A First Aid Guide for Gout Attacks

Sometimes, gout can be a stealthy villain that would come and visit you when you least expect it. The excruciating pain can leave you in panic, which doesn’t really help in alleviating the symptoms. However, there are some really simple solutions to treating gout at its onset.

Pain and Swelling Treatment

Obviously, the pain and swelling are the first two things to address, and they can be addressed by following these common practices:

  • Elevate the affected joint to help reduce the swelling.
  • Use an ice pack to numb and soothe the pain.
  • Avoid putting pressure on the affected limb.
  • Take non-steroidal anti-inflammatory drugs (NSAIDs). They’ll help in controlling inflammation and reducing the pain during a sudden attack of gout. They can be bought over the counter (OTC) in the form of ibuprofen (e.g. Advil and Motrin) and naproxen (e.g. Aleve). Just take note that these medicines have side effects like stomach pain. For safety, always consult your doctor and keep an approved drug in stock.
  • Combine equal quantities of mustard powder and wheat powder. Add a little bit of water to form a paste. Apply the paste on the affected joint. Leave it overnight for effective pain relief.
  • For gout specifically in the foot, add charcoal powder to water for a soothing foot soak. Soak the feet in this solution for 30 minutes to an hour for pain relief.
  • Eat 15-20 cherries in the morning, preferably after waking up. This is a time-tested remedy for gout because cherries have anti-oxidants that relieve the inflammation of the affected joint. They also help prevent future gout attacks.

Uric Acid Elimination

Since pain and swelling are just symptoms, it’s better to treat the real cause of gout – the uric acid crystals that accumulate in the affected joints by following these simple remedies:

  • Drink plenty of water. If the blood is thin enough, the formation of uric acid crystals can be avoided.
  • Drink a solution of baking soda and water. Mix a teaspoon of baking soda in a glass of warm water. Because baking soda is sodium bicarbonate, it will help in neutralizing uric acid and stop the formation of the uric acid crystals in the joints.
  • For gout in the toes, mix three cups of ginger powder to water. Soak the foot in the solution for 30 minutes. It will help eliminate uric acid because ginger powder can make people sweat. Do not let the foot dry out; immediately wash the feet since ginger could irritate the skin.
  • Drink lime juice twice a day. Cut a lime in half and drink it with water. The citric acid in the lime will help in dissolving uric acid. Also, citric acid or vitamin C helps strengthen connective tissue, which is good for sore joints.
  • Eat apples after every meal. Apples contain malic acid that helps in neutralizing the uric acid, too.

These simple solutions could really help in alleviating the symptoms of a sudden gout attack. Despite the pain and swelling, having these procedures handy can help you combat that villainous gout attack and get back on your toes to seek professional help. As always, talking with a doctor would be the best thing to do to avoid any complications that may be unique to your medical or health requirements.

Gout and Turkey: Is Turkey Bad for Gout?

Gout is often associated with pain, discomfort, and suffering. It is never associated with the holidays even when the holiday season brings the gout-prone individuals closest to the food items that could bring about an attack. According to Johns Hopkins University, organ meats like hearts and livers and red meats such as pork, beef, and lamb increase the chances of getting a gout attack, which is no wonder why some people get it right after Christmas or some celebration. However, what of white meats like turkey? Does Thanksgiving also herald a gout attack?

According to the Mayo Clinic, turkey has a moderate amount of purine in it. It is the chemical precursor of uric acid, which is the main cause of gout attacks; the uric acid accumulates in the blood stream and causes urate crystal needs to accumulate in the joints of the big toe, which causes swelling and pain. Since there is purine in turkey, it can cause a gout attack even if it is not as high as those meats that were previously listed.

However, it does not mean that eating turkey at a Thanksgiving dinner would automatically bring on gout pains. The Mayo Clinic says that it can still be eaten, but it should be enjoyed in moderation. They recommend that a person limits eating turkey and poultry in general to only 4 to six ounces (or 113 up to 170 grams) on a daily basis. That should be enough to enjoy without totally getting incapacitated the next day.

Despite the sizeable amount that the Mayo Clinic has to offer, people should also take into consideration that when turkey is involved, other food items are also involved. They should also be wary of the beverages and side dishes – alcoholic beverages, beans, and mushrooms among many others – that come along with the turkey to ensure that they do not ingest food items that are moderately high in purines only to find out that they have eaten several varieties that would push them over the top.

