Gout is a type of arthritis that occurs when too much uric acid builds up in the body, causing crystals to form in joints, and joints to become inflamed and painful. It can be hereditary or the result of another condition. Gout usually affects men over 40 with a family history of gout, but it can occur at any time and also affects women, especially after menopause. Excessive intake of food and alcohol, surgery, infection, physical or emotional stress, or the use of certain drugs can lead to the development of gout symptoms.
Signs and Symptoms
What Causes It?
The body produces too much uric acid, doesn't excrete enough uric acid, or both, so that the acid accumulates in tissues in the form of needle like crystals that cause pain. Uric acid is formed when the body digests purines, compounds found in some foods and beverages, including dried beans, liver, wine, and beer. Gout generally occurs because of a predisposition to the condition, but it can result from blood disorders or cancers, such as leukemia, or the use of certain drugs. Risk factors include:
What to Expect at Your Provider's Office
Your health care provider will examine the affected joint, evaluate your pain, and may ask if there is any history of gout in your family. Your health care provider may take a sample of fluid from the affected joint, draw blood for a blood test, or take x-rays to rule out other possibilities.
Your health care provider may give you ibuprofen or another nonsteroidal anti-inflammatory drug (NSAID) to help with the pain and swelling. You must avoid alcohol and foods that trigger your attacks. Besides NSAIDs, you may receive other drugs. Colchicine can help treat an acute attack and prevent future attacks but has serious side effects. Corticosteroids, corticotropin and intra-articular corticosteroids are also used, particularly in patients who have contraindications to NSAIDs and colchicine. Most rheumatologists use combination therapy to treat acute gout. In a patient without complications, NSAIDs are the preferred therapy. These drugs help control gout but do not cure it.
Complementary and Alternative Therapies
A combination of therapies can be very effective at decreasing both the length and frequency of attacks. When choosing complementary and alternative therapies for gout treatment, it is best to work with a knowledgeable provider. Herbs and supplements that may be beneficial for some people, may be harmful for others.
Nutrition and Supplements
These nutritional tips may help reduce symptoms:
You may address nutritional deficiencies with the following supplements:
Avoid taking extra niacin and vitamin A. Both may play a role in some attacks of gout.
Herbs are generally a safe way to strengthen and tone the body's systems. As with any therapy, you should work with your health care provider before starting any treatment. You may use herbs as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, make teas with 1 tsp. herb per cup of hot water. Steep covered 5 - 10 minutes for leaf or flowers, and 10 - 20 minutes for roots. Drink 2 - 4 cups per day. You may use tinctures alone or in combination as noted.
Acupuncture may help manage pain associated with gout.
Although few studies have examined the effectiveness of specific homeopathic therapies, professional homeopaths may consider the following remedies for the treatment of gout symptoms (such as pain and inflamation) based on their knowledge and experience. Before prescribing a remedy, homeopaths take into account your constitutional type -- your physical, emotional, and psychological makeup. An experienced homeopath assesses all of these factors when determining the most appropriate treatment for you individually.
Some of the most common remedies used for gout are listed below. A common dose is 3 - 5 pellets of a 12X to 30C remedy every 1 - 4 hours until your symptoms improve.
Nettle tea compress, applied externally. Use 1 - 2 tsp. per cup of hot water.
If you have had several attacks and the joint is damaged, your health care provider may refer you to an orthopedic specialist.
People who have had gout have an increased risk of developing kidney stones, high blood pressure, kidney disease, diabetes, high levels of triglycerides, and atherosclerosis.
Choi HK. A prescription for lifestyle change in patients with hyperuricemia and gout. [Review].Curr Opin Rheumatol. 2010;22(2):165-72.
Choi HK. Diet, alcohol, and gout: how do we advise patients given recent developments? Curr RheumatolRep. 2005;7(3):220-6.
Choi HK, Curhan G. Coffee consumption and risk of incident gout in women: the Nurses' Health Study. Am J Clin Nutr. 2010;92(4):922-7.
