
nderstand what gout is and on the latest research and
what it means for you recommendations, and has been
reviewed by Australian experts in the
• u
nderstand how medicines can
field of arthritis to make sure it is
help treat gout attacks and
current and relevant to your needs.
prevent future attacks
So go ahead — take control of
• w
ork with your healthcare team
your gout!
to manage the disease in the
short and long term
© Copyright Arthritis Australia 2014
Supported by:
AstraZeneca Pty Limited ABN 54 009 682 311
Alma Road, North Ryde NSW 2113
2 Taking control of your Gout
Contents
Understanding gout 4
Treating gout 10
Diet and lifestyle 16
Who can help? 21
Working with your GP 22
Seeing a rheumatologist 23
Other health professionals 24
Seeking support 26
Glossary of terms 28
Useful resources 29
Medical and consumer consultants
Tanya deKroo, Information Resources Coordinator, Arthritis Australia
Wendy Favorito, Arthritis Australia Consumer Representative and Board Member
Assoc Prof Neil McGill, Rheumatologist
Assoc Prof Julian McNeil, Rheumatologist and Chair of Australian Rheumatology
Association’s Therapeutics Committee
Assoc Prof Peter Youssef, Rheumatologist and Chair of Arthritis Australia’s Scientific
Advisory Committee
Arthritis Australia 3
Understanding gout
What is gout? the main reason for more than
Gout is an extremely painful form nine out of ten people with gout).
of arthritis. Often referred to as the If uric acid levels remain high, small,
‘disease of kings’, it was thought that needle-like crystals of monosodium
gout resulted from overeating and urate monohydrate (urate) start
drinking too much alcohol. In fact, forming in and around the joints
gout can affect anyone regardless (Refer figure 1 on page 5). These
of diet and alcohol intake. crystals form slowly, over months or
Gout occurs as a result of high levels even years. A gout attack occurs when
of uric acid in the body. there is inflammation in the joints
where these crystals have formed.
What is uric acid? As the gout attack settles, the pain
and inflammation will disappear but
Uric acid is present in small the crystals still remain in the joint(s).
amounts in our blood. It is
made as our bodies break
down natural substances called What are the symptoms
purines. Purines are found in of gout?
our bodies’ cells, as well as Generally, the first symptom of gout is
some of the foods we eat. severe pain from a gout attack.
Uric acid levels can be high for months
or even years before a gout attack
Our kidneys usually remove any occurs. An attack of gout usually comes
excess uric acid from our bloodstream on very quickly, over just a few hours,
into our urine. However, people
and often overnight. The affected
with gout have higher-than-normal
joint(s) becomes inflamed, causing
amounts of uric acid in their bodies.
intense pain, redness, heat and swelling.
This can be a result of:
Often the joint is extremely sore to
• producing too much uric acid touch – even just the light pressure of
and/or the bed sheets can be excruciating.
• t he kidneys being unable to Without treatment, a gout attack
remove it quickly enough (this is usually lasts about one week.
4 Taking control of your Gout
While the affected joint(s) is What causes gout?
inflamed, it can be extremely painful Gout occurs in people with
to walk or use the joint normally. higher-than-normal levels of uric acid
Gout commonly affects the big in their body. Some people with gout
toe, although other joints can be may produce too much uric acid.
More commonly, it results from the
affected, including the ankles, knees,
kidneys being unable to get rid of
hands, wrists and elbows.
enough of the excess uric acid. Some
Urate crystals can also collect under of the known risk factors for having
the skin forming small, solid, white high uric acid levels include:
painless lumps called tophi (Refer • G
enetic factors: Having
figures 2 and 3 on page 6 and 7). higher-than-normal uric acid
The most common places tophi form levels can run in families and
are on the toes, ears, fingers, hands, is one of the most common
forearms, knees and elbows. causes of gout
FIGURE 1
Bone Cross-section
Capsule of joint with
(ligament) urate crystals
Synovium
Cartilage
Urate
crystals Cross-section of
a joint showing
urate crystals
deposited in
the cartilage
Graphics used with kind permission of Arthritis Research UK.
