When you were young, you probably knew one or more older persons who struggled with rheumatism, arthrosis or gout. Today you probably have to think about whether these plagues will affect you. In modern society, gout, in particular, is an affliction of prosperity – too many good things, too often. Fortunately, we now know more about it than our grandparents, who just blamed their pain on their advanced age.
Arthrosis, rheumatism and gout have very similar symptoms but different causes. Arthrosis leads to pain from wear and tear of the joint cartilage. Rheumatism makes life difficult through a variety of similar joint diseases caused by a malfunction of the immune system. Gout, however, is a metabolic disease.
Going deep on gout.
Gout is triggered by elevated uric acid levels in the blood. In healthy people, uric acid usually dissolves into the bloodstream or is excreted by the kidneys through urine. With gout, however, the uric acid remains in the body, depositing tiny acid crystals in the joints, skin and tendons near the joints. For the average person, increased uric acid levels can continue for years without symptoms. But the older we get, and the longer uric acid levels rise unobserved, the higher the risk of gout.
Above a certain level, continuous crystal formation can lead to an acute attack of gout with severe pain, redness and swelling lasting several hours or even days. However, in contrast to the permanent pain of arthrosis, gout can attack the joints instantly, then symptoms can retreat altogether. However, this doesn't mean the gout is gone. Even those who experience one or more single seizures can develop chronic gout.
Gout symptoms include hard, painless deposits under the skin, called gout nodes. These are about one centimetre in size and contain a white mass of uric acid crystals. They mainly affect the big toe joints, but can also appear on hands, fingers, eyelids, ears and nostrils. Affected joints are extremely sensitive to touch of any kind.
If gout progresses unnoticed and untreated, i.e. becomes a chronic disease, it can also attack internal organs, such as the kidneys. Particularly devastating is the fact that chronic gout can permanently damage or even destroy joints. Extreme restrictions of mobility are one consequence, deformities of the affected parts another.
Orthodox medicine distinguishes between two different types of gout:
- Primary gout is a congenital metabolic disorder. In most patients, genetic inheritance reduces uric acid excretion via the kidneys.
- Secondary gout features increased uric acid production as a result of other diseases, such as kidney disease, leukaemia or poorly controlled diabetes.
Gout from good life?
Research shows our affluent society is an excellent breeding ground for the spread of gout. This disease occurs far more frequently in industrialized than in poorer countries because of the greater availability of a wide range of foods anytime, any place. This ready availability means we shovel more purines into our bodies every day than we need to thrive. Too much meat, alcohol and sweetened fruit juice don't just lead to obesity – they also promote an excess of purines.
It's important to remember, however, that even healthy choices can, when pushed to an extreme, cause the body to produce too many purines. Strict diets, for example, promote elevated uric acid levels and physical overexertion produces lactic acid that blocks the breakdown of uric acid in the kidneys.
Of course, you can counter gout head-on with cooling compresses or prescription non-steroidal anti-inflammatories that come with unpredictable side effects. However, the essential factor in controlling gout is diet.
Don't panic! You can breathe a sigh of relief because a special diet isn't necessary for gout. It's all about eating in a balanced way and avoiding extremes. Reducing purines is about maintaining a healthy, wholesome and happy medium.
Here are some tips to make sure gout doesn't rear its ugly head:
- Reduce alcohol or avoid it altogether. When alcohol breaks down, it slows down the kidney’s uric acid excretion. Even an occasional drink can trigger a gout attack. Beer with an unusually high purine content is an absolute no-go here, even in alcohol-free form.
- Eat only small portions of purine-containing food. Eating excessive quantities of meat, offal, sausage, seafood and certain fish species, like oily sardines, anchovies or herring, can provoke an acute attack of gout.
- Watch out for fructose. No longer found exclusively in fruit, fructose gives many juices, yoghurts and other foods their sweeter taste. When it breaks down, it forms purine and makes excreting uric acid via the kidneys more difficult.
- Reduce fatty foods. A low-fat diet is beneficial for uric acid excretion. Too much fat can slow it down. You may prefer to get your protein from low-fat dairy products instead of meat. Studies show even 250ml of skim milk or natural yoghurt every day is good for uric acid excretion.
- Drink up to two litres a day. The best choices for gout sufferers are sugar-free drinks such as water or unsweetened tea. The more you drink, the better the chances your uric acid levels will remain low and you can support your kidney's filter function to flush it out of your body quickly. By the way: coffee’s allowed!
Gout often emerges sporadically at first. But it remains malignant if you don’t actively work to diminish it. Get rid of gout and enjoy life without pain. You don't even have to do without much, just change a little – an occasional wine instead of a beer for example. Experts agree that this is entirely justifiable.
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Editorial office for nutrition: jk