Gout

Anybody here got any suggestions of how to avoid it?

Gout is a disease related to one's diet - To much uric acid in the system forms crystals which collect in the joints and around the bones, especially of the big toe.  Heredity, age and sex, males are more susceptible play a role too.

From what I know after helping a friend with gout, you should avoid -

un-fermented grains/seeds and their flours.  A diet which starts with avoiding foods as seen in the Celtic disease diet is a good placed to start.  No gluten, etc.  if your having a gout attack.

Then, once your attacks are under control, you can start to add back in grains which have been pre-digested by soaking (see Nourishing Traditions cook book).  To this add natural acid foods such as those that have been fermented; yogurt, sauerkraut, kefir, kombucha and ACV (raw apple cider vinegar).  When these foods are added to a diet they cause the body to become more alkaline, which greatly helps with production of to much acid in the body.

Here are some other treatments -

Treating Gout using Cherry - The cherry, sweet or sour, is considered in effective treating gout. To start with, the patient should consume about fifteen to twenty five cherries a day. Thereafter, about ten cherries a day will keep the ailment under control. While fresh cherries are best, canned cherries can also be used occasionally.
Gout Treatment using Vegetable Juices

Raw vegetable juices are used for gout treatment. Carrot juice, in combination with the juices of beet and cucumber, is especially valuable. Beet juice - 100 ml and cucumber juice - 100 ml should be mixed with 300 ml of carrot juice to make 500 ml of combined juice and taken daily
Treating Gout using French Beans

The juice of French or string beans has also proved effective in treating gout. About 150 ml of this juice should be taken daily by the patient suffering from this disease.
Cure for Gout using Apple

Apples are regarded as an excellent source for curing gout. The malic acid contained in them is believed to neutralise the uric acid and afford relief to gout sufferers. The patient is advised to take one apple after each meal.
Gout Relief using Banana

Bananas have been found beneficial in the treatment of gout. A diet of bananas only for three or four days is advised for providing some relief from gout. A patient can take eight or nine bananas daily during this period and nothing else.
Treating Gout using Lime

Lime is also used as a source in treating gout. Vitamin C is known to prevent and cure sore joints by strengthening the connective tissues of the body. The citric acid found in lime is a solvent of the uric acid which is the primary cause of this disease. The juice of half a lime, squeezed into a glass of water, should be taken twice daily.
http://www.home-remedies-for-you.com/remedy/Gout.html

Thanks Jami

I never actually had gout, but when I first started a low-carb diet I had my blood checked and my uric acid levels were through the roof and my doctor wanted to put me on meds.  I asked him for a six week reprieve and threw every home remedy I could find at find. 

From memory, the daily list went something like this...

no more than 25 g carbs
at least an hour of gentle excercise
loads of vitamin c and any other antioxidants I could find
a big dose of alpha-lipoic acid
20 cherries
a broad spectrum vitamin/mineral supplement, just in case I was lacking something

After six weeks I re-did the blood tests and my uric acid levels were on the low side of normal. But I have absolutely no idea which, or which combination, of the home-remedies brought about the 'cure'. 

I did read that uric acid is an antioxidant that the body makes when it feels the need, so if you top up the amount of antioxidants in the diet, the body doesn't bother making so much uric acid. 

A friend of ours gets severe gout attacks whenever he eats shellfish (crabs, lobsters, etc.) or large chunks of fat meat.  He knows it, but these things are part of his traditional diet and he just can’t stay off it.  Instead of changing his diet he takes medicine to make the pain go away.  The medicine will probably kill him by ruining his kidneys or liver.  Such is the force of habit.  I think, cutting down on meat and shellfish and eating more fruits and vegetables will probably do the trick in many cases.

Dieter

Thanks for the replies, I really appreciate them. I live by the code "if it comes from the sea, I don't eat it". I eat a lot of cherries, and stay away from the beans, etc. I can go for a year or two and everything is hunky dory, then wham, gout for two or three months off and on. People; let me tell you, unless you experience it yourself, you will never be able to imagine the pain. I have legitimate issues I can get pain meds from the VA and I turn them down because I try to manage with aspirin, but hello sister, the gout hurts.

Just stumbled on this page about natural food toxins. From the section on Purines:

When the body metabolizes purines - an aromatic organic compound whose derivatives are naturally occurring in foods as DNA/RNA constituents - inefficient enzyme action can result in the build up of their end metabolite, uric acid. It then crystallizes in joints, causing gout. Foods highest in purines are meats, and particularly organ meats.

But then there's a chart, and up at the top, far above the levels of ox liver and pig's heart, are brewer's yeast and theobromine, the alkaloid in chocolate.

I get gout in my big toes, so from now on I'm not buying any more nutritional yeast or raw cocoa nibs.

Edit: I posted this on my blog and someone pointed out that cocoa is only 2% theobromine, while ox liver is 100% ox liver, so even pure cocoa would not make the chart. Someone else argued that since kids don't get gout with any diet, the deeper issue is the declining capacity of your kidneys.

Yes, whenever the kidneys cannot excrete purines and related compounds fast enough, gout is possible.

Eat less, avoiding high purine foods in particular, but reduce the total burden on the kidneys. And drink more water. 

I think the reference to 'theobromine' means cocoa (Theobroma).  Theobromine is not a food but cocoa is. Theobromine is by definition 100% a purine, but the tables that list theobromine as a food to avoid say it has 2300 mg/100 g (ie, it is 2.3% purine) - which is obviously wrong for pure theobromine but could be right for cocoa. Caffeine and theophylline (in tea) are also purines.  Chocolate, coffee and tea need to be restricted if the goal is to reduce purines to bring down gout - these can add hundreds of milligrams of purine to the diet, which can be a problem for some people. 

Yikes! I think you're right about cocoa. Your numbers fit with the Wikipedia page on theobromine, which also puts cocoa around 2%.

I've done some more math. If cocoa is 2% purine, and a typical Endangered Species bar is 72% cocoa and 85 grams, that comes out to more than 1200 mg of purine. Going back to the purine chart on this page, that's as much purine as 500g of chicken liver. So in English units, a good chocolate bar causes more gout than a pound of chicken liver!

I describe my gout as "hit yourself in the foot with a sledgehammer, and you will understand."  I try to stay away from beef, as it contains high levels of uric acid, as do other meats in lesser degrees.  Interestingly, I have found that, during a gout attack, a lack of exercise (walking) makes it worse, and walking, although painful and slow, reduces the length of the gout attack.

I do take colchicine when it gets bad, it stops it quick.  However, today I discovered that the medicinal herb, germander, can be made into a tea as a tonic for gout.  I picked up a small plant today, will have to propogate it and try it out.

I suffer this curse.

My research indicates that its actually very often hereditary and not as diet-based as people think.  I have maintained an extremely healthy diet for years - one which I believe RanPrieur would respect as a lot of my theories came through him - yet started to suffer attacks anyway.

It is perhaps the most pain I have ever experienced.  Anyone who has had an attack can relate - even the pressure of a breeze in the room feels like an avil falling on your foot.  Its really ridiculously bad.

I've decided it is a case where I will take a pharmaceutical as long as its available - allopurinol.  It keeps the attacks at bay and from what I can determine, not very bad risk of unwanted effects.  Maybe someday I will believe that cherry juice works (I tried it for months before giving in).

I suggest the forums at http://www.goutpal.com/.

Sure, genetics play a role, some people have a constitution that makes them more likely to develop a particular disease.

But nothing we can do changes our genes. Medicines, herbs, diets, excercise - they don't change the ATGC cards we were dealt.  But all of these can be very useful in some circumstances.

I have had several friends tell me they have to go on cholesterol meds because 'it is genetic' ... seems that they (and their doctors) are convinced that pharmaceuticals trump genes while other therapies are ineffective in the face of genealogy. It's a silly fallacy.  But the bottom line is whatever works for a person is what works for them, effective treatments with minimal side effects are good. 

Moringa leaf reduces uric acid and other chemical markers of metabolic syndrome in a study on rats ... preliminary and may not apply to humans, but then again, it might.
http://www.ncbi.nlm.nih.gov/pubmed/20045461
Lots written about moringa as a permaculture plant on this website.

