What is gout?
Gout is an inflammatory disease that typically only affects 1 joint but can affect more/others. The joint in the big toe is most commonly affected. It occurs as a result of high levels of uric acid crystals accumulating in the joint(s). This condition is most found in adult men (about 90% of cases).
What is happening in the body?
When uric acid levels get too high, the body starts to put the excess (uric acid) somewhere… In the case of gout, it accumulates in the joint(s). Uric acid is formed when purines are broken down. (Purines are from nucleotides which are the building blocks of our DNA). They are found in certain foods, especially animal products.
This excess uric acid occurs for one of two reasons:
1. The body isn’t removing it. If the kidneys are not working well (due to certain medications, acidosis, kidney disease, etc.), the elimination of excess uric acid can be hindered.
2. The body is making too much of it. Also, if the body is producing too much uric acid, that can also cause an accumulation.
*When excess uric acid accumulates, the immune system gets activated and attacks the crystals, resulting in pain and inflammation. If left untreated, joint damage can occur. Although this is considered an auto-immune condition, recall as I often teach that your body was created smart and is always trying to help you heal. It is working FOR you, even when it hurts. When we get to the root of the issue, and make needed changes, the “attack” is no longer needed.
Risk factors include:
- A diet rich in seafood, organ meat, red meat and refined carbs… Even fish and poultry can contribute.2
- Regular consumption of sugary beverages (alcohol, sodas, sugared coffee drinks, etc.)
- Some medications including NSAIDs (anti-inflammatory pain meds)
- Many diseases (diabetes, kidney disease, etc.)
- Genetics tendencies do play a role, although this is fairly easy to overcome with lifestyle changes.
Symptoms can include:
- Tophi: These are nodules that can be found, felt and seen almost anywhere on the body but commonly in the ears, fingers and joints
- Kidney stones can occur with this condition
- Red, swollen, painful joint(s)
- The big toe joint is most impacted, sometimes making it hard to even walk
Some people have high uric acid levels but no symptoms at all for a long time. Often in these cases, certain stresses will promote a gout attack which appears to come out of nowhere… The onset is sudden, and pain is often intense.
If you have high uric acid (on your blood test) but no symptoms, don’t wait for the pain! Get balanced asap!
Diagnosis
Gout is diagnosed by looking at synovial fluid within the joints. The crystals look like little needles under a microscope (a clue as to why it hurts so much). Also, many doctors will look at urate levels in the blood to verify or rule out gout.
What food plan can help?
A whole food plant-based (WFPB) diet is an excellent choice to help with gout. Uric acid from purine breakdown is helped by a WFPB diet because plants have MUCH lower levels of purines. Meat (including fish and seafood) cause uric acid levels to rise but it appears that even plants with a higher purine level don’t have the same impact that the animal flesh does (despite much propaganda telling those with gout to avoid ALL purines regardless of the source).3 In fact, it seems that even vegetables, beans and other plants containing purines actually have a protective impact against gout… This is likely due to other micronutrients in these whole plant foods such as vitamin C, folate and fiber.4
Also, a WFPB diet is typically more alkaline than a standard American diet (SAD) rich in meat, dairy and processed food. Improving urine pH helps the body excrete uric acid so that it’s less likely to accumulate.5 Altering your pH naturally can be challenging but is SO important and full of reward.
One study showed a 90% reduction in uric acid levels after less than 1 week on a plant-based diet.6 Although there are lots of variables, long term suffering is never inevitable and there is ALWAYS hope!
A couple of special foods:
- Cherries! Fresh, frozen or cherry juice concentrates can all help with this condition.7 Cherries contain antioxidants, fiber and other phytonutrients that support a reduction in inflammation and pain.
- Green or black tea and coffee! These are also associated with lower uric acid levels and thus have a beneficial impact on the pain and inflammation associated with gout.8 Of course it would be ideal to look at your Nutrigenomics testing* to see if caffeine will be beneficial or harmful to you. Also, note that you want clean sources of caffeine with no added harmful agents such as dairy, sugar or chemicals. In other words, organic black coffee, organic green tea or organic black tea can be helpful.
