Overindulgence over the holidays may lead to this painful joint condition
Once known as the disease of the rich, gout can attack all socio-economical groups. While gout is most in men aged 40 to 60, it can occur in younger men as well as in women. In women, gout is found mainly in post-menopausal women. For the 8.3 million Americans suffering from this disorder it is not a trivial matter. There are lifestyle and dietary changes that may help.
Tis’ the season to be jolly, fa la la la la…la la la la…It is also the season to overindulge. Did you find yourself not exercising as much? Perhaps you did not get your usual intake of water. How about drinking too much beer and red wine? Did you eat too much shellfish or red meat? If so you may be experiencing an ugly aftermath called gout.
These behaviors can trigger an extremely painful gout attack, which is a condition when uric acid builds up and crystallizes in and around your joints. It is often noticed first in the big toe of the body because it is sensitive to temperature changes and the big toe is the coolest part of the body. It can however present in the joints of your fingers or in your ears which are also likely to be cooler.
A recent study shows the prevalence of gout in the U.S. has risen steadily over the past two decades and now affects over 8 million Americans. It is no coincidence that obesity and hypertension also jumped during this same time period. This research can be found in the Arthritis & Rheumatism, a journal published on behalf of the American College of Rheumatology (ACR)
What is gout?
Elevated levels of uric acid in the blood cause gout. When you over indulge in foods and drinks rich in purines such as organ meats or yeast (beer/bread), the body breaks down the purines and produces uric acid. Normally the uric acid is flushed out of the body through the kidneys by urinating. However, if the body is producing too much uric acid, the levels of uric acid can rise dramatically. It may be too much for the kidneys to process, especially if you have co-morbidities such as obesity and hypertension which makes the kidneys work harder anyhow. This can cause the fine needle like crystals of uric acid builds up around the joints resulting in severe inflammation and pain.
Gout may be associated with a group of other health conditions under the umbrella of metabolic syndrome. This syndrome is characterized by obesity, insulin resistant diabetes, hypertension and elevated cholesterol which has more than doubled between 1960-1990. Research has now shown that when obesity and hypertension was controlled so was the prevalence of gout.
- It begins without any warning and can last hours to well over a week.
- Pain is in the joints with a warm feeling along with swelling of the area.
- It tends to occur in the night or the early hours of the morning when arising.
- The affected area may become red, maroon or even purple in color.
- As the pain and swelling subsides, you may be left with a reminder with peeling and itchy skin
- Some people may develop a fever during the attack.
- Genetics – It can be inherited (not the inheritance you would like to have for sure). Start preventative measures as soon as you can to reduce your risk.
- Hypertension – An elevation in blood pressure to unhealthy levels can increase your risk for gout as well.
- Diabetes – Insulin resistant diabetes raises your risk of having gout.
- Obesity – The more you weigh the higher your risk of gout.
- Medications - Diuretics – Certain medications could cause a rise in uric acid levels in the body. Studies show that diuretic drugs used to treat high blood pressure, some chemotherapy agents and anti-rejection drugs used after transplant surgery and can increase the level of uric acid in the body. Even too much aspirin or niacin can increase gout symptoms.
- Diet-Consuming foods and beverages that contain high levels of purines, yeast or oxalates can trigger an attack of gout.
Your physician will ask about your family and personal health history. Lab tests and x-rays are often ordered to determine uric acid levels in the blood and to make sure that the swelling in your joints are not from another cause.
Doctors will prescribe medications such as Colchicine, NSAIDS or corticosteroids. Sometimes they may give steroid injections into the area to treat the pain, swelling, and inflammation.
There are other options that can be done instead of or in conjunction with this. It can be managed effectively with natural measures such as diet and lifestyle changes.
Foods and beverages that are high in purines should be avoided. It is the purines that are converted in the body to uric acid that cause your symptoms.
Reduce or avoid all together the following: