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.