*If you’d like more information about how to know how your specific genetic make up interacts with caffeine, click here for more info about Nutrigenomix testing. If you don’t have your genetic information on this, I’d recommend consuming NO MORE than 100 mg/day of caffeine (about 1 cup of coffee or 2 ½ cups of tea).
Two supplements that can support: (name, dose, contraindications, form etc)
- Vitamin C reduces serum uric acid levels.9 Vitamin C is generally safe, although if you take too much it can cause loose stool. If that happens, reduce dose until it’s gone. (All of the ones below are whole food sources!)
- Premier Plant Vitamin C (from PRL) – 500 mg/day (3 capsules)
- Health Force Truly Natural Vitamin C powder– 500 mg/day (1 Tbsp.)
- Physica Camu Camu Vitamin C Liposome powder-1000 mg/day (1 scoop)
- Vitamin D has also been found to reduce uric acid levels.10 Vitamin D plays many roles in the body and, although you can overdose as it is fat-soluble, most people are low in vitamin D. It is considered safe in prudent doses.
- Premier Vitamin D3– 5000 IU/day with protein (5 drops)
A final reminder:
Remember, gaining the benefits of having an overall healthy lifestyle include reducing alcohol, meat and sugar, increasing hydration (to dilute uric acid), reducing stress and maintaining a healthy bodyweight. Food is important but it’s not the only factor. Drinking water, reducing stress and other lifestyle factors should also be considered foundational.
If you need help, please reach out to the clinic at 269-204-6525. We’d love to support you on your way to radiant health!
References:
1. Cnick. Gout feet picture. Pixabay. https://pixabay.com/photos/feet-gout-pain-foot-human-anomaly-174216/. Accessed June 2, 2021.
2. Teng GG, Pan A, Yuan JM, Koh WP. Food sources of protein and risk of incident gout in the Singapore Chinese Health Study. Arthritis Rheumatol. 2015. doi:10.1002/art.39115
3. Jakše B, Jakše B, Pajek M, Pajek J. Uric acid and plant-based nutrition. Nutrients. 2019. doi:10.3390/nu11081736
4. Zhang M, Chang H, Gao Y, et al. Major dietary patterns and risk of asymptomatic hyperuricemia in Chinese adults. J Nutr Sci Vitaminol (Tokyo). 2012. doi:10.3177/jnsv.58.339
5. Kanbara A, Hakoda M, Seyama I. Urine alkalization facilitates uric acid excretion. Nutr J. 2010. doi:10.1186/1475-2891-9-45
6. Siener R, Hesse A. The effect of a vegetarian and different omnivorous diets on urinary risk factors for uric acid stone formation. Eur J Nutr. 2003. doi:10.1007/s00394-003-0428-0
7. Collins MW, Saag KG, Singh JA. Is there a role for cherries in the management of gout? Ther Adv Musculoskelet Dis. 2019. doi:10.1177/1759720×19847018
8. Pham NM, Yoshida D, Morita M, et al. The relation of coffee consumption to serum uric acid in Japanese men and women aged 49-76 years. J Nutr Metab. 2010. doi:10.1155/2010/930757
9. S.P. J, E.R. M, A.C. G. Vitamin C supplementation and serum uric acid: A meta-analysis of randomized controlled trials. Arthritis Rheum. 2010.
10. Nimitphong H, Saetung S, Chailurkit L or, Chanprasertyothin S, Ongphiphadhanakul B. Vitamin D supplementation is associated with serum uric acid concentration in patients with prediabetes and hyperuricemia. J Clin Transl Endocrinol. 2021. doi:10.1016/j.jcte.2021.100255
Nothing said or implied in this post is intended to treat, cure, diagnose or prevent any disease. It does not take the place of a qualified health care practitioner and is intended for educational purposes only.