Gout

Menstuff® has compiled the following information on Gout.

Gout is one of the most controllable of the metabolic disorders. Left untreated however, it can lead to kidney disease and even death. It is a major risk factor in high blood pressure and coronary artery disease. It can also cause a stroke. Gout affects millions of Americans each year. The main symptom of Gout is severe pain, sometimes in your elbow or knee, but more often in your hand or foot and frequently at the base of your big toe. The pain usually comes without warning, though experienced sufferers may note some early twinges. Within a few hours your joint is so swollen and tender that you cannot endure even the weight of a sheet. There is often a fever of up to 101°F and the inflamed skin over the joint is likely to be red, shiny and dry.

The first attack usually involves only one joint and lasts only a few days. Sometimes there will be no more attacks but there is usually a second, which may not occur for months or years. After the second attack the gout occurs at shorter intervals, lasts longer and involves more and more joints. If the disease is not treated the inflammation of soft tissue around your joints and the irritation on overlying skin may degenerate. There may be symptoms of kidney damage, such as renal colic or kidney stones. Gout is a common form of joint disease. It can affect males after puberty but women get it generally only after menopause. Women are less likely to be affected than men.

Learning More

An excess of uric acid is the cause of Gout. It occurs when there is too much uric acid for the body to dispose of. It then settles into the joints and forms crystals that may lodge in areas of the body where blood flow is too meager or sluggish to carry them away. When uric acid crystals are caught in the spaces between one of your joints, the tissue surrounding it becomes inflamed. The inflammation irritates the nerve endings in the joint causing extreme pain. Sometimes the crystals also accumulate in the kidneys themselves, which may eventually cause kidney failure.

Since all human beings produce about as much uric acid as the kidneys can handle, everyone is, to some extent, susceptible to gout. However, some people are more susceptible than others for no apparent reason other than an inborn predisposition. Sometimes gout develops because of an environmental factor that upsets the uric acid balance. Such factors can include overindulgence in food or alcohol, infections, and treatment with some antibiotics.

1) Uric Acid Crystals can take a long time (months or years) to accumulate, most commonly in connective tissues in and around joints, especially in the lower limbs. During this period there may well be no symptoms whatsoever. About 95% of people with hyperuricaemia will not have a gout attack throughout their lives. However, they may experience pain and discomfort from crystallized uric acid in their joints. Pain in the heel, "Achilles Tendon", is very common. Sometimes uric acid problems are even misdiagnosed as Rheumatoid Arthritis. The uric acid crystals will cut into the synovial fluid sacks that cushion all joints releasing the synovial fluid into the blood. This can cause blood readings to indicate Rheumatoid Arthritis when in fact the problem is really uric acid crystals.

2) Acute attacks where a single joint is almost always involved in all initial episodes, and most often in the joint of the big toe. Typically local irritation and aching proceeds to tissues becoming swollen, red, hot, shiny and extremely painful. The pain is often describes as the worst ever experienced.

3) These are periods between attacks. Some never have a second attack, or perhaps after many years, but in most the second attack occurs with a year. The frequency of attacks and number different places the attacks occur then increase with time, leading eventually to joint damage and chronic pain, after an average of about 10 years.

4) Chronic tophaceous gout large crystal deposits, or tophi, produce irregular firm nodules, predominantly around the upper surfaces of the fingers and hands, but other places as well, including forearms or Achilles tendons or ears. When untreated, these can lead to severe deformity.

The Uric acid problem do not manifest themselves overnight but instead are the results of years of more uric acid being produced than you expel on a daily basis. Each day your system has produced a little more than it secreted leading up to your first attack. If we do not bring the system back down to a manageable level then new attacks can become more frequent.

The uric acid that is floating in your blood supply has nothing to do with the uric acid that has become crystallized and is now residing in connective tissue. This uric acid cannot be measured but is always there in a solid form melting when the levels in the blood allow and adding to when levels in the blood become to high for the blood to carry. These deposits are what migrate into the joint causing the "Gout Attack," when the tissue is full and your indulgence in foods produce more uric acid than your blood can hold and uric acid starts to crystallize between bone joints.

