Gout is one of the most painful
forms of arthritis. It occurs when too much uric acid builds up in the body.
The buildup of uric acid can lead to:
Sharp uric acid crystal deposits in joints,
often in the big toe
Deposits of uric acid (called tophi) that
look like lumps under the skin
Kidney stones from uric acid crystals in the
For many people, the first
attack of gout occurs in the big toe. Often, the attack wakes a person from
sleep. The toe is very sore, red, warm, and swollen.
Gout can cause:
Stiffness in joints.
In addition to the big toe, gout
can affect the:
A gout attack can be brought on
by stressful events, alcohol or drugs, or another illness. Early attacks
usually get better within 3 to 10 days, even without treatment. The next
attack may not occur for months or even years.
Gout is caused by the buildup of
too much uric acid in the body. Uric acid comes from the breakdown of
substances called purines. Purines are found in all of your body's tissues.
They are also in many foods, such as liver, dried beans and peas, and
Normally, uric acid dissolves in
the blood. It passes through the kidneys and out of the body in urine. But
uric acid can build up in the blood when:
The body increases the amount of uric acid it
The kidneys do not get rid of enough uric
A person eats too many foods high in purines.
When uric acid levels in the
blood are high, it is called hyperuricemia. Most people with hyperuricemia
do not develop gout. But if excess uric acid crystals form in the body, gout
You are more likely to have gout
Have family members with the disease
Are a man
Drink too much alcohol
Eat too many foods rich in purines
Have an enzyme defect that makes it hard for
the body to break down purines
Are exposed to lead in the environment
Have had an organ transplant
Use some medicines such as diuretics,
aspirin, cyclosporine, or levodopa
Take the vitamin niacin.
How Is Gout Diagnosed?
Your doctor will ask about your
symptoms, medical history, and family history of gout. Signs and symptoms of
Hyperuricemia (high level of uric acid in the
Uric acid crystals in joint fluid
More than one attack of acute arthritis
Arthritis that develops in 1 day, producing a
swollen, red, and warm joint
Attack of arthritis in only one joint,
usually the toe, ankle, or knee.
To confirm a diagnosis of gout,
your doctor may draw a sample of fluid from an inflamed joint to look for
crystals associated with gout.
Doctors use medicines to treat
an acute attack of gout, including:
Nonsteroidal anti-inflammatory drugs (NSAIDs),
such as Motrin*
Corticosteroids, such as prednisone
Colchicine, which works best when taken
within the first 12 hours of an acute attack.
Sometimes doctors prescribe
NSAIDs or colchicine in small daily doses to prevent future attacks. There
are also medicines that lower the level of uric acid in the blood.
* Brand names included in
this booklet are provided as examples only, and their inclusion does not
mean that these products are endorsed by the National Institutes of
Health or any other Government agency. Also, if a particular brand name
is not mentioned, this does not mean or imply that the product is
Can People With Gout Do to Stay Healthy?
Some things that you can do to
stay healthy are:
Take the medicines your doctor prescribes as
Tell your doctor about all the medicines and
vitamins you take.
Plan followup visits with your doctor.
Maintain a healthy, balanced diet. Avoid
foods that are high in purines, and drink plenty of water.
Exercise regularly and maintain a healthy
body weight. Ask your doctor about how to lose weight safely. Fast or
extreme weight loss can increase uric acid levels in the blood.
Nutritional and Herbal Therapy for Gout
Consume plenty of water. Dehydration may make gout worse.
Limit purines in your diet. Purines will increase lactate production in your
body. Lactate competes with uric acid for excretion. Foods that are high in
purine content include beef, organ meats, sweetbreads, mussels, anchovies,
herring, mackerel, and yeast. Foods with a moderate level of purines include
meats, poultry, fish and shellfish not listed above. Other foods with a
moderate level of purines include spinach, asparagus, beans, lentils,
mushrooms, and dried peas.
not drink alcohol beverages, especially beer.
a half a pound of cherries a day (fresh or frozen) for two weeks in
order to lower uric acid and prevent further attacks. Cherries and other
dark berries, such as hawthorn berries and blueberries, contain
anthocyanadins that increase collagen and decrease inflammation. Cherry
juice (8 to 16 ounces of a day) can also be helpful.
Folic acid (10 to 75 mg a day) inhibits xanthine oxidase, an enzyme that
is required for uric acid production.
not take Niacin in doses greater than 50 mg a day. Nicotinic acid can
cause a gout attack.
Bromelain (125 to 250 mg three times a day) is an anti-inflammatory that
can be helpful during an attack.
Chinese herbal formula, Si Miao Wan can help relieve symptoms of