Arthritis Australia 5
Understanding gout
• Being overweight or obese • O
vereating, particularly certain
foods that are linked with gout
• H
aving high cholesterol, high
attacks, although this is still not
blood pressure or glucose
well understood from research.
intolerance
See page 16 for information
• Having kidney disease about gout and diet
• T aking certain diuretics (‘water • D
rinking too much alcohol may
tablets’): These medicines drain raise uric acid levels in the blood
water from the body and can by increasing the production
affect the kidney’s ability to get of uric acid and reducing how
rid of uric acid. much is passed out in urine. Gout
attacks seem to be more common
Some people can have high uric acid in beer and spirits drinkers than in
levels but do not experience gout people who drink wine. However
attacks. However, if you’re prone to there is no scientific proof that
gout, several factors have been linked only certain types of alcoholic
to gout attacks including: drinks cause gout
FIGURE 2
Gout affecting
the big toe
Gout most
commonly affects
the big toe. The
joint becomes red,
hot, swollen and
extremely painful.
Photography
Photographyused
usedwith
withkind
kind permission
permission ofofElsevier.
Elsevier.©©Elsevier
Elsevier 2011.
2011. Taken
Taken fromfrom Rheumatology,
Rheumatology, fifth edition.
fifth edition.
Edited
Edited byby MarcCCHochberg,
Marc Hochberg, Alan
Alan JJ Silman,
Silman,Josef
JosefS SSmolen,
Smolen,Michael E Weinblatt
Michael and and
E Weinblatt Michael H Weisman.
Michael H Weisman.
Graphics used with kind permission of Arthritis Research UK.
6 Taking control of your Gout
Understanding gout
• C
onsuming large amounts of Who is affected by gout?
fructose, a type of sugar, can Anyone can get gout. However, gout
increase uric acid levels in the in pre-menopausal women is rare
blood. It is found in high levels in and your doctor may wish to further
soft drinks sweetened with corn investigate your symptoms.
Gout most
syrup (not used in soft drinks commonly affects
the big toe. The
manufactured in Australia) and Can gout cause
jointlong-term
becomes red,
fruit juices problems? hot, swollen and
extremely painful.
• D
ehydration (not drinking Once the inflammation of a gout
enough water) attack settles down, your joints may
Photography used with kind permission of Elsevier. © Elsevier 2011. Taken from Rheumatology, fifth edition.
feel normal
Edited by Marc C Hochberg, Alan J Silman, Josef S Smolen, Michael E Weinblatt and Michaelagain.
H Weisman.However, the urate
• Being ill with a fever
crystals remain in the joints.
• ‘Crash diets’ or fasting
• Having an operation
• Injury or trauma to the joint.
FIGURE 3
Tophi caused by
urate collecting
under the skin
Urate may collect
under the skin,
forming small white
pimples (tophi),
but these aren’t
usually painful
Photography
Photography used with kind
used with kindpermission
permissionofof Elsevier.
Elsevier. © Elsevier
© Elsevier 2011.
2011. Taken
Taken from from Rheumatology,
Practical fifth
Rheumatology, edition.
third edition.
Edited
Editedby
byMarc
Marc C
C Hochberg, AlanJ JSilman,
Hochberg, Alan Silman, Josef
Josef S Smolen,
S Smolen, Michael
Michael E Weinblatt
E Weinblatt and Michael
and Michael H Weisman.
H Weisman.
Graphics used with kind permission of Arthritis Research UK.
