Saturday, 4 April 2015

Dealing with Gout

Before approaching any condition, it’s as well to understand what is happening in the body before starting to treat.  Gout is one of those which affect joints but is not a form of arthritis. It is incredibly painful, can occur at any age and usually reoccurs unless changes to lifestyle and diet are adhered to.

Historically it has been associated with overweight, red-faced old men who love their roast beef and port and there are many depictions of such people in both eighteenth and nineteenth century cartoons and later novels. The sufferer’s pain has been seen as a cause of hilarity and general dismissal.

Put simply, gout is caused by an inability to process lactic acid which leads to a precipitation of uric acid crystals in joints instead of being excreted in urine. This may come from a genetic insufficiency. It is often caused by a diet rich in purines (a component of protein) coupled with large body mass and an underactive digestion.

Gout can happen to anyone, male or female at any age. It can occur in any joint but is most frequently experienced in toes or hands.  In my experience, gout usually occurs 

a)    after a lifetime of “good living” (lots of heavy, meat-driven meals accompanied by alcohol)
b)    after excessive stress or
c)    as a side effect of medication.

Treatment needs to consist of a four-pronged approach

  • pain relief,
  • anti-inflammatories,
  • something to break up and eliminate the uric acid crystals
  • lifestyle changes

They are all equally important. Once the initial attack is over, it is tempting for the sufferer to return to his or her previous lifestyle and ‘just avoid the food which triggers an attack.’ 

Unfortunately it is not that simple. Just because you are not in pain does not mean you are now effectively processing lactic acid. Uric acid crystals may still be building up in your joints and causing damage. It is best to make some long-term lifestyle changes and develop strategies to ensure your good health unless you are content to develop a chronic condition.

Let us look at the four areas in turn 

      Pain relief 

      Perhaps the most effective painkiller for gout is potato juice, 4-6 fluid ozs of juice made from uncooked potatoes taken every hour. It tastes dreadful and must be drunk fresh but does the trick. More palatable may be cherry, blackcurrant or blueberry juice (unsweetened). The dose is 6 to 8 ozs of “black/blue” fruit a day (fresh or frozen).  Taken for two weeks, this dosage will lower uric acid and will help to prevent attacks by reducing levels of uric acid.

      Cherries and other dark red berries (hawthorn berries and blueberries) contain anthocyanidins which increase collagen integrity and decrease inflammation.  You could also take 8 to 16 fl ozs. of cherry juice per day. A lower, maintenance dose of 4 fl ozs. per day can be continued as a preventative measure to guard against new attacks.  A supplement with high levels of proanthocyanadins can be used in addition during crisis or instead of cherries and blueberries during non-crisis times. 

      Reducing inflammation and eliminating uric acid crystals

These two factors need to be tackled together. When my husband developed gout in his hand following an incredibly stressful time at work, the doctor only prescribed anti-inflammatories which, to me, seemed worse than useless so I went to my herbs and he recovered quickly.

I used David Hoffman’s tried and tested formula of equal parts celery seed, burdock and yarrow. Wild carrot is another herbal diruretic which could be used. A gout sufferer needs to increase water intake significantly to help eliminate the uric acid crystals, so I made the celery seed (1tsp) and yarrow (1tsp) into a tea and added 1 tsp of burdock tincture as that was all I had available. Ideally alcohol should be excluded completely from the diet during an attack but I didn’t know this at the time. This dose is taken three times a day.

The principal reason for increasing liquid consumption (think 6-8 glasses per day) is to try to dilute the contents of the blood so that uric acid has less chance of precipitating out and depositing in the synovial fluid around joints.

Other foods which can help are apples, black currants, watercress, kale, strawberries, dandelion greens, potato, potato broth, chicory, cherries, blueberries, raspberries, parsnips, celery, olives, rye, lima beans, rice bran, bananas, sprouts, watercress.

Fresh juices are also helpful such as cherry juice, potato juice, celery and parsley juice, celery juice, carrot and spinach juice, carrot, beet, and cucumber juice or carrot, celery, and parsley juice, potato peeling broth, dried olive tea, nut milk and liquid chlorophyll.

Juices start to oxidize immediately they come into contact with air, so should be made fresh every time. If you are making a juice from fresh cherries, remove the stones first before juicing, otherwise you will damage your machine. 

