I couldn’t resist – sorry!All joking aside, Gout arthritis can be an extremely painful and debilitating dis-ease characterised by acute intense joint pain, typically involving the first joint of the big toe. Gout is a common type of arthritis caused by an increased concentration of uric acid in biological fluids.What happens with gout is that uric acid crystals are deposited in joints, tendons, kidneys and other tissues where they cause considerable inflammation and damage.  This increase in the uric acid concentration has three possible causes:

1. increased manufacture of uric acid (most common)
2. reduced ability to excrete uric acid (less common – about 30%)
3. overproduction and under excretion of uric acid (least common)

Further, secondary gout arthritis can be caused by kidney disease, diuretic therapy for high blood pressure and low-dose aspirin therapy which can cause decreased uric acid excretion. Several dietary factors are known to be causes of gout: consumption of alcohol, high purine content foods, fats and refined carbohydrates.Dietary treatment of gout focuses on reducing production of uric acid and enhancing urinary excretion:

1. Eliminate alcohol consumption – alcohol is the primary trigger in many people as it increases uric acid production while decreasing uric acid excretion – a double whammy!
2. Low-purine diet – foods containing high purine levels include anchovies, mackerel, mincemeat, goose, gravy, herring, organ meats (kidney, heart, liver, brains), sardines, scallops, yeast.
3. Reduce weight – weight reduction significantly decreases blood levels of uric acid
4. Limit protein intake – no more than 0.8 grams of protein per kg of body weight
5. Cherry cleanse – 1/2 lb of fresh or canned cherries (unsweetened) per day and/or 1 cup of cherry juice concentrated – lowers uric acid levels
6. Adequate fluid intake – very important step – keeps urine dilute and promotes uric acid excretion

Supplements – for an acute attack, diet modifications alone may not provide relief. Colchicine is the main pharmaceutical anti-inflammatory drug used in treating gout, however it doesn’t affect uric acid concentrations and its long-term side effects can include liver damage, depression, and respiratory depression. It does offer immediate short-term relief, but with gastrointestinal side effects. Try the following supplements for long-term relief:

1. Quercetin inhibits uric acid production – dosage 200-400 mg, 3 times per day, between meals
2. Folic acid (one of the B vitamins) inhibits production of uric acid – dosage 10-40 mg per day – Caution: if taking pharmaceuticals, this dosage may interfere with some drugs.
3. Bromelain – dosage 250-750 mg, 3 times per day, between meals – to reduce inflammation.

(Source: Encyclopedia of Natural Medicine, Murray, pp. 489-496)