Despite the risk that it poses, people who have gout can still enjoy turkey. They can still eat it, but still, there is a cautionary warning, especially when it is eaten with other food items that may have high purine content, too. As such, for people who enjoy their turkey during and after Thanksgiving dinner, it is still a possibility to eat, but off course, it is better safe than sorry. Eat only in moderation to avoid paying the consequences the next day.

References

  1. Gout diet
  2. Ask Your Doctor About Gout: Diet and Gout

Are Whey Protein Supplements Safe for Gout?

Gout Questions Answered

The market is being flooded by a lot of food supplements. There are supplements that promise to help in weight control, diabetes management, and even whitening. One type of supplement involves whey proteins, usually in the form of protein shakes. Whey proteins come from whey. Whey is a byproduct when cheese is made. Specifically, it is the liquid part, and the solid part is what we call curd. The manufacturers mention that they could help in reducing the risks of heart disease and even cancer. They also claim that whey protein supplements also help in body building because of its high protein content.

However, that same protein content makes people wonder if it could increase the likelihood of other diseases to occur or worsen, specifically gout. Basically, gout is an inflammation of the big toe. It is considered as an inflammatory type of arthritis characterized by redness, tenderness, and swelling. This condition is caused by an overabundance of uric acid in the system. Usually, the uric acid accumulates in a person’s system when there’s a problem in the breakdown of purines – usually found from protein-rich foods. If the purines do not break down properly, uric acid accumulates and crystallizes into tiny crystals that come into the joints of the big toe, causing gout. This begs the question: are whey protein supplements safe for people with gout?

Little is known about whey proteins and their effects on people with gout. However, there are some items that could be considered when sipping your favorite whey protein shake, especially if you’re concerned about gout.

According to some websites, whey protein supplements are actually low on purines. In fact, they claim that the process that the whey undergoes before they get to the familiar forms that we see such as protein shakes takes care of separating the milk by a process of isolation, whey protein should contain only small amounts of it. At any rate, dairy-based products are already low in purine content, so according to some experts, there’s little to no major threat. Moreover, a study in 2004 actually claimed that people who had a high intake of dairy products actually had lower risks for getting gout. Some say that this is because dairy products actually help our kidneys excrete uric acid better.

On the other hand, considering that whey protein supplements contain other substances that need to be filtered by the kidneys, there’s still a chance of getting gout. Since they are the major organs that filter out harmful substances from our body, the increased protein in your system could make it harder for them to do their job. Even if the whey protein supplements and protein shakes that we drink are not necessarily high in purines, they may lower your abilities to excrete uric acid.

As with all kinds of medication and health supplements, whey proteins still need to be further studied. Even though they have health benefits, something in it could be harmful for somebody. Also, there is not enough scientific study to link whey proteins to gout, so we cannot say yea or nay to this for certain. What is certain though is for you to consult with your physician regarding your condition, especially since supplements, specifically protein supplements, may have an effect on our bodies even if they come in the form of innocuous protein shakes.

Gout Questions Answered: What Is the Proper Blood Test for Gout?

For today’s question, we ask, “what kind of blood test should I get for gout?” or, even, “should I get a blood test if I have or if I suspect I have gout?”

First and foremost, many different scenarios may come to mind when the words “blood test” and “gout” are combined in a question—and we plan to tackle them all in typical Got Gout? fashion (straight to the point and not leaving anything behind).

Before we think of scenarios, let us answer the question in the simplest manner first. The blood test associated with gout is a specific type of blood test that checks the level of uric acid in the blood—particularly in the blood plasma. You may call it the uric acid blood test, or any name you wish so long as it gives you the results you’re looking for—concentration of uric acid in your blood. The test is done like any other blood test—by taking a sample of blood from a vein (usually in the arm) via needle and syringe. More information about the test before we end this article.

Moving on to scenarios, probably the first and most common scenario is when someone suspects he or she may have gout. Quite frankly, a good and experienced physician should be able to tell just by looking at the affected joint and/or by checking your symptoms if what you have is indeed gout. More often than not, a blood test may not even be required. If it is indeed gout, pain and anti-inflammatory medications are usually prescribed, then a follow-up visit to discuss long-term management (gout is a chronic ailment) which might include a blood test usually follows.

Another scenario arises when a patient is already a gout veteran—has either had an episode or multiple episodes of gout in the past. If no uric acid blood test has been administered in the history of the patient, a physician might order one to pinpoint something that might be causing the high uric acid levels. It may be that the patient simply consumes too much foods high in purines, has a hard time getting rid of uric acid—kidney problem—or worse, both.

