Gout

Gout is caused by excessive accumulation of uric acid in the tissues. The underlying cause of uric acid accumulation is unknown, yet research has found that it can basically be attributed to metabolic or kidney problems. Increased production of uric acid may be the result of metabolic enzyme defects, certain types of chronic anemia, or other complex conditions.

Dehydration and kidney disease can cause poor clearance of uric acid from the body.

Proper diet, nutrition, and metabolic balance all play crucial roles in the prevention and treatment of this disease. The conception of gout as a condition of affluence is tenuous, but a heavy diet, particularly organ meats that increase amount of uric acid, and alcohol consumption, can hinder the removal of uric acid by the kidneys.

Although most people initiate a gout attack through poor lifestyle choices (obesity, rich

foods, alcohol), 10%-15% of gout patients have attacks due to a metabolic problem, such as a deficiency of enzymes (xanthine oxidase) and purine imbalances. Purines come from certain foods (meat products, especially liver and other organ meats, sausages and other processed meats, anchovies, crab, shrimp, milk, eggs, and many beans, including soy), but are also normally present, in the form of DNA and RNA in the cells. Purines are broken down into uric acid, which is then normally excreted through the urine.

Medications, including aspirin and diuretics, can cause gout by putting extra stress on the kidneys; these drugs cause 25% of new gout cases. Kidney stones and other kidney problems are present in 90% of gout sufferers, because urate crystals also accumulate in the kidneys.

These crystals accumulate because of the build-up of uric acid. They occur if you produce too much uric acid or excrete too little when you urinate and the crystals  form in and around joints. They are hard, needle-shaped and build up slowly over several years, and you will not know this is happening.

The crystals may cause two problems:

• Some may spill over into the soft lining of the joint (synovium), which causes the pain and inflammation associated with gout.
• Some pack together to form hard, slowly expanding lumps of crystals (“tophi”) which can cause progressive damage to the joint and nearby bone; this eventually leads to irreversible joint damage which causes pain and stiffness when the joint is being used.

Factors which increase your risk of gout include:

• age and gender: gout is more common when you get older and is three-to-four times more likely in men
• being overweight or obese
• having high blood pressure or diabetes
• having close relatives with gout (gout often runs in families)
• having long-term kidney problems that reduce the elimination of uric acid
• a diet rich in purines; such as frequently eating sardines and liver
• drinking too much beer or spirits – these types of alcoholic drinks contain relatively high levels of purines

Risk factors:

Some things can increase the amount of uric acid in your blood, making you more likely to develop gout. These risk factors fall into one of two categories:

• medical conditions known to increase levels of uric acid, such as obesity, high blood pressure (hypertension), high lipid levels and long-standing impairment of kidney function
• lifestyle factors, such as diet or certain types of medication that you may be taking

Medication:

Certain types of medication can increase your uric acid levels and your risk of developing gout. These include:

• diuretics, used to treat high blood pressure (hypertension) or an abnormal build-up of fluid in your body
• niacin, used to treat high cholesterol

Sex:

Men are more likely to develop gout than women because their uric acid levels rise during puberty. During the menopause, women experience a similar, albeit smaller, rise in their uric acid levels. This explains why symptoms start later in women than in men.

Diet:

Foods naturally high in purines include:

• beef
• pork
• bacon
• lamb
• seafood
• liver
• kidneys

Alcohol:

Alcoholic drinks raise the level of uric acid in the blood by increasing its production in the liver and by reducing how much is passed out in urine.

Beer and spirits do so more than wine, and beer also contains significant quantities of purines. (Moderate consumption of wine – one or two glasses a day – should not significantly increase your risk of gout).

Family history:

Studies have shown that gout often runs in families. Around one-in-five people with gout have a close family member who also has the condition.

Medical conditions:

Medical conditions that can increase your risk of developing gout include:

• high blood pressure (hypertension)
• diabetes, both type 1 diabetes and type 2 diabetes
• kidney disease
• having high levels of fat and cholesterol levels in your blood

Susceptibility:

Gout attacks occur most frequently in the joints of the feet and hands, possibly because the temperature in these joints is often lower than the rest of the body, which increases the likelihood of crystals forming.

It is still uncertain why some people are more susceptible to crystal formation and gout than others with equally high blood levels of uric acid. Many people with a high level of uric acid in their blood and tissues never develop gout.

One theory is that certain genes you inherit from your parents may make you more likely to develop gout by causing your kidneys that are otherwise healthy to be relatively inefficient at excreting uric acid. Several genes have recently been identified that are associated with high uric acid levels and gout and which influence uric acid elimination by the kidney.

Now we’ve looked at the causes, we will look at the things to do when it comes to natural remedies for gout.