Arthritis Australia 7
Understanding gout
Another attack may not happen for are crucial in preventing long-term
months or even years. If gout is not complications from gout.
managed well and uric acid levels
remain higher-than-normal, the time How will my doctor
between attacks may get shorter, the diagnose gout?
attacks may become more severe and
Many people with gout do not
more joints may be affected.
receive the right treatment because
The first few attacks of gout may not they have not been diagnosed
cause any permanent damage to the properly in the first place.
joint(s). However, if uric acid levels
The only way to diagnose gout with
remain high over time, gout can
certainty is by your doctor looking at
progress into a chronic (long-term)
samples of your joint fluid under a
condition causing:
microscope. A needle is used to draw
• F ormation of tophi (solid lumps a small amount of fluid from one of
of urate crystals), especially on your affected joints. This fluid is then
the toes, ears, fingers, hands, examined under a microscope to see
forearms, knees, and elbows whether urate crystals are present. If
(Refer figures 2 and 3 on pages the crystals are present, your doctor
6 and 7) can confirm that you have gout. If
there are no crystals in your joint
• P ermanent damage to the
fluid, your doctor will consider other
cartilage and bone due to the
causes for your symptoms, such as an
formation of tophi inside the joint.
infection in the joint.
This can lead to constant mild
pain and inflammation, similar to A blood test can measure the
osteoarthritis amount of uric acid in your blood.
If uric acid levels are higher than
• Kidney stones. normal, this can help support a
The good news is that, although diagnosis of gout. However blood
gout is very painful, it is extremely tests can sometimes show normal
treatable for most people. Early uric acid levels during an attack.
diagnosis and the right treatment Blood tests are most useful for
8 Taking control of your Gout
Understanding gout
working out if your symptoms
are due to other conditions, or to Top tip: Be certain it’s gout
monitor your uric acid levels once
you have started treatment for gout.
X-rays are often normal in the early
stages of gout so are not very useful
in diagnosing gout. They may show
signs of joint damage if you have
had poorly managed gout over an
extended period.
Arthritis Australia 9
Treating gout
There are two main parts to treating (needle) into a joint or muscle.
gout: Corticosteroids are usually given
only for a few days as a treatment
1. Treatment of the gout attack
for gout and so do not normally
2. Treatment to lower uric acid levels cause any of the serious side
and prevent future gout attacks. effects that can occur with
long-term use of these medicines.
Treating a gout attack • Colchicine: This medicine helps
There are several medicines that to reduce pain and swelling
can help reduce the pain and during gout attacks, particularly
inflammation of a gout attack: if NSAIDs cannot be used for
safety reasons. Side effects, such
• N
on-Steroidal
as nausea, vomiting or diarrhoea,
Anti-Inflammatory Drugs
are common so your doctor will
(NSAIDs): These medicines reduce usually recommend low dosages
pain and inflammation in the joints. of this medicine. This typically
Some NSAIDs can be bought involves 1mg (milligram) initially,
over-the-counter while others are 0.5mg one hour later and then
only available with a prescription. no further colchicine for 24 hours.
Like all medicines, NSAIDs can Seek advice from your doctor if
cause side effects so it is important you experience any side effects,
to get advice from your doctor as he/she may alter the dose or
before taking them. Your doctor will prescribe a different medicine.
recommend the lowest dose for the
Taking your prescribed medicine at
shortest period of time to reduce
the first sign of a gout attack can
your risk of developing side effects.
help reduce the length and severity
• C
orticosteroid injections or of the attack so work with your
tablets: This type of medicine doctor to find the right treatment
is also very effective in reducing plan for you. Have your prescribed
gout pain and inflammation. medicines readily available so you can
Corticosteroids can be given start treatment as early in the attack
as a tablet or as an injection as possible.
10 Taking control of your GoutApplying ice/cold packs to the Treatments to lower uric acid
painful joint for ten to fifteen levels and prevent attacks
minutes at a time, may help reduce There are several medicines that
pain. You may also need to protect lower uric acid levels in the blood
the affected joint. For example, if to prevent future gout attacks. Your
your big toe is affected you may doctor may suggest taking these
medicines if you are having frequent
need to limit the amount of walking
gout attacks, your blood tests show
and standing you do, and create a high levels of uric acid, or you
bed cradle to keep the bed sheets develop tophi, kidney stones or signs
off your foot when sleeping. of permanent joint damage.