Ashawagandha ("Indian Ginseng") reduces symptoms of gouty arthritis in an animal model:
http://www.ncbi.nlm.nih.gov/pubmed/17084827
Ashwagandha is an easy to grow plant related to tomato/potato/etc. It grows further south than panax ginseng, loves the heat. It can be harvested after one year (while panax ginseng is slow growing and takes 4 or 5 years).

Anthocyanins from purple sweet potato reduce uric acid levels by 60% in a mouse model:
http://www.ncbi.nlm.nih.gov/pubmed/21433153

Olive leaf extract reduces uric acid in 2 models of metabolic dis-ease in rats:
http://www.ncbi.nlm.nih.gov/pubmed/20335636
http://www.ncbi.nlm.nih.gov/pubmed/8035301
Calcium channel blockers (including several blood pressure meds) also reduce uric acid levels.
http://www.ncbi.nlm.nih.gov/pubmed/20048433
Olive leaf extract coincidentally contains calcium channel blockers and lowers blood pressure (raising concerns about interactions with prescriptions and side effects with high doses). 


Here's a study that found that the kidney's ability to excrete uric acid is related to the pH of urine. In comparing a 'normal' high protein/high renal acid diet to an 'alkaline' diet with lower protein/lower renal acid load, the kidneys actually excreted more uric acid on the alkaline diet, even though dietary intake was lower. More fruits and veggies, less high protein foods might make a nice difference for some.   
http://www.ncbi.nlm.nih.gov/pubmed/20955624

High sugar levels in the diet also seem to be a way to elevate uric acid levels - seems to include sucrose and fructose.
High fructose elevates uric acid levels in healthy human males:
http://www.ncbi.nlm.nih.gov/pubmed/20029377

Regular alcohol use a risk factor for high uric acid levels in Japanese men:
http://www.ncbi.nlm.nih.gov/pubmed/21421297
Ten percent increase in high uric acid levels in light drinkers (less than 10 drinks per week) compared to non-drinkers, 40% increase in men drinking 11-20 drinks/week, 64% increase in men drinking 21-30 drinks per week, risk is 98% higher (double!) in men drinking more than 30 drinks a week.

As is often the case Johnathan your posts are excellent.

I haven't got a source for this (though I could probably find one in short order if I tried) but excess levels of iron lead to gout (while copper is protective). Men accumulate iron through their lives as a general rule, and as they age often times their muscles will start to break down releasing both Iron and uric acid, making the problem worse. So if you are having problems with gout the answer may be to start donating blood.

Thanks for all the good info.

Goutweed- Aegopodium podagraria, also known as ground elder or bishop's weed, is so named because it has historically been used to treat gout.  It's planted as an ornamental that often gets really pushy and takes over.  However, it was originally cultivated as a vegetable and is really tasty- just like celery.  You could bust out some multiple functions and eat the plant for food, benefit from the medicinal qualities and keep it from becoming too invasive all at the same time!

Stinging nettle is classic treatment for gout- the dried pre-flowering leaf as a long steeped infusion, several cupfuls a day.

And willow can be used to manage the pain.

(Full disclaimer: I don't have personal experience using these herbs specifically for gout, although I do have a friend just starting out on nettle and I hope to hear back from him soon.  This is just what I have learned from my herbal studies and thought it might be useful info to share. )

Of course, addressing the underlying cause if possible is ideal, otherwise you are just treating the symptoms.

