Home Remedies For Gout

Yes, gout is still around, but it’s not just prime rib–downing, beer-swilling guys who get it. Women can develop it, too; in fact, it’s more common than rheumatoid arthritis in females! But what’s really surprising is that it’s really easy to cause gout with dietary supplements. I spend more time telling patients with gout what not to take as opposed to what to take to prevent this disease. Many doctors are surprised by what actually works and what’s worthless.

What is Gout?

Hippocrates called gout “the unwalkable disease” for obvious reasons. It’s an inflammatory condition of the joints that can be very painful. The culprit: increased blood levels of uric acid, which crystallizes and gets deposited in the joints. Elevated uric acid can be caused by diet (you’re at risk if your daily menu is heavy in meat, seafood, or alcohol, especially beer), genes, and reduced elimination by the kidneys (for some reason you’re not peeing enough out). Some medications, including diuretics and low-dose aspirin, can increase levels as well.

The risk of gout increases as we get older because our bodies are no longer as efficient at getting rid of uric acid and because our lifestyle choices, unfortunately, often lead to weight gain. And this leads me to the true reason gout is on the rise worldwide: because conditions like obesity, hypertension, metabolic syndrome, and type 2 diabetes—the epidemics of our time—increase uric acid levels.

Classic gout attacks cause sudden onset of pain, redness, and swelling and tenderness in one or more joints, especially the big toe (people say it feels like the big toe is on fire). Repeated episodes over the years can lead to clumps of uric acid called tophi in or around the joints as well as deformities in and around the affected joints. Besides pain and deformities, gout needs to be controlled and prevented because it is also a potential risk factor for chronic kidney disease, hyper-tension, and cardiovascular disease.

All that said, as a researcher and physician, I believe uric acid is one of the most fascinating compounds in the human body because it has antioxidant properties. For example, uric acid is found in the brain, where it may protect cells from oxidative stress. A higher level of uric acid is associated with a lower risk of the progression of Parkinson’s disease, and whether uric acid can slow the progression of multiple sclerosis is being studied. In other words, in the short term and in “normal” amounts, uric acid can potentially protect tissues from damage. But if it’s abnormally elevated over a long period of time, it can increase the risk of gout and other problems, like uric acid kidney stones. So, uric acid has both a positive and negative role in the body depending on the levels.

Home Remedies For Gout

1. Vitamin C 500 milligrams a day

In one clinical trial, people taking vitamin C (500 milligrams) reduced their uric acid levels by an average of 0.5 mg/dL; there was no change in the placebo group. The same dose reduced uric acid by as much as 1.5 mg/dL on average in individuals who had abnormally high uric acid levels to start with (>7.0 mg/dL). 

Good old cheap vitamin C appears to work by increasing the rate at which the kidneys filter uric acid into the urine and by preventing its reabsorption as it moves through the kidneys. Some studies suggest that higher daily doses—1,000 to 1,500 milligrams— may be more effective, but I believe they’re also risky because large doses of vitamin C can increase the chances of getting kidney stones. Per usual, I recommend starting at the lowest effective dosage for 2 to 3 months and working your way up if needed. If you’ve had kidney stones before, stick to the 500-milligram dose.

If regular vitamin C upsets your stomach, buffered or pH-neutral vitamin C (calcium ascorbate) might have fewer side effects, but its impact on uric acid levels is not as well known. Talk to your doctor if you want to give vitamin C a try. 

2. Cherry extract supplements

Cherry extract supplements are being studied by researchers to reduce the risk of gout attacks, with positive results (there’s strong data suggesting that eating cherries and drinking cherry juice can help as well.) The extract products I reviewed have much larger quantities of anthocyanins (anti-inflammatory compounds that may reduce gout attacks) and virtually none of the calories that the juice provides. When buying cherry extract, always look for an anthocyanin content of 100 milligrams per 500-milligram pill, or at least 20 percent.

But there may be another compound at work here: Bing cherries contain an unusually large amount of dehydroascorbic acid, a form of vitamin C that’s absorbed more quickly by the body than regular ascorbic acid. It’s also able to get to places that “normal” vitamin C can’t. For example, vitamin C itself cannot enter the brain via the blood due to the blood-brain barrier, but your noggin’ still has large concentrations of vitamin C.

How is this possible? Dehydroascorbic acid can pass through the blood-brain barrier, and the moment it crosses over, it gets changed back into ascorbic acid to help support brain functions! Kind of awesome (something my kid would say) and kind of groovy (something my father would say when he was my age) and kind of awesome-groovy-amazing (something I would say)! I have seen gout attacks reduced in plenty of individuals taking cherry extract supplements with prescription gout medication.

Studies have shown that eating 20 to 24 bing cherries daily (that’s about two servings and 90 to 100 calories) reduces the risk of an attack by almost 50 percent, but the supplements might work just as well (and without as many calories!). I recommend taking small amounts of liquid cherry extract (a couple of teaspoons a day) or 200 to 500 milligrams of cherry extract supplement (in pill form) with at least 20 percent anthocyanins in addition to your gout medication.

