Q and A: Get Rid of Gout

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Eating cherries daily can reduce the uric acid levels associated with gout attacks.

My brother has gout and can’t seem to get rid of it. Could you recommend something that might help?
Via e-mail

Khalsa Responds: Gout is caused by an excess of uric acid in the body, resulting from the breakdown of purines, which are part of all human tissue and found in many foods. Eating foods high in purines (mainly proteins) can raise uric acid levels in the blood and exacerbate gout. In addition to careful protein selection, people should watch their alcohol consumption. Alcohol consumption aggravates gout by reducing uric acid elimination from the body and slightly increasing uric acid production. Beer and wine measure higher in purines because of their yeast residues. Further, very high intake of fructose, namely high-fructose corn syrup, can elevate uric acid.

People with gout should avoid:
• Beer and other alcoholic beverages
• Anchovies, oil-packed sardines, fish roes and herring
• Yeast
• Organ meat (liver, kidneys, sweetbreads)
• Legumes (dried beans, peas)
• Meat extracts, consommé, meat gravy
• Mushrooms, spinach, asparagus and cauliflower
• Beverages with high-fructose corn syrup

A gout-prevention diet is high in complex carbohydrates (whole grains, fruits and vegetables), low in protein and low in fat. Dark berries contain chemicals that lower uric acid and reduce inflammation. Fatty acids found in certain fish, nuts, and flax or olive oil have anti-inflammatory benefits. Be sure to include plenty of water, which dilutes the urine and promotes the excretion of uric acid.

The enzyme xanthine oxidase catalyzes the last step in the conversion of purines to uric acid. Allopurinol, the main gout drug, works by inhibiting xanthine oxidase. Certain flavonoids, especially luteolin and apigenin, work nearly as well. Carrots, celery, celery seed, chamomile (Matricaria recutita), many mints (Mentha spp.) and yarrow (Achillea millefolium) are rich sources. Baikal skullcap root (Scutellaria baicalensis) contains several anti-inflammatory flavonoids.

Anthocyanidins and proanthocyanidins, abundant in cherries, grapes and blueberries, also are xanthine oxidase inhibitors. Eating cherries lowers uric acid levels and prevents gout attacks.

Willard Responds: Even though gout was once considered a “rich man’s disease,” it still is relatively common among modern middle-age men. Although women can get gout, 95 percent of those afflicted with the disease are male. Gout produces extreme pain in the big toe of one foot. The pain will often start in the middle of the night, waking a person up. It can affect other areas of the body, including the knees, wrists and other joints.

Gout is a buildup of uric acids crystals in the joints. The main cause is a diet too rich in meats (particularly organ meats) and other high-purine foods. Alcohol, especially dark beer and cognac, contribute to this condition–these substances inhibit uric acid secretion by the kidneys. Excess weight and insulin sensitivity related to eating too much sugar have been directly associated with gout.

To reduce gout, eliminate alcohol intake; lower the intake of purine-rich food; maintain an ideal body weight; eat liberal amounts of complex carbohydrates; and reduce fat and protein intake. Drinking plenty of fluids, especially clean water, will help flush the uric acid out of the body.

The basic supplements we employ in our clinic to reduce gout are fish oil, folic acid, organic dark cherries, anthocyanoside extracts from bilberry or blueberry, and devil’s claw root (Harpagophytum procumbens).

The eicosapentaenoic acid (EPA) found in fish and krill oil has been shown to limit the inflammation and tissue damage caused by gout. Folic acid has been shown to reduce the production of uric acid. Consuming half a pound of fresh cherries daily can reduce the uric acid levels associated with gout attacks. Canned cherries and cherry juice also have been shown to be beneficial. Other berries, such as hawthorn (Crataegus spp.), blueberries and other dark red- and blue-colored berries high in anthocyanidins and proathocyanidins are beneficial and should be enjoyed liberally.

Devil’s claw can be used for a variety of arthritis-related conditions, including gout. It will relieve joint pain and can be used both as a preventive and to reduce the duration of acute cases. If using the dried root, take 1 to 2 grams daily. If in tincture form (1:5), use 4 to 5 ml, three times daily. I often suggest a solid extract (3:1), 400 mg three times daily.

Take 1 to 2 grams of EPA daily and 4 to 20 mg of folic acid daily. Cherries, cherry juice and berries can be eaten every day.

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