Arthritis Australia 11Treating gout
These medicines need to be taken acid levels to work out the right
every day, even if you are not having dose for you. It may take several
a gout attack. They can be very months of gradually increasing the
effective in lowering blood uric acid dose to find the right amount as
levels and controlling gout, if: taking sudden, high doses of these
medicines can actually cause a gout
• Y
ou continue taking the medicine.
attack. Bringing uric acid levels down
Keep in mind your doctor
slowly, by starting with a low dose
may recommend you take the of these medicines and gradually
medicine forever increasing the dose, is much less
• Y
ou take the medicine and do not likely to trigger an attack and can
miss doses reduce the risk of side effects. Your
doctor may also suggest taking other
• You take the full/correct dose. medicines, such as a very low dose of
The medicines that reduce uric acid colchicine, to protect against a gout
levels work in slightly different ways attack during the first few months of
and can produce varying side effects. starting these medicines.
Examples of medicines that can lower
uric acid levels in the blood include: Top tip: Ask your doctor
• A
llopurinol, which decreases the about medicines to
body’s production of uric acid lower your uric acid
• P robenicid, which increases the levels for long-term gout
kidney’s ability to remove uric management
acid into the urine
• O
ther medicines may also be
The medicines used to treat a gout
available through specialist
attack only treat the pain and
doctors if your uric acid levels
inflammation. They do not affect
are not controlled with these
uric acid levels so you must continue
medicines.
taking your regular dose of uric acid
When first taking these medicines, lowering medicine (for example
your doctor will monitor your uric allopurinol) during a gout attack.
12 Taking control of your GoutTreating gout
Know your target uric acid level
The goal of treatments for gout is to lower uric acid levels to a
level that prevents gout attacks and other long-term problems.
Your uric acid levels can be checked with a blood test. For most
people with gout, the target uric acid level (serum urate) level you
are aiming to achieve is
Less than 0.36 millimoles per litre (Treating gout
Call the Arthritis Helpline professional advice without knowing
1800 011 041 for copies or visit all the treatments you are using. This
www.rheumatology.org.au or includes vitamin supplements, herbal
www.arthritisaustralia.com.au medicines and other therapies.
See Arthritis Australia’s
Can natural or alternative Complementary therapies
therapies help? information sheet for more about the
There are many promises made for safe use of these types of treatments
non-medical ‘cures’ or treatments at www.arthritisaustralia.com.au
to ease gout – but there’s very little
proof that any of these work and
further research is needed. For
example, there is very little evidence
that supplements such as celery seed
or garlic are helpful in reducing the
symptoms of gout.
Because herbal, homeopathic,
ayurvedic or Chinese medicines may
affect the treatments prescribed by
your doctor, please tell your GP and
specialist what other treatments you
are thinking about using.
You may feel concerned that your
doctor or other members of your
healthcare team will disapprove of
complementary therapies. However
it is very important to keep your
healthcare team informed, even if
they do not approve. Your healthcare
team, particularly your doctor and
pharmacist, can’t give you the best
14 Taking control of your GoutTreating gout Arthritis Australia 15
Diet and lifestyle
There are many beliefs and claims
about the role of diet and other
lifestyle factors in preventing and
managing gout. Research has shown
certain factors are associated with
having gout. For example, people
with gout may tend to eat similar
types of foods or drinks. However
it has not been proven that any of
these factors actually cause someone
to develop gout. Although there
is little scientific proof about the
usefulness of many of these lifestyle
changes to prevent gout, there can
be definite benefits for your general
health and wellbeing.
Purine-rich diet
Several studies have shown that people
who have gout are more likely to eat
high amounts of purine-rich foods.
These foods are often reported to
trigger gout attacks as purines are
made into uric acid by the body. Some
of the purine-rich foods commonly
linked to gout attacks include:
• m
eat – particularly red meat and
offal, such as liver, kidneys and
heart
• s eafood – particularly shellfish,
scallops, mussels, herring,
mackerel, sardines and anchovies
16 Taking control of your Gout• f oods containing yeast – such as are linked to gout. For example, a
Vegemite and beer. number of vegetables (asparagus,
mushrooms, cauliflower and spinach)
However there is very little good
are rich in purines but do not appear
quality, scientific evidence to show
to trigger gout attacks. Dairy foods
that eating foods rich in purines
(which can contain purines) actually
actually causes gout. Additionally,
appear to lower our risk of gout.
there is little proof that avoiding the
purine-rich foods in the list above can Completely cutting purine-rich foods
reduce gout attacks. In fact, research from your diet may cause you to miss
shows that not all purine-rich foods out on important nutrients and vitamins.
Arthritis Australia 17Diet and lifestyle
For most people with gout, a healthy syrup may be beneficial for your
balanced diet is all that is needed to overall health. However naturally
manage gout, alongside medicines to occurring fructose in fruit and
reduce uric acid levels. vegetables also provides general
health benefits and should not be
If you notice certain foods trigger
completely avoided without advice
your gout attacks, you may benefit
from your doctor or dietitian.
from cutting down the amounts of
those foods in your diet. Most
people taking medicines to reduce
uric acid levels find they can still eat
purine-rich foods without attacks
of gout by being careful with the
quantity they eat.
Fructose
Fructose is a sugar that is found in
fruits and vegetables. High fructose
corn syrup - a mixture of glucose
and fructose - is often used as a
sweetener in food products such as
bread, cereal and soft drinks (not
Australian-made soft drinks). An
American study found that men who
drank five to six servings of
fructose-sweetened soft drinks
per week were more likely to have
gout. However there is no research
showing that fructose actually causes
gout or that other fructose-rich foods
can be linked to gout. Cutting down
on the amount of food artificially
sweetened with high fructose corn
18 Taking control of your GoutDiet and lifestyle
Weight loss www.eatforhealth.gov.au. For
help with weight loss, you can ask
your GP to refer you to a dietitian
or find one directly via the Dietitians
Association of Australia - call
1800 812 942 or visit www.daa.asn.au
Alcohol
Drinking large amounts of alcohol
may increase your risk of a gout
attack. Alcohol affects the ability of
the kidneys to remove uric acid from
An obese person is four times more the blood. Some types of alcohol,
likely to develop gout than someone such as beer, are rich in purines,
with ideal body weight. If you are which can also lead to increased uric
overweight, gradual weight loss can acid levels. However many people
help lower uric acid levels and reduce with gout can control gout attacks
the risk of gout attacks. However without completely cutting out
it is important to avoid fasting or alcohol. Try reducing the amount of
‘crash’ dieting, where you go without alcohol you drink and avoid binge
adequate food for long periods drinking (drinking a lot of alcohol
and lose weight rapidly. This type at one time). Gout attacks are more
of dieting can actually increase uric common in beer and spirits drinkers
acid levels and trigger a gout attack. than in people who drink wine.
A combination of balanced healthy However there is no scientific proof
eating and regular physical activity that only these types of alcoholic
is the best way to lose weight. The drinks lead to gout attacks. Talk to
Australian Government provides your doctor for advice about
advice about the amount and kinds your alcohol intake or see
of foods that we need to eat for www.alcohol.gov.au for
health and wellbeing including Australian Government Guidelines on
Australian Dietary Guidelines at recommended alcohol consumption.
Arthritis Australia 19Diet and lifestyle Other healthy lifestyle choices Top tip: A healthy diet • D rink enough water: and lifestyle can help you Dehydration (not drinking enough manage your gout water) may be a risk factor for gout although this is not well proven in research. Drinking 1 – 1.5 litres of fluids a day is recommended for general health benefits. If you are taking diuretics (also known as ‘water pills’ or tablets which help the body get rid of water) or have heart or kidney problems, follow your doctor’s advice about how much water you should be drinking. • V itamin C: Vitamin C appears to reduce the risk of developing gout although it does not seem to reduce uric acid levels in people already with gout. • S tay active and try to fit in at least 30 minutes of physical activity most days of the week. • Quit smoking. 20 Taking control of your Gout
Who can help?