If you look at your uric acid metabolic process as a 16 ounce glass. When you are young your glass has 6 ounces. After years of eating foods that are high in purines and are acidic your glass is now at 14 ounces and 16 ounces results in a gout attack. An average meal in purines may bring you up to 15.5 and your system within 4 to 6 hours brings it back to 14.1 this is repeated until one day you top the 16 ounces and you are now in a gout attack.

This melting of old stored uric acid is also the reason the non chlorinated water in large amounts is needed to flush the newly melted uric acid out of your blood supply and past your kidneys.

Uric acid

Humans excrete a nitrogenous waste, uric acid. It is the product of nucleic acid, not a protein,of the metabolism.

Uric acid is the end metabolism product of purine, purine being the nitrogen-containing compound that occurs in nucleic acid. Confusion arises between the purine and protein, but they’re a totally different chemical structure however most foods that contain protein also have purines.

Uric acid is only slightly soluble in water and may precipitate out of solution contributing to the formation of kidney stones. Uric acid may also form needle like crystals in one or more joints producing the excruciating pain of a acute gout attack.

Curiously, our kidneys reclaim most of the uric acid filtered at the glomeruli. Why, if it can cause problems? Uric acid is a potent antioxidant and thus can protect cells from DNA damage. In our blood, for example, uric acid serves as an antioxidant and helps prevent damage to our blood vessel linings, so a continual supply of uric acid is important for protecting our blood vessels.

People who suffer with gout usually either overproduce uric acid or under excrete it. In severe cases a person may fall into both categories, causing severe gout attacks over and over again. A test for uric acid in the blood will not show the amount of uric acid that is crystallized in connective tissue waiting to cause the next Acute Attack.

Atkins Diet and Gout

Not only is this diet full of purines that cause excess uric acid production, but the diet also causes stored body fat to be consumed thereby releasing more uric acid. This is a double dose of uric acid for the gout sufferer causing an overload on the system and perhaps creating some of the worst gout attacks and build up of in connective tissue an individual has ever experienced. Gout sufferers after they cleanse their system can use a modified Atkins diet for weight loss.

All of the foods below can be responsible for excessive uric acid production. Even though some do not contain purines, they can still cause the system to naturally produce uric acid. They are as follows: alcohol, anchovies, asparagus, cauliflower, mushrooms, consommé, herring, meat gravies, broth, bouillon, mussels, sardines, red meats, organ meats, processed meats (hot dogs, lunch meats, etc.), fried foods, roasted nuts, any food cooked in oil (heated oil destroys vitamin E), rich foods (cakes, sugar products, white flour products), dark greens vegetables, dried fruits, fish, caffeine, beans, lentils, eggs, oatmeal, peas, poultry, yeast products, acetaminophen, and low doses of aspirin.

While under a Gout Attack all of the above foods should be completely avoided as well as the following.

Extremely Acid Forming Foods - with a pH of 5.0 to 5.5

Artificial sweeteners, Carbonated soft drinks & fizzy drinks , Cigarettes , Flour (white wheat), Goat, Lamb, Pastries & cakes from white flour, Pork, Sugar, Beer, Brown sugar, Deer, Chocolate, Coffee , Custard with white sugar, Jams, Jellies, Liquor , Pasta, Rabbit, Semolina, Table salt refined & iodized, Tea black, Turkey, Wheat bread, White rice, vinegar.

Unfortunately, many people with gout continue to suffer because knowledge of effective treatments has been slow to spread to patients and their physicians.

Gout is caused by an excess of uric acid in the body. This excess can be caused by an increase in production by the body, by under-elimination of uric acid by the kidneys or by increased intake of foods containing purines which are metabolized to uric acid in the body.

With time, elevated levels of uric acid in the blood may lead to deposits around joints. Eventually, the uric acid may form needle-like crystals in joints, leading to acute gout attacks. Uric acid may also collect under the skin as tophi or in the urinary tract as kidney stones.

Gout afflicts an estimated 840 out of 100,000 people. Gout and its complications occur more commonly and at a younger age in males.

The definitive diagnosis of gout is dependent on finding uric acid crystals in the joint fluid during an acute attack. Uric acid levels in the blood alone are often misleading and may be transiently normal or even low. Additionally, uric acid levels are often elevated in individuals without gout.

Traditional Medical Treatments

No medical treatment is usually advised for asymptomatic hyperuricemia (high uric acid levels with no symptoms) mainly because of the side effects associated with traditional medical treatments.

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