      Lifestyle changes

Peter Bryam, a Connecticut herbalist, believes that gout can only be successfully treated with a complete lifestyle change to reduce any excess body mass and to maintain a diet which reduces or removes the chance of uric acid precipitation. He recommends a diet comprised of

  •  Protein 70% of Calories
  • Fat 12 -15% of Calories
  • Fiber 5-18% of Calories

He also suggests short juice fasts, which include supplementation with "super food" complexes, followed by a diet very low in purines if you are trying to lose weight. He warns against any kind of fast where only water is drunk because this will cause concentration of toxins and precipitate a gout crisis.

Bryam has put together a set of dietary "standards" or rules for individuals with gout.

  • Eliminate homogenized milk as it may be a source of xanthene oxidase which will increase levels of uric acid.  It may be necessary to switch to soy or nut milks.
  • Significantly restrict or completely eliminate purines in the diet.  Purines are organic compounds that contribute to the formation of uric acid in the system.  Purines increase lactate production which then competes (and loses) with uric acid for excretion.

Foods with high purine content are:
"Red" meats of any kind: goose, organ meats (e.g. liver, kidney, sweetbreads), shellfish (e.g. mussels, prawns),  anchovies, sardines, herring, mackerel,  baker's yeast, dry peas, alcohol, mincemeat, vitamin B3, ketones, coffee (even decaf), tea , cocoa, cola, saturated fat, refined carbohydrates,

Foods with a moderate amount of purines are:
"White" meats, poultry, spinach, asparagus, beans, lentils, mushrooms, fish and shellfish not listed above.

In addition to avoiding the above purine containing foods, Byram recommends not eating any foods cooked in heated oils. This includes anything labelled “fried” including "roasted" nuts.  It also means staying out of most restaurants or fast food establishments. 

Bryam reasons that fats used for cooking, once heated even a little, will oxidize and turn rancid very quickly and even though they don't necessarily taste bad when this happens, he believes they “have become poison for an individual with gout”.  He says that rancid fats destroy Vitamin E which is a major antioxidant that the body utilizes in cleaning up oxidative damage in the system.  Destruction of Vitamin E triggers the release of increased uric acid into the system which will promote an attack. 

Recently, I have become aware of people who develop gout as a side effect of their medication. It is really important to read all the small print on any tablets you are taking and see if there is a mention of gout as a side effect. If it is there, it is worthwhile eliminating high purine foods and alcohol from your diet and increasing your fluid intake before you experience an attack, rather than waiting for the pain and then acting.

Finally, I would like to discuss the issue of food as medicine. I have noticed that when I suggest something to someone who does not normally include herbs as medicines in their diet, they try to interpret what I have suggested into something they can easily understand and incorporate into their current lifestyle rather than taking on board exactly what I’ve said.

One example of this was an elderly gentleman who was suffering with extreme constipation. I suggested he try including fresh or dried figs in his diet. Both he and his daughter looked at me with a slightly puzzled expression and said, “Would bananas be as good?”

My second example comes from the wife of a transplant patient whose extremely painful gout came from his numerous medications. His doctors could do nothing for the pain. I suggested fresh potato juice but instead of trying this, she reinterpreted my suggestion as “leek and potato soup”. I didn’t have the heart to tell her she would probably see no effect whatsoever from the soup except as a comfort food because the medicinal pain relieving aspects came from concentrated fresh potato juice.

Celery is another case in point. Eating the vegetable either fresh or cooked will help but the diuretic effects will not be as great as using a tea made from the dried seeds. Including celery in your diet can be greatly beneficial but when a gout attack happens, use the concentrated form – the seeds.


Unknown said...

You always amaze me of how much knowledge you have. I could not ever remember all the things you share here.
Thanks so much for putting it here in print.

Anne Patterson said...

Ground Elder is traditionally used as a remedy for gout, it was grown in the gardens of monasteries for that purpose in the past. See

Anonymous said...

My husband has gout but he doesn't fall into any of the reasons stated. He doesn't drink, doesn't eat tons of read meat, isn't overweight and has pretty good digestion. The only vise he does have is he drinks about 5 cups of coffee a day.
We'll have to try some of the remedies for gout. Thanks so much for posting about this.