The good news is that gout can practical advice. Contact your
be effectively managed - and a State/Territory Arthritis Office on
team approach is the best way to 1800 011 041. They can provide
combat it. This involves you and your information and introduce you to
healthcare professionals together support groups, exercise programs
with support from family, friends and and other arthritis management
community organisations. services. See Arthritis Australia’s
range of information sheets at
How can you help? www.arthritisaustralia.com.au
Remember, you are the most
important member of your
healthcare team. By understanding
your condition and how to stay on
top of it, you can carry on living a
normal life.
Work closely with your healthcare
team to develop a management
plan for your gout. This will include
medicines to treat a gout attack and
possibly medicines to lower uric
acid levels. This will help you be
actively involved in your care and
decision-making about treatments.
With the right treatment, gout
doesn’t have to get in the way of
working, travelling, relationships,
hobbies and leisure activities.
Understand how your treatments will
help and how to get the most out
of them. Your healthcare team can
address your concerns and provide
Arthritis Australia 21Working with your GP
How can my GP help? When should I see my GP?
Your GP is an important partner in • Y
ou should visit your GP when
managing your gout. They can also you have your first gout attack.
help you to access other specialists, Your GP can prescribe the right
health professionals and services. medicines to treat the initial gout
Your GP will most likely make the attack and advise about medicines
initial diagnosis of gout and may refer that lower uric acid levels to
you to a rheumatologist (arthritis prevent future attacks.
specialist) if required.
• Y
our GP should also regularly
Once your gout is fully assessed, monitor your uric acid levels to
your GP or specialist may prepare make sure they are staying below
a care plan to manage the services the target levels described on
and treatments you require. They page 13. This may take several
will prescribe medicines and other visits when you are first taking
lifestyle changes to improve your medicines to lower your uric acid
symptoms and will also see you levels and then may require a
regularly to monitor your uric acid blood test every six months.
levels and check your treatment is
• V
isit your GP immediately if you
still keeping your levels to the target
notice your gout attacks are
level.
becoming more severe, more
Your GP may employ a practice nurse frequent or affecting more joints.
to coordinate your care and access to
services.
Top tip: Work with your
How do I find a GP? doctor to develop a
If you don’t have a regular GP, find management plan for
one who can support you. Speak to your gout
your local practice or medical centre.
22 Taking control of your GoutSeeing a rheumatologist
How can a rheumatologist • Y
our GP may recommend a
help? rheumatologist
Rheumatologists are doctors who • Y
ou can also contact the
specialise in problems of the joints Australian Rheumatology
such as gout. Your GP may refer you Association on (02) 9252 2334 or
to a rheumatologist if: visit www.rheumatology.org.au
to find a rheumatologist (but
• it is unclear whether you have
you will still need a referral
gout or if your symptoms are
from your GP).
caused by another condition
• y our gout attacks are not When should I see my
prevented with medicines to
rheumatologist?
lower your uric acid levels or are
becoming more severe • Y
our rheumatologist may initially
want to see you every few weeks
• y ou require an injection into your to work out how well your uric
joint acid levels are responding to
• you
and your GP wish to seek treatment.
advice about newer treatments. • O
nce the treatment is working
While your GP may have prescribed well to control your gout, you
some medicines to treat and prevent may only need to return to the
gout attacks, the rheumatologist rheumatologist if your gout
might also recommend other attacks or other symptoms start
medications to control your symptoms. to worsen.
How do I find a
rheumatologist?
• Y
ou will need a referral from
your GP to see a rheumatologist
- they will then stay in touch to
coordinate your care
Arthritis Australia 23Other health professionals
Your GP or rheumatologist may also inserts or advice on footwear to
refer you to other therapists for reduce pain in your toes and/or feet.
further advice.
See the section on Seeking support
on page 26 for information on health
How can other health professionals who can help you to
professionals help? cope with the emotions you may
A dietitian can give you tailored be feeling.
advice about weight loss, if you are
overweight, and provide advice about
a healthy, balanced diet to improve How do I find a health
your general wellbeing. professional?