Also part of the above scenario is when a doctor wants to find out if the course of treatment is working. Obviously, if it’s not working, certain adjustments should be made—a lifestyle change for the patient, perhaps.

A different scenario comes way before a gout attack even happens (should it happen). Gout is hereditary and if you have history, it may be wise, especially if you have come of age, to have your uric acid checked. At this point, all you may need is a simple adjustment in your diet. This can not only prevent you from experiencing excruciating pain, but save up on medical bills as well.

Going back to the blood test itself, the normal uric acid range falls between 3.6 mg/dL and 8.3 mg/dL or milligrams per decilitre. A high concentration of uric acid in the blood is called hyperuricemia and hypouricemia for the opposite. An abnormal concentration is not in itself a medical condition, but is associated with a medical condition such as, you guessed it, gout.

Uric acid can also be detected in the urine. A urine uric acid test also exists. This test comes in conjunction with the blood test to see if the kidneys are efficiently getting rid of uric acid. We will discuss this the urine test in detail in a future post.

Gout in Images: Elbow Gout

Wednesday has sort of unofficially become our Gout in Images day, so today we feature another set of photos related to gout: gout in the elbow.

Unlike most other joints commonly affected by gout, the elbows are more prone to other ailments that have symptoms of inflammation. Regular arthritis is one, and bursitis, the inflammation of the fluid-filled sac called the bursa between the tendon and skin, looks awfully like gout—especially in the elbow—under simple observation.

Anyway, below are some pictures you can use for comparison. The latter photos show tophi have formed. In this case, it would be hard to mistake the condition for any other except gout.

A word of warning once again, this post is not suited for those with a weak stomach.

elbow gout 01

The onset of gout in the elbow. Affected area is clearly swollen and red.

elbow gout 02

Once you feel something in your elbow, visit a physician. It is likely that they will take a fluid sample to analyze for uric acid crystals. Only then can an official diagnosis be made.

elbow gout 03

A more advanced case where tophus is already present.

elbow gout 04

Gout in women is rarer than in men. Older women, or those who are already menopausal, are more at risk.

elbow gout 05

Severe uric acid crystal formation.

elbow gout 06

Another severe and rare case of elbow gout where both elbows are affected.

elbow gout 07

Do not let it come to this. Cases like these have rendered elbows immovable and useless, and would already require removal surgery.

Is gout without high uric acid levels possible?

It may seem paradoxical but there are some rare cases wherein a low to normal uric acid level may present itself at the onset of gout.

Hyperuricemia is the condition where the level of uric acid in the blood is abnormally high. Gout cannot NOT be caused by this as it is the crystallization of uric acid—from concentration—and the buildup of this on joints that defines gout.

So, how then can gout happen without hyperuricemia?

It can therefore only mean that at the time of an attack, acute or chronic, when testing is conducted—uric acid test—the levels have already subsided or are temporarily normal.

This phenomenon can happen due to a number of reasons. Patients who suddenly find themselves under attack without a history of hyperuricemia may not be able to saturate their blood (serum) at certain temperatures, especially those required for proper testing. It may also be due to hyperuricemia that is only triggered by outside causal factors such as obesity and alcoholism. When these patients suddenly stop the affecting cause, perhaps from previous experiences with gout, they suddenly become normouricemic (from normouricemia—a state/condition of normal uric acid levels). Finally, it may also be due to an undergoing treatment cycle with a uricosuric drug, which might have just kicked in during the attack itself.

Whichever way, such are just technicalities or odd coincidences that happen. Gout and uric acid cannot be separated by strict medical definition. If at all, the more real irony is persistent hyperuricemia from people who do everything to avoid it. Such cases are hereditary, or, a case of bad genes that allow their bodies to hyper-metabolize purines (uric acid comes from the breakdown of purines) even at minute levels. Learn more about this and gout in general from browsing our other articles.

Gout Terms Defined: Polyarticular Gout

Welcome as we premiere another segment here at Got Gout? called Gout Terms Defined; what it is about is pretty much self-explanatory.

Definition of “polyarticular gout”

Today’s term is actually quite simple, even though it may seem and sound medically deep. “Polyarticular” comes from the Latin word articulus, which means joint or a joint. Polyarticular gout is nothing but gout that happens on multiple joints at the same time. It is the opposite of monoarticular gout, which is gout happening at only one joint. Most gout cases—even yours, probably—as long as only one joint is affected per episode is technically monoarticular gout.

Polyarticular gout happens; I would imagine it to be really painful and disturbing, as one is too much to handle already. They also say that it can happen to first-timers, accounting for about fifteen percent of recorded cases.