Anthocyanins reduces inflammation from uric crystals very effectively. Anthocyanins are naturally occuring in most purplish-red fruits& veg. Potassium helps melt the Uric Acid crystals so that they can re-enter the bloodstream and be filtered out by the kidneys. Vitamin C slows the production of more Uric Acid. These beneficial compounds gradually become more ineffective the longer the fruit is off the vine (though Black Cherry Juice has quite a lot, as Black Cherries are loaded with anthocyanins) so eat your fruit fresh if you can.

foodstuff / Anthocyanin in mg per 100 g food

aubergine (egg plant) / 750
black currant / 130-400
blackberry / 83-326
blueberry / 25-497
cherry / 350-400
chokeberry / 200-1000
cranberry / 60-200
elderberry / 450
orange / ~200
radish / 11-60
raspberry 10-60
red currant / 80-420
red grape / 30-750
red onions / 7-21
red wine / 24-35
strawberry / 15-35


There really is no reason to resort to prescriptions meds if you have only occasional problems with Gout. Get a nice fresh basket of berries and eat them for dessert; you should be good to go by morning. Most people have horrid Gout when these foods are not in season. I've given this advice to many people and have received no few 'thank you!' gifts.


More info:

http://EzineArticles.com/2183535
http://tbfrascone.hubpages.com/hub/Cherries-and-Gout-Pain

My father used to get attacks fairly often till an older man on the farm told him about Queen Anne's Lace. Make a tea and drink. "About the nastiest thing you could ever taste" my father said, but he drank it twice a year for the last 15 - 20 years of his life and never had another attack (AFAIK). No personal experience, as I've never had gout, so YMMV.

A quick search found these.....

http://www.localharvest.org/wild-carrot-queen-annes-lace-tea-C20455

http://hollirichey.com/2010/06/24/queen-annes-lace-wild-carrot-for-weight-loss/

http://www.ryandrum.com/threeherbs.htm

Interesting info here! My husband ended up having symptoms very similar to gout (he never went to doc's for diagnosis) but we learned the well water was a big part of the culprit. Changing our water changed everything. However, he does say beer and heavy meats made it worse - and herbal teas for kidney (i.e. Nettle, Parsley, Dandelion, Juniper, etc.) made it better. He hates Cherry, but used Celery seeds with good success. Get good water - spring water or (at least at first) distilled will help wash the toxins out. He also noticed raw spinach, lamb's quarters and other plants with oxalic acid affected him too (cooked is OK, just not raw in large amounts). I hope this helps!

For those interested, if you live in the Northern USA, nearly everywhere is a plant called Field Bindweed. In the Himilayan system of Ayurveda, it is the SAME plant as what they term "Ashwagandha" - use the roots and tincture - see Todd Caldecott's website for more info.

Burdock root is good for gout too. You can include it as a food. I also use the stems as a celery substitute. Just peel them and chop. I use the roots in stir fry.

Lisa Allen wrote:For those interested, if you live in the Northern USA, nearly everywhere is a plant called Field Bindweed. In the Himilayan system of Ayurveda, it is the SAME plant as what they term "Ashwagandha" - use the roots and tincture - see Todd Caldecott's website for more info.

You have misread Caldecott. He said that some in the Himalayas use bindweed in place of Ashwagandha (ashwagandha likes the heat, not widely available in colder mountain regions). But they are two very different plants!! Field bindweed is Convolvulus arvensis, a species of morning glory. Ashwagandha is Withania somnifera, a nightshade that looks rather like a pepper plant. Their activities might overlap, but they are different herbs. Bindweed root might help with gout, I don't know. There is much less knowledge about its traditional uses as compared to ashwagandha.

http://www.toddcaldecott.com/index.php/herbs/learning-herbs/395-ashwagandha

Thank you Jonathan, but I did not misread Todd's article. Commercial Ashwagandha is indeed a different plant. What I was saying is that the medicinal USES of Field Bindweed root are the same and that it was the Himalayan one, and as noted by others here, even pre-dates the use of the commercial one that grows in warmer areas of India, where commercialization of crops is obviously an easier way in these regions. I am sorry to confuse the issue. Funny enough, we are talking more about this on this thread: https://permies.com/t/14563/permaculture/bindweed-quackgrass-holding-me-back

Since we are on the topic of Gout, and since I have become a homeopathic student, I have seen in my materials a few remedies to check out for those interested: Ledum, Plumbum met. and Urtica urens (which is the one that worked for my husband, perhaps next I will try low doses of Nettle tincture next haha). Please learn how homeopathy works before implementing these remedies but I thought I would pass it along for those of you who are already familiar with homeopathy use

I started a new thread talking about gout, gallstones, blood type and diet:

https://permies.com/t/72810/kitchen/Gout-blood-type-relationship-gallstone

Gout is a form of arthritis; it is characterized by sudden, severe attacks of pain, swelling, redness and tenderness in the joints, often the joint at the base of the big toe.

