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GOUT
Description
Gout, also known as gouty arthritis, results from monosodium urate deposits that cause red, swollen, and acutely painful joints. Gout may affect any joint but mostly affects those in the feet, especially the great toe, ankle and midfoot.1
Causes
Painful
gouty arthritis is caused by uric acid crystal deposits in joint tissue.
This happens when uric acid levels in the body are abnormally high.
The underlying cause of primary gout is not clearly understood but in many
patients the disease results from decreased renal excretion of uric acid.
In a few patients gout is linked to a genetic defect in purine metabolism
that causes an overproduction of uric acid.2
Gout and hyperuricemia can be promoted by obesity, acute weight gain, alcohol
intake, high blood pressure, abnormal kidney function, and certain drugs.
Types
Primary gout typically occurs in men over thirty and postmenopausal women who take diuretics. Secondary gout develops during the course of another illness (i.e. obesity, diabetes mellitus, hypertension, renal disease and others) or following treatment with drugs (i.e. hydrochlorothianzide).3
At Risk
The tendency to develop gout and elevated blood uric acid level (hyperuricemia) is often inherited.
Prevention and Management
General:
Gouty
arthritis attacks can be precipitated by dehydration, injury, fever, heavy
eating, heavy drinking of alcohol, and recent surgery. Because obesity may
be a factor in secondary gout, weight loss is often suggested.
Almost all people with gout have too much uric acid in their blood, a condition
called hyperuricemia. However, there are many people who have hyperuricemia
but not gout.
It is important to drink plenty of fluids.
Nutritional Influences:
Adjunct
therapy attempts to reduce the consumption of alcohol and purine-rich foods
such as anchovies, liver, sardines, kidneys, sweet-breads, lentils and other
beans.
An experimental study suggested that vitamin C lowers uric acid levels in
serum by increasing renal excretion.4
Zinc levels may be depressed during disease activity.5
Healthier Lifestyles Product Recommendations
Additional Information
http://www.medicinenet.com
http://www.ohsu.edu/cliniweb
http://weber.u.washington.edu
Abstracts
Emmerson BT. The management of gout. N Engl J Med 1996 Feb 15;334(7):445-51. We now have sufficient knowledge to be able to identify the factors contributing to hyperuricemia in most patients with gout. Some of these factors, such as obesity, a high-purine diet, regular alcohol consumption, and diuretic therapy, may be correctable. In patients with persistent hyperuricemia, regular medication should lower the serum urate concentration to an optimal level. The continuing challenge is to educate patients about correctable factors and the importance of regular medication and ensure their compliance so that attacks of gout do not recur.
1
Diseases. Springhouse (PA):Springhouse Corporation; 1993 p 50.
2 Diseases. 2nd ed. Springhouse (PA):Springhouse Corporation; 1993. p 898.
3 Diseases. 2nd ed. Springhouse (PA):Springhouse Corporation; 1993. p 893.
4 Stein HB et al. Ascorbic acid-induced uricosuria: A consequence of megavitamin
therapy. Ann Intern Med 1976;84(4):385-8.
5 Mataroan Perez L et al. [Zinc in arthrosis and microcrystalline arthritis].
Rev Clin Esp 1991;189(2):60-2.
Information provided by Usana Health Sciences (www.usana.com)