A physiotherapist (physio) can • Y
our GP or rheumatologist can
show you exercises to do at home to provide a referral, or you can
strengthen and stretch the muscles contact a private therapist directly
in your joints and improve your (see Useful resources on page 29).
function. They will also show you
• If your GP refers you to a health
pain relief techniques to use at home,
professional as part of a care
including the use of heat packs and
walking sticks, to keep your joints as plan, you may be able to have
flexible and pain-free as possible. five sessions per year funded by
Medicare. Ask your GP for more
An exercise physiologist can give
information.
you advice about exercise, including
how to get started safely and the • M
ost health professionals are
best type of exercise for your health available in the public health
and ability. If you need to lose system (such as at a community
weight, they can also design an health centre or public hospital).
exercise program to work alongside There is often a waiting list and
a healthy diet. you will usually need a referral
A podiatrist can help take care of from your GP. Their services are
your feet, perhaps by providing shoe usually free or low cost.
24 Taking control of your GoutWhen should I see a health
professional?
• Y
ou may be referred to one or
more therapists soon after your
diagnosis of gout by your GP or
rheumatologist.
• A
sk your GP or rheumatologist
about seeing a health professional
if you notice your physical
condition or abilities change.
Arthritis Australia 25Seeking support
Why me? They may also refer you to a
It’s perfectly normal to wonder why counsellor or psychologist, who
you have developed gout, and to can talk to you about your worries,
feel angry, worried, frightened or feelings and moods, then suggest
confused about it. By taking control practical ways to work through
of your gout and working with your them. If you want to contact a
healthcare team, you can approach psychologist directly, call the Australian
the disease with a positive attitude. Psychological Society on 1800 333 497
However, sometimes the condition or visit www.psychology.org.au
can get you down, especially if beyondblue provides information
repeated gout attacks are affecting and advice about depression, anxiety,
your everyday life. It may also feel as available treatments and where to get
though people around you, even close help. Visit www.beyondblue.org.au
friends or family, don’t understand or call 1300 22 4636.
what you’re going through.
Lifeline provides a 24hr confidential
telephone crisis support service for
Who can help? anyone across Australia experiencing
There are many people who can help a personal crisis. Call 13 11 14.
you deal with the emotional side of
gout. Your first step is to try to talk
honestly with your partner, parents
What about information
or children about how you feel. Give from websites?
them a chance to talk too – they The web can be a useful source of
might have worries or feel that they information and support. However,
don’t know enough about your not everyone who puts information
disease and how it is affecting you. on the web is a qualified health
practitioner.
Visit your GP if you are worried that
unwanted feelings are too strong or Some organisations make unrealistic
have been there for a long time. Your promises in order to sell their
GP may be able to suggest ways of products. Treatment options and
coping, or may prescribe medicines if practices from overseas may also not
you are especially worried or depressed. be relevant or approved in Australia.
26 Taking control of your GoutAlways check information from the is an excellent starting point for web
web with a trusted member of your searches, as every site that
healthcare team. Healthdirect links to has been
The Australian Government’s checked for quality and accuracy
Healthdirect www.healthdirect.gov.au of information.
Arthritis Australia 27Glossary of terms
Arthritis are-thry-tiss A name for over 100 different conditions
that affect the joints.
Corticosteroid core-tick-o-ster- A type of medicine that is very effective in
oyd reducing inflammation in the joints.
Dietitian die-et-ish-un A health professional who can help you with
a healthy diet and weight loss.
Inflammation in-fla-may-shun The body’s response to damage or infection.
Inflammation can cause pain, swelling,
warmth, redness and difficulty moving the
joint.
NSAIDs en-sayds A group of medicines known as non-steroidal
anti-inflammatory drugs. These can reduce
inflammation and pain.
Purines pyu-reens Natural substances found in the body’s cells
and many different foods.
Rheumatologist roo-ma-tol-o-jist A doctor who is a specialist in treating
problems of the joints such as gout.