Choi HK, Curhan G. Soft drinks, fructose consumption, and the risk of gout in men: prospective cohort study. BMJ. 2008; [Epub ahead of print].
Choi HK, Gao X, Curhan G. Vitamin C intake and the risk of gout in men: a prospective study. Arch Intern Med. 2009;169(5):502-7.
Dubchak N, Falasca GF. New and improved strategies for the treatment of gout.Int J Nephrol Renovasc Dis. 2010;3:145-66.
Eggebeen AT. Gout: an update. Am Fam Physician. 2007;76(6):801-8. Review.
Falasca GF. Metabolic diseases: gout. Clin Dermatol. 2006;24(6):498-508.
Gagnier JJ, Chrubasik S, Manheimer E. Harpgophytum procumbens for osteoarthritis and low back pain: a systematic review. BMC Complement Altern Med. 2004 Sep 15;4:13.
Hak AE, Choi HK. Lifestyle and Gout. Curr Opin Rheumatol. 2008;20(2):179-86.
Jana S, Shekhawat GS. Critical review on medicinally potent plant species: Gloriosa superba. [Review].Fitoterapia. 2011;82(3):293-301.
Kang EH, Lee EY, Lee YJ, Song YW, Lee EB. Clinical features and risk factors of postsurgical gout. Ann Rheum Dis. 2008;67(9):1271-5.
Lee SJ, Terkeltaub RA, Kavanaugh A. Recent developments in diet and gout. Curr Opin Rheumatol. 2006;18(2):193-8.
Li EK. Gout: a review of its aetiology and treatment. Hong Kong Med J. 2004;10(4):261-70.
Li S, Micheletti R. Role of diet in rheumatic disease. [Review]. Rheum Dis Clin North Am. 2011;37(1):119-33.
Pascual E, Sivera F. Therapeutic advances in gout. Curr Opin Rheumatol. 2007;19(2):122-7.
Peterson DM. Nonsteroidal anti-inflammatory drugs and colchicine to prevent gout flare during early urate-lowering therapy: perspectives on alternative therapies and costs. J Pain Palliat Care Pharmacother. 2010;24(4):402-4.
Rakel & Bope: Conn's Current Therapy 2009, 1st ed. Philadelphia, PA: Saunders Elsevier. 2008.
Richette P, Bardin T. Gout. Lancet. 2010;375(9711):318-28.
Saag KG, Choi H. Epidemiology, risk factors, and lifestyle modifications for gout. ArthritisRes Ther. 2006;8 Suppl 1:S2.
Schelesinger N. Overview of the management of acute gout and the role of adrenocorticotropic hormone. Drugs. 2008; 68(4):407-15.
Schlesinger N, Dalbeth N, Perez-Ruiz F. Gout -- what are the treatment options? Expert Opin Pharmacother. 2009;10(8):1319-28.
Schumacher HR Jr, Chen LX. Newer therapeutic approaches: gout. Rheum Dis Clin North Am. 2006;32(1):235-44, xii. Review.
Suresh E, Das P. Recent advances in management of gout. QJM. 2011 Dec 23. [Epub ahead of print].
Vaghamshi R, Jaiswal M, Patgiri BJ, Prajapati PK, Ravishankar B, Shukla VJ. A comparative pharmacological evaluation of Taila (oil) and Ghrita (ghee) preparedwith Guduchi (Tinospora cordifolia). Ayu. 2010;31(4):504-8.
Wegener T, Lupke NP. Treatment of patients with arthrosis of hip or knee with an aqueous extract of devil's claw (Harpagophytum procumbens DC.). Phytother Res 2003;17(10):1165-1172.
Zhang SJ, Liu JP, He KQ. Treatment of acute gouty arthritis by blood-letting cupping plus herbal medicine. J Tradit Chin Med. 2010;30(1):18-20.
Review Date: 3/4/2012
Reviewed By: Steven D. Ehrlich, NMD, Solutions Acupuncture, a private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.