From what I have read, things to do to help:

Drink lots of water; take Vitamin C; 1 T apple cider vinegar before meals (most folks add it to a cup of water); eat cherries or drink cherry juice; eat celery or celery seeds;

Avoid - High Fructose Corn Syrup;

Avoid the following types of seafood, which are higher in purines than others: anchovies, herring, sardines, mussels, scallops, trout, haddock, mackerel and tuna.

Avoid meats such as liver, kidney and sweetbreads, which have high purine levels and contribute to high blood levels of uric acid

Losing weight may decrease uric acid levels in your body. But avoid fasting or rapid weight loss, since doing so may temporarily raise uric acid levels.

This information might be helpful during an attack of Gout:

Take medicine you have on hand. Start treatment immediately with over-the-counter ibuprofen (Motrin, Advil) or naproxen (Aleve), but never take aspirin, which can actually worsen an attack.  If you have had an attack before and your doctor has prescribed an anti-inflammatory medication to take in the event of another, take your prescribed medication as your doctor directed. If you are already taking a uric acid-lowering drug to reduce the risk of attacks, continue to take that drug through this attack.

Get a cane. Walking with a cane during an acute gout attack can help keep pressure off your painful joint.

Drink plenty of fluids. Staying hydrated helps flush out uric acid (the cause of your joint pain) and prevent kidney stones, another possible problem associated with high uric acid levels.  Aim for eight to 16 cups of fluids a day, at least half of them water.

A weight reduction diet for people who are overweight is important and following a Mediterranean diet probably has the most impact on uric acid levels and general health.

http://www.arthritis.org/about-arthritis/types/gout/articles/how-to-stop-a-gout-attack.php

Dealing with a Gout Flare-Up

Don't put any weight on the joint. This usually means staying off your feet as much as possible until the episode subsides. Any pressure you put on the joint will increase the pain and possibly damage the area further.

Keep the joint elevated. Let gravity help reduce inflammation by slowing the rush of blood to the painful joint.

Immobilize the joint. The less you move the joint, the better it will feel. Simply lying still will help, though you may want to build a splint for the injured joint.

Avoid icing or heating the area. Unlike other types of pain, gout doesn't respond well to heat or ice therapy. For instance, the warmth of a heating pad may feel good, but it will also speed up circulation, which will in turn increase inflammation by sending more white blood cells to the joint. On the other hand, crystals form more rapidly in low temperatures, so hold the ice. (By the way, doctors believe that gout tends to strike joints in the hands and feet for this very reason, since body temperatures are lowest in the extremities.)

Do keep your toes warm enough. Gout seems to rear up more often when it's chilly

Wear comfortable shoes. Styles that offer a lot of room for the toes are the best choice. A shoe with a narrow, pointed toe box forces the big toe inward, which can worsen gout pain.

Various mind and body techniques, such as progressive relaxation and meditation, can lead to an easing of pain.

Here's a simple relaxation technique that can ease pain and may reduce inflammation.

Wearing loose clothing, sit or lie down in a comfortable position. Begin breathing deeply and slowly. With each breath, invite a different part of your body to relax. Imagine each inhaled breath as light going to the joints of your body and each exhaled breath as the pain flowing out of your joints.

Continue the slow, deep breathing for as long as you are comfortable. When you are ready, slowly return to your normal rate and rhythm of breathing and open your eyes slowly.

Home Remedies from the Refrigerator

Cherries. Cherries may remove toxins from the body, clean the kidneys, and yes, even help give you a rosy complexion. Because of their cleansing power, they're at the top of the gout-relief list. If you can bake a cherry pie, you may be making a gout treatment. Cherry compote, cherry juice, cherry jam, cherry tea, cherry anything works.