One word of warning here regarding fruit juices and health claims: Juice companies are funding research all over the place, whether it’s pomegranate juice for prostate cancer, cranberry juice for uri-nary tract infections, or cherry juice for gout. The FDA has sent warning letters to approximately 30 companies that manufacture, market, or distribute products made from cherries for making unproven claims about their ability to prevent or treat diseases, such as gout, arthritis, lupus, and fibromyalgia. Cherry juice may help, but I worry about the calories and sugar content. Opt for raw cherries or supplements. Also, watching your calorie intake can help you lose weight, which could correct your uric acid issue by itself, eliminating the need for gout-related pharmaceuticals and supplements altogether.

What Supplements Are Useless For Treating Gout?

Inosine (inosine monophosphate). This compound is involved in energy production in the body, so people frequently take it to improve athletic performance, energy, and general vitality. However, individuals with gout should not take this supplement because it can dramatically raise uric acid levels and increase the risk of kidney stones.

Niacin (vitamin B3)

For some reason, many experts believe that only the prescription drug niacin can increase the risk of gout, but supplements are equally guilty. It’s a small increase, but check with your doctor regardless. Niacin (in both forms) is under a lot of scrutiny right now anyway because it may not be as beneficial in reducing heart disease as researchers once thought.

Ribose (a.k.a. D-ribose)

Ribose (it usually comes in powder form) is a naturally occurring carbohydrate or simple sugar (monosaccharide) that is best known for being part of the structure of RNA, which is found in every cell and tells the body which proteins to form for various bodily functions. Ribose is also a component of ATP—the energy “currency” that your cells run on. It’s a popular energy-booster, and researchers are looking at D-ribose’s role in enhancing exercise performance and increasing energy levels in people with chronic fatigue and similar disorders. A few clinical trials found small increases in uric acid levels with supplementation of 5 to 10 grams per day of 

D-ribose

Although the bump wasn’t statistically significant—research-speak for being big enough to make any claims about—and the levels returned to normal after 14 days on average, I believe it is clinically significant for individuals who need to keep an eye on their uric acid levels, so I would avoid it if you have gout or a high risk for it.

White willow bark

This supplement is considered a “natural” version of aspirin because the active ingredient in it acts like aspirin. But aspirin can raise uric acid levels, and so can white willow bark. If your doctor tells you that you should be taking a low-dose aspirin daily, opt for a cheap, proven, over-the-counter brand and not the dietary supplements; they’re not standardized and you just don’t know how much of the active ingredient you’re getting.

What Lifestyle Changes Can Help With Gout?

Adjust your diet

People with gout should avoid foods high in purines, compounds that are converted to uric acid during digestion. This usually means cutting out meat, poultry, seafood, alcohol, and high-fat foods in general. Most people have a hard time doing this, so I suggest practicing moderation. Vegetables, nuts, legumes, whole grains, and fruits (not fruit juices or large servings of fruit) may help prevent gout, and dairy products may help encourage excretion of uric acid in the urine. You can still eat protein, just don’t make it the focus of every meal. If you’re unsure what to eat, speak with a nutrition-ist to create a healthy eating plan.

Lose weight

Being overweight doubles your risk of having a gout attack; obesity triples your risk. The less you weigh, the better your kidneys will be able to process and excrete uric acid. Increased muscle mass and healthy cholesterol levels are also associated with lower gout incidence.

Amp up

Coffee and caffeine intake may reduce uric acid. Yeah!!!

Limit your consumption of sugary drinks and fructose

Soft drinks and fructose-rich fruit and especially fruit juices (in particular, apple, grape, and orange juice) can increase uric acid levels. Always make sure you read the label and look for phrases like “low-calorie,” “zero sugar,” or “almost zero sugar.” Agave syrup is high in fructose (up to 90 percent in some cases), but sweeteners like brown sugar, brown rice syrup, and honey are lower. Regardless, you should still try to limit your intake. While the increased sugar does lead to uric acid production in the body, the extra calories and weight gain that these sugary drinks can cause is of bigger concern. One could argue that the popularity and increased intake of high-fructose corn syrup is probably partly to blame for the dramatic increase in gout that is being seen around the world.

What Else to Know About Gout?

Once you have a gout attack, you’re at higher risk for experiencing another one (especially if you don’t alter the lifestyle habits that contributed to it), just like with kidney stones. As a result, doctors generally handle it in two ways: They treat the attack and then manage the condition long term. During an attack, the goal is to reduce inflammation and pain, usually with medication. Afterward, the goal is to better control any diseases associated with gout, such as diabetes, hypertension, high cholesterol, and cardiovascular disease. Your doctor may prescribe medication to keep your uric acid levels low.

Gout should not be occurring in kids. If it does, it’s time to see a specialist. Doctors never used to see type 2 diabetes in kids, and now it’s a freakin’ epidemic. So, I assume we will be seeing a lot of gout in kids soon.

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