What is a Gout Attack? - GOUT: A Special Report

GOUT: A Special Report

What is a Gout Attack?
Gout is a form of arthritis that is caused by the build-up of a substance
found in the body called uric acid. This acid is used by the body to break
down a common substance in many different foods known as purines.

When people suffer from gout, the uric acid that has built up in their system
begins to form jagged crystal-like formations in the blood stream. It is these
painful little crystals that cause the horrible swelling and pain that gout is
known for. But what causes the uric acid build up and how do you know if
you’re having a gout attack?

The causes of gout attacks can be attributed to many different things. Foods
high in purines are a common culprit. Things like salmon, seafood and
alcohol. Also, offal meats (parts of animals we eat other than muscle, like
liver and kidneys) are suspected of causing gout because of their high purine
content.

For reasons unknown to doctors, about 75% of gout sufferers’ first start to
feel an attack in the joint of the big toe. Other likely joints that might signal
a gout attack are the ankle, knee or elbow.

The pain associated with gout comes from two different sources. There is the
sharp, stabbing pain caused by the crystals that get caught in the toe joint,
as well as the pain caused by the swelling and inflammation of the tissues
around the joint.

Gout has four stages that a sufferer could end up going through if the
condition is left untreated. The first is asymptomatic, which simply features
rising levels of the sinister uric acid rising in the blood stream, but before
any symptoms manifest.

The second is acute gout, which features a person’s first gout attack, most
of which go away quickly and there isn’t a frequent reoccurrence.
Remember, the sooner you get treatment, the sooner the pain will go away.
The average case of gout lasts only a day or two with proper care.

The third stage of gout is inter critical, which is just the symptom-free time
between attacks, and the fourth and final stage of gout is the chronic stage.
Chronic gout is made up of multiple bouts of the disease and the gout
attacking more than one joint at once.

If gout isn’t treated properly, serious health problems can arise, such as
kidney damage and the formation of kidney stones, as well as hypertension
(high blood pressure).

While there is no “cure” for gout in the traditional sense, since the disease
can return anytime there is an imbalance in your body’s uric acid levels,
there are many different treatments and you can effectively eliminate the
risk of gout through natural means.

Most doctors prescribe a change in diet from foods high in purine to foods
that help the body absorb excess uric acid in the blood stream. Most berries
and fruit are great at absorbing uric acid, whereas foods high in protein,
such as chicken or even tofu should not be eaten at all during a flare up
since it is believed those foods make matters worse.

In conclusion, even though gout is associated with a period in history long
gone when knights on horseback were busy saving fair maidens, it is very
much an ailment of today’s world. But with the proper diet and early
diagnosis, the horrible pain of gout can be controlled.

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The Four Stages of Gout
Gout is a very painful form of arthritis. Gout occurs when there is an
abundance of uric acid built up in the body. When there is a buildup of Uric
acid in the body it can lead to things such as sharp uric acid crystals in the
joints throughout the body especially in the big toes, other deposits of uric
acid, which are called, tophi, that look very similar to lumps underneath the
skin, and the formation of kidney stones which is a result from a buildup of
uric acids in the kidneys.
For the majority of people that have the unfortunate occurrence to get gout
it most often strikes in the area of the big toe. Many times the gout attack
can be severe and very painful as it often awakens one from sleep when the
attack occurs. The big toe which is inflicted with gout is extremely sensitive
and sore and often times warm and swollen.
Gout can be broken down into four main stages:
1. Asymptomatic Hyperuricemia is the first stage of gout in which you will
not feel any symptoms but gout is starting to form. In stage one the uric
acid levels are higher and it needs to be taken care of so that the uric acid
does not precipitate out of blood and then become crystallized in kidneys or
the joints.
2. The second stage of gout is acute gout or acute gouty arthritis. It is at
stage two when gout starts to do damage to the body. High levels of uric
acid make it so it is impossible for the blood to keep it in a form that is
dissolved and it begins to crystallize and then be deposited in joint spaces.
This is when pain and swelling then occurs. Attacks generally happen in the
evening and if not treated can last for weeks at a time. If not treated still the
attacks become more severe and last for longer periods of time.
3. The third stage of gout is Intercritical gout as this is the time when an
attack of gout has subsided. In stage three there are no symptoms but it is
because the body’s immune system is stabilizing itself for more attacks on
the uric acid crystals which form because of the high concentration of blood.
If the person afflicted with gout does not get treatment by stage three the
disease can be hard to control.
4. The fourth and final stage of gout is chronic gout which is the worst and
most destructive stage of the disease. By stage four the gout has caused