Apple preserves. This may neutralize the acid that causes gout. Take as many apples as you wish, then peel, core, and slice. Simmer in a little water for three hours or more, until they turn thick, brown, and sweet. Refrigerate. Use as you would any preserve.

Spice Rack

Chicory. If you've been to New Orleans, you know the flavor. It's in the coffee, and it's definitely an acquired taste. Chicory is an old herb, its first use recorded around the first century A.D., and over the past 2,000 years it's seen many medicinal uses. Gout is one of them. Here's a recipe said to relieve symptoms. Mix 1 ounce chicory root to 1 pint boiling water, and take as much of it as you want. This can work as a poultice, too, when it is applied to the skin in the area affected by gout.

Mustard powder. Make a mustard plaster and apply to the achy joint. Mix 1 part mustard powder (or crushed mustard seeds) to 1 part whole wheat flour and add enough water to form a thick paste. Slather petroleum jelly, vegetable shortening, or lard on the affected area. Spread a thick coat of mustard paste on a piece of gauze or cloth, then apply over the greased-up area. Tape down and leave in place for several hours or overnight.

Thyme. Drink as a tea. Add 1 to 2 teaspoons to a cup of boiling water. Sweeten, and drink.

Take fish oil supplements to ease the inflammation that comes with gout.

https://health.howstuffworks.com/wellness/natural-medicine/home-remedies/home-remedies-for-gout2.htm

About ten years ago I had my first round of gout, but I didn't know what it was.  It went away.

In time, I learned.  And then I looked up purines.  It took me a few years to realize that one of my supplements (a type of algae) was off the charts for purines - so I cut that and that solved everything.

For a while.

I read that excess of vitamin c caused gout.  And/or an excess of calcium.  So I avoided those.

A year and a half ago I had gout so bad, in both feet, that I ...   well, it was really awful for ten days.  And it kept getting worse.  I was doing all the things, but it still got worse.  Then I gave the internet a powerful workout and stumbled across something that said that while it is true that too much vitamin C or calcium could cause gout, so could too little.  I took a tiny dose of each and in 30 minutes I felt 95% better.

A small dose of vitamin C, and a small dose of calcium.

(Note that it was a very high quality vitamin C, not simply ascorbic acid)

So simple and so much relief.


....  a year and a half passes until this week ...


I had eliminated the calcium supplement thinking that maybe it was only the vitamin c.  And, for other reasons, I bumped up the vitamin C.

Gout came back. Not as bad as the last time, but definitely gout.  

I pulled up this thread because it is time to get all this stuff in my head again.  For a couple of days I did all my old research and some new.  The gout seems to now be on the run.

The gout is now almost gone.  I want to write my notes here for next time. And maybe these notes can be mixed in with all the other notes to be of benefit to people.  

need to get it just right:

   vitamin C (about 200mg every six hours or so) https://amzn.to/483Oycy
   calcium (about 300mg every six hours or so) https://amzn.to/42rO5zG

cut out:

   chocolate
   hazelnuts
   liver supplement (made of organic beef liver)

more:

   water (LOTS!  more important than all other things combined)
   cassia cinnamon https://amzn.to/3Sqo4wd
   hold the foot up
   stinging nettle tea
   potassium (electrolyte stuff, and food sources)
       kale
       avacado
       pistachios https://amzn.to/48X7viF
       sweet potato
   gout pellets
       https://amzn.to/48Vd8xC
       https://amzn.to/49avpa2
       https://amzn.to/3SHqY0R
   turmeric
   fermented foods
   apples (apparently malic acid fights the uric acid?)
   more celery, especially the little leaves


I have heaps of cherry stuff and jumped on that.  But I'm not really sure if it does much.  I have a jar of stuff that is sorta like cherry jam - but sweetened with apple juice ( https://amzn.to/42oCMs6 ).  So I get the cherry factor, and the malic acid of the apples.  And yogurt is supposed to be ultra good - so I would put the cherry-jam-ish on that.  Not sure I wanna go down that road next time.

Go easy on the protein, and bump up the quality fats.


Here are some things I didn't try this time, but could be worth further exploration if needed:

   alpha-lipoic acid

   broad spectrum vitamins

   possibly due to high iron?