You might also encounter the term being paired with words such as “acute” and “tophaceous.” For example, acute polyarticular gout or tophaceous polyarticular gout. Acute in medicine simply means happening only once or in a short term. It is the opposite of chronic which is long term or recurring. Tophaceous is how one would describe the occurrence or presence of tophi. We just previously defined tophus (singular of tophi), which is the deposit of uric acid crystals enough to form a nodule or bulge out of the skin.

Gout Questions Answered: Is Gout Contagious?

Answering this question seems like a backwards move for Got Gout? as we have covered far more advanced topics in previous posts. However, this also marks our decision to conjure a regular questions-and-answers segment wherein we’ll answer every conceivable gout-related inquiry for any discerning patient—newbies or veterans alike.

So, going back to the question: NO, gout is NOT contagious.

Gout is not an infection; gout is not viral. It is caused by the decisions you make and the lifestyle you choose—the foods you eat, drinking, not exercising, or basically just not taking care of yourself. You cannot possibly give it to someone else just by staying near him or her. If at all, gout is believed to be hereditary which in a very technical way is still “passing it on to someone.”

However, birds of the same feather flock together. I guess it would also be pertinent to note that people from the same household eat the same foods. Friends drink when friends drink. People who do not exercise are probably surrounded by people who are alike. All we’re saying is don’t be surprised if you get gout just around the same time someone you know or are related to does.

Gout is caused by excess uric acid in the body, which is caused by eating foods high in purines. To know everything you need to know about this painful ailment, we highly suggest spending some more time in this site.

Gout in Images: Tophi

This series of photo posts will now become a regular feature here at Got Gout? Today, we follow suit from our previous what-are-tophi article. Gouty tophi, plural of tophus, are very deforming. Most of the pictures here are not for those with a weak stomach—don’t say we did not warn you, it will get really gory.

However, we shall start mildly.

tophus 01

Above is a micrograph—a photo taken from a microscope—of a tophus.

tophus 02

This next photo was taken from an arthroscope while performing removal surgery on a knee joint.

tophus 03

Tophi can occur almost anywhere on the body. Above, the uric acid crystals chose to accumulate on the outer ear.

tophus 04

Another tophus; this time on the helix of the ear.

tophus 05

Tophus on the elbow.

tophus 06

We move over to the hands. This is where it starts to get gory. Tophi at the joints of the finger.

tophus 07

An almost unusable hand with gouty tophi.

tophus 08

Extreme deformation at the index finger.

tophus 09

Just when you thought it couldn't get worse.

tophus 10

Jesus. You can clearly see the removed solidified uric acid crystals.

tophus 11

Picture above shows tophus and not just gout. Swelling from regular gout is more uniform.

tophus 12

Remember this photo? From our uric acid crystals post—surgery to remove crystals on toe.

Nuts About Gout: Do Nuts Cause Gout?

To be able to answer this question comprehensively, we need to first split it into two contexts: first is if nuts directly cause gout, and second, if nuts are bad for gout.

To tell you the truth, I am one of the many who have always associated nuts with gout. Call it wisdom of the elderly but I have always been under the impression that nuts are “high in uric acid.”

To explain how many levels of wrong that last statement was, we need to establish one thing: uric acid cannot be ingested. Uric acid is not present in foods, it is a byproduct (of our bodies) from the metabolism slash breakdown of purines. If at all, these alleged high uric acid foods are actually foods high in purines. Also, nuts are actually not high in purines.

So, going back to the original question(s), the first answer would be that nuts do not directly cause gout. However, to be able to answer the second question (are nuts bad for gout?) with absolute certainty, we need to clear up some technicalities.

Nuts by strict botanical definition are fruits. Examples include hazelnuts, chestnuts, pecans and acorns; these are what scientists call true nuts. However, there are other foods that moonlight as “nuts” such as cashew nuts, pistachios and peanuts.

True nuts are not high in purines. In fact, given that an ideal gout diet should be low in protein (but protein is essential for everyone), nuts are recommended as an alternative protein source along with low fat dairy and eggs.

Peanuts, on the other hand, are legumes like peas and beans. These are foods that fall in the moderate purine content category. If we are to visualize this protein source-purine content chart, those under low would include nuts and eggs, those under moderate would include legumes and beef, and those under high would include animal internal organs such as liver and kidney, and fish such as anchovies and sardines.

So there you go. Nuts do not cause gout. They do contain purines, as all protein sources do, but they are not that bad for gout—talking about true nuts. And, other “nuts” such as peanuts can still be consumed in moderation.