permanent damage to the joints and in some cases the kidneys as well. At
stage four the affiliated joint can become deteriorated and cause extreme
pain which can be crippling. In extreme cases the kidney can lose its
functions which can lead to kidney failure and death.
Gout is a disease like many others which builds upon itself if not treated at
the beginning stages. By seeing the symptoms early and being checked by a
physician you can reduce the chances of gout reaching the latter stages.

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Top Ten Causes Of Gout
The disease of Gout is caused by the accumulation of too much uric acid in
the body. Substances called purines are broken down and the outcome is an
abundance of uric acid. Purines can be found in tissues all over the body.
Purines can also be found in many foods that we eat such as liver,
anchovies, peas, and green beans. Generally uric acid is naturally dissolved
in the blood. The uric acid passes through the kidneys in the body and then
exits the body in the urine. Sometimes though uric acid builds up in the
blood when:
  1. The body naturally increases the amount of uric acid it produces.
  2. The kidneys, for some reason, do not do their job of purifying the
     blood and does not exit enough of the uric acid from the body.
  3. A person eats a diet that consists of foods that have high levels of
     purines.
When the uric levels in the blood are very high it is then called
hyperuricemia as most people that have hyperuricemia do not go onto
develop gout. Gout can develop though if there are large amounts of uric
acid crystals form in the body.
There are some reasons you can be more likely to get gout.
  1. If you have a family history of gout you are more likely to be afflicted
     with the disease.
  2. Men are more at risk to get gout than women.

3. If you drink a lot of alcohol or have a drinking problem in which you
     drink a large amount on a regular basis than you are more likely to get
     gout.
  4. People who have a weight problem also are more likely to become
     afflicted with gout. The more obese a person is the higher the chances
     that they will get gout.
  5. Considering that foods high in purines can cause gout it goes without
     saying that by consuming large amounts of foods high in purines will
     increase a persons chance of developing gout.
  6. If you have had an organ transplant than you are more likely to have
     gout than those who have not had any organ transplants.
  7. Being exposed to lead in any way will increase a person’s chance of
     getting gout. By knowing the chemicals with lead in them you can
     decrease your chances of becoming afflicted with gout.
  8. If you have an enzyme defect within your body that does not naturally
     break down purines than you are more likely to get gout. By not
     breaking down the purines the uric acid crystals can start to form
     throughout the body.
  9. There are some medicines that if taken can increase your change of
     getting gout such as diuretics, cyclosporine, levodopa, and even
     aspirin.
  10. By taking the vitamin of niacin you increase your chances of
      developing gout.
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Gout vs Diet

  The cause of gout is a high blood level of uric acids which is a waste
  product. The waste product is a breakdown of purines which are
  substances naturally found in your body. Purines are also found in several
  types of food.

  The treatment of gout, in times past, included very strict dietary
  regiments but because of medications that are used to combat gout the
  regiments are not as harsh as they once were.

There still are some recommended dietary modifications though as they
   can greatly help your chances of avoiding gout flare-ups. Many
   medications for gout cause many, potentially serious, side effects so
   dietary modifications can be a better option than the medications.

   Some of the foods that are high in purines and should be avoided are
   liver, brain, kidney, sweetbread, anchovies, peas, beans, mackerel,
   mincemeat, scallops, muscles, and herring. Other foods such as poultry,
   meat, and fish have lesser amounts of purines so it is suggested that they
   be eaten in moderation.