Tophi toe-fi Hard lumps of urate crystals that form
beneath the skin on the ears, fingers, hands,
forearms, knees, and elbows.
Uric acid you-rick a-sid A normal waste product found in the
blood. It is made as our bodies break down
substances called purines.
Urate you-rayt A normal waste product found in the
blood. It is made as our bodies break down
substances called purines.
28 Taking control of your GoutUseful resources
Australian resources
For access to quality online To find a podiatrist, contact the
information about gout, start at Australasian Podiatry Council
Healthdirect www.apodc.com.au
www.healthdirect.gov.au Ph: (03) 9416 3111
For advice on healthy eating and To find an exercise physiologist,
appropriate exercise, visit Healthy contact Exercise and Sports Science
Australia www.essa.org.au
Active www.healthyactive.gov.au
Ph: (07) 3862 4122
To find a specialist, contact the
To find a dietitian, contact the
Australian Rheumatology Association
Dietitians Association of Australia
www.rheumatology.org.au www.daa.asn.au
Ph: (02) 9252 2334 Ph: 1800 812 942
To find a physiotherapist, contact the To find a psychologist, contact the
Australian Physiotherapy Association Australian Psychological Society
www.physiotherapy.asn.au www.psychology.org.au
Ph: 1300 306 622 Ph: 1800 333 497
International resources
The public area on the website Arthritis Research UK also provides
of the American College of a wide variety of information for
Rheumatology contains many people with gout
useful resources www.arthritisresearchuk.org
www.rheumatology.org/public
The Gout and Uric Acid Education
Society (US) has information for
both medical professionals and
people with gout at
www.gouteducation.org
Please keep in mind that some issues and treatments from overseas may not be relevant in Australia.
Arthritis Australia 29Notes 30 Taking control of your Gout
My contact details
My name:..................................................................................................
Telephone:.................................................................................................
My GP
Name:........................................................................................................
Telephone:.................................................................................................
My specialist
Name:........................................................................................................
Telephone: ................................................................................................
My support team
Name:........................................................................................................
Telephone: ................................................................................................
Name:........................................................................................................
Telephone: ................................................................................................
My medicines
Name Dosage Instructions
Arthritis Australia 31Arthritis Australia
Arthritis Australia is a not-for-profit organisation that provides support and
information for all Australians affected by arthritis.
Contact your State/Territory Arthritis Office to find out about the range of awareness
and education programs, support services and resources available.
Arthritis Helpline: 1800 011 041 www.arthritisaustralia.com.au
Arthritis ACT Arthritis South Australia
Level 2B Grant Cameron 118-124 Richmond Road
Community Centre Marleston SA 5033
27 Mulley Street Holder ACT 2611
PO Box 4017 Weston Creek ACT 2611 Arthritis Tasmania
19A Main Road
Arthritis New South Wales Moonah TAS 7009
Suite 1.15 32 Delhi Road GPO Box 1843 Hobart TAS 7001
North Ryde NSW 2113
Locked Bag 2216 North Ryde NSW 1670 Arthritis Victoria
263–265 Kooyong Road
Arthritis Northern Territory Elsternwick VIC 3185
Shop 18 Rapid Creek Business Village PO Box 130 Caulfield South VIC 3162
48 Trower Road, Millner NT 0810
PO Box 452 Nightcliff NT 0814 Arthritis Western Australia
17 Lemnos Street
Arthritis Queensland Shenton Park WA 6008
1 Cartwright Street PO Box 34 Wembley WA 6913
Windsor QLD 4030
PO Box 2121 Windsor QLD 4030
Arthritis Australia Level 2, 255 Broadway Glebe NSW 2037
Mail: PO Box 550 Broadway NSW 2007
Phone: 02 9518 4441 Fax: 02 9518 4011
Email: info@arthritisaustralia.com.au
Web: www.arthritisaustralia.com.au
Arthritis Helpline: 1800 011 041 ISBN: 978-0-9923052-1-5You can also read