Other ways that you can lower the risk of gout naturally
are:

   1. Avoiding alcohol altogether or only drinking it in moderation, perhaps
      saving drinking alcohol for special occasions only. Drinking a lot of
      alcohol increases the risk of hyperuricemia, as the alcohol gets in the
      way of the natural removal of uric acids from the body. If you have
      gout and especially if you are having a gout attack alcohol should be
      avoided completely.
   2. Make sure to drink plenty of fluids to flush the system of uric acids.
      Aim for around 2 liters of water a day, more if you are exercising or
      have a physical job.
   3. Try to maintain a healthy weight. The more excess weight you are
      holding the more stress is then put on your joints increasing the
      possibility of gout.
   4. Try to lose excess weight but do not do so by rapid weight loss diets
      as they can increase uric acid levels in the blood. In weight loss also
      avoid low-carb diets as they are high in fat and protein. Consuming
      too much of these types of foods can increase your chances of
      developing hyperuricemia.

Foods that are low in purines will help in keeping gout at bay. Below is a list
of foods which are low in purines.

   1. Breakfast – Cereals and breads, coffee, tea, oatmeal, eggs, fruits,
      juices, cheese (low fat), milk, and peanut butter.
   2. Lunch – Nuts and peanut butter, pasta macaroni, soups, cream style
      soups, cheeses (low fat) and broths

3. Dinner – Pasta, macaroni, eggs, vegetables, breads and cereals, low-
      fat cheeses and soups.

Other foods and food items low in purines are gelatin, fats and oils (in small
amounts), soda, sugar, syrups, and other sweets in moderation.

As with anything, moderation is the key to a low purine diet. Some foods
which have a moderate purine level are: beef, lamb, pork, vegetables such
as mushrooms, asparagus, cauliflower, spinach, wheat germ, all types of
yeast and gravies.

It is ok to have these foods as long is it is in moderation. Even foods that are
high in purines can be eaten occasionally unless you have gout or are having
an attack of gout.

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Can Low Carb Diets Cause Gout?

Even though it’s unclear on how someone can decrease their risk of
pseudogout, as far as gout is concerned, the best way to reduce the risk is
to control your diet and your weight. If you are overweight, it is imperative
that you know there is a ideal method to utilise when it comes to shedding
pounds for gout prevention.

There is no question that obesity is a major risk factor for gout. Studies on
overweight men have shown that the more weight they gain, the higher
their risk of developing the condition.

How does obesity contribute to gout risk? Think about it, people who are
obese, or considerably overweight, usually lead a sedentary lifestyle, have a
diet rich in fatty foods, alcohol and caffeinated beverages that are
dehydrating.

Studies have concluded that men, who are overweight, are two times as
likely to develop gout, while obese men are three times as likely. It was also
discovered that when the overweight men lost only 10 pounds, they
decreased their risk of gout by 40 percent!

Now that you know the role weight plays in gout risk, it’s time to take a look
at the right way of losing weight to prevent gout, and the wrong way.

The ideal weight loss method for gout...

First of all, when it comes to losing weight, it’s not about “going on a diet”,
it’s about making a lifestyle change by transforming what you eat and the
amount you ingest. For instance, a healthy diet for the average individual
should consist of the following:

   Fresh fruits and vegetables
   Nuts
   Whole grain products (brown rice whole grain cereal/breads/pasta)
   Low fat dairy products
   Fish
   White meat (chicken and turkey with no skin)
   Lots of water

When the above foods are consumed on a regular basis, they lower your
intake of cholesterol, saturated fats, trans-fats and high sugared foods such
as fried foods, chips, cookies, cake, white rice/pasta/bread, red meat and
organ meat. Furthermore, healthy foods provide your body with fish oils,
and calories from mono unsaturated fats and poly unsaturated fats. As a
special bonus, healthy foods also help to suppress your appetite.

Avoid the low carb weight loss method

One of the most popular diets to be introduced to society over the past few
years, as a method to lose weight fast, is the famous low carb diet. Low
carb diets, such as the Atkins diet, are about dramatically reducing the daily
intake of carbohydrates and replacing them with protein. Although the low
carb diet certainly does achieve excellent weight loss results in a short
period of time, whether or not it is a healthy choice for your body, is
questionable.

Some low carb diets contain high amounts of animal protein, cholesterol and
saturated fats, but lack fiber, nutrients and complex carbohydrates that are
necessary for the body to maintain ideal health. This has lead many medical
researchers to believe that low carb diets actually increase certain health
risks such as gout.

Why? Gout is caused by too much uric acid in the body, which can occur
from eating too many foods rich in purines - foods that essentially make up
a low carb diet. In addition, it is believed that by eating less than 130
grams of carbs per day can cause a build up of ketones in the blood, which
can also result in higher levels of uric acid.

Thus, adopting a healthy diet, in combination with regular exercise (IE, daily
20-minute brisk walk), is a great way to lose weight. Sure the results may
not be as fast as a low carb diet, but at least you will stay healthy and
prevent gout while you’re at it.

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The Missing Link Between Gout
and Alcohol Consumption

Although there are many factors that can contribute to a build up of uric acid
within your system, alcohol consumption appears to be a leading factor in
gout development. However, this doesn’t mean that people who drink
alcohol modestly on a regular basis will develop gout. Furthermore,
research has discovered that different types of alcoholic beverages have
different impacts on uric acid levels.

For hundreds of years, medical researchers have suspected that gout is
linked to specific lifestyles such as diets high in red meat, salt and alcohol,
combined with little to no exercise. This type of lifestyle, which many people
in Western countries tend to adopt as they become older and closer to
middle age, is very much like the lifestyle that was once led by English
kings. In fact, gout is often called “the disease of kings”.

Today, researchers that have conducted studies on men in relation to alcohol
consumption and its link to gout, have found that men who drank excessive
amounts of certain forms of alcohol – especially beer – greatly increased
their risk for developing gout.

What has been discovered is alcohol may not only affect the production of
uric acid, but also its removal from the body.

It appears that when alcohol is changed into lactic acid, it decreases the
quantity of uric acid that the kidneys are able to remove from the body. The
reason is because uric acid has to compete with the lactic acid in order to be
removed by the kidneys.

In addition, researchers have found that certain types of alcohol have less
risk of causing gout than others. Of all the alcohols studied, it appears that
Beer poses the highest risk of gout, while moderate consumption of wine or
spirits has little to no increased risk of gout.

What’s so risky about beer? Some researchers believe that beer has a non-
alcoholic ingredient that makes the increase of gout even higher than other
alcoholic beverages. Beer is apparently the only alcoholic beverage to
include purines, and an excessive amount of purines in the system can lead
to higher production of uric acid.

Conversely, other researchers do not believe it is the purines in the drink
that increase the risk of gout. These researchers don’t believe that having
too many purines in the diet increase the risk of gout. Their reasoning is
based on a study that was conducted on vegetarians from Taiwan who
indulged in a diet that was high in purines. The study revealed that theses
individuals actually had a lower risk of developing gout.

So, if it’s not the purines in beer then what is it? Some experts have a
hunch that excessive beer drinkers have a higher risk in contracting gout
due to their lifestyle. For instance, a person who drinks wine usually has
their alcoholic beverage with a meal, or with healthy snacks such as fruits,
vegetables, crackers and cheese.

A beer drinker, on the other hand, will often indulge in eating salty and fatty
snacks such as peanuts and chips, while they sit and watch TV on the couch
hour after hour. Thus, enthusiastic beer drinkers are likely to have a more
sedentary lifestyle.

Regardless of the alcohol beverage you enjoy, you can dramatically reduce
your risk of developing gout by drinking modestly (IE a glass of wine or beer
per day). Overindulging in alcohol on occasion isn’t going to have a
dramatic effect on your chances of getting gout, but regular overindulgence
may eventually lead to a serious pain in the big toe.

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