Gout

Gout is a form of arthritis that occurs when crystals of uric acid accumulate in a joint, leading to the sudden development of pain and inflammation. Individuals with gout either overproduce uric acid or are less efficient at eliminating it. The big toe is the most commonly afflicted joint to accumulate uric acid crystals, although other joints may be affected.

Lifestyle changes that may be helpful: Individuals who are overweight or have high blood pressure are at greater risk of developing gout.¹ Because gout is triggered by elevated uric acid levels, and since restriction of calories is known to increase uric acid levels temporarily, it makes sense not to lose weight rapidly.

Dietary changes that may be helpful: There is a very clear relationship between diet and gout. Foods that are high in a compound called purine raise uric acid levels in the body. Restricting purine intake can help control uric acid levels and in turn the risk of an attack in individuals susceptible to gout. Foods high in purine are generally protein-rich foods, such as sweetbreads, anchovies, mackerel, sardines, chicken, dried beans and peas, liver and other organ meats, herring, scallops, red meat, and turkey. Refer to the low-purine diet entry for more detailed information.

Avoiding alcohol, particularly beer, or limiting alcohol intake to one drink per day or less can reduce the number of attacks of gout.^{2 3} Refined sugars, including sucrose and fructose, should also be restricted, because they raise uric acid levels.⁴

According to a study of twelve individuals with gout from 1950, eating one-half pound of cherries or the equivalent amount of cherry juice prevented attacks of gout.⁵ Black, sweet yellow, and red sour cherries were all effective. Since that study, there have been many anecdotal reports of cherry juice as an effective treatment of the pain and inflammation of gout. The active ingredient in cherry juice remains unknown.

Individuals with gout should not consume nutritional yeast or brewer’s yeast, as they can raise uric acid levels.

Nutritional supplements that may be helpful: There is a limited number of studies indicating that large amounts of supplemental folic acid (up to 80 mg per day) reduce uric acid levels.⁶ However, other research does not confirm the effectiveness of folic acid.⁷

In one small study, vitamin C was shown to increase urinary excretion of uric acid.⁸ This enhanced excretion of uric acid from the body might be beneficial.

Quercetin, a bioflavonoid, inhibits the enzyme xanthine oxidase, which makes uric acid.⁹ Quercetin has shown anti-inflammatory effects in test tube studies.¹⁰ Although human research is lacking, some doctors of natural medicine recommend 150–250 mg of quercetin three times per day (taken between meals).

Are there any side effects or interactions? (Refer to individual supplement for complete information.) Folic acid is remarkably safe. However, folic acid supplements can mask a vitamin B12 deficiency in individuals lacking adequate vitamin B12, which could lead to permanent neurological damage. Although this problem is rare, folic acid and vitamin B12 should always be taken together, to prevent masked vitamin B12 deficiencies.

Some individuals develop diarrhea after as little as a few thousand milligrams of vitamin C per day, while others are not bothered by ten times this amount. However, high levels of vitamin C can deplete the body of copper, an essential nutrient. It is prudent to ensure adequate copper intake at higher intakes of vitamin C (copper is found in many multivitamin/mineral supplements). No clear toxicity has been identified with quercetin.

Herbs that may be helpful: Autumn crocus (Colchicum autumnale) is the herb from which the drug colchicine was originally isolated and is used as a conventional treatment for gout. The drug colchicine is much more commonly used than are herbal extracts of colchicum. Both the herb and the drug have significant toxicity and for this reason should only be used under the guidance of a physician.

Checklist for Gout

Nutritional Supplements	Herbs	Homeopathic Remedies
Folic acid Vitamin C Quercetin	No herbs commonly recommended for this condition	Nux vomica 6c Belladonna 6c Urtica urens 30c Colchicum 6c

 

References:

1. Loenen H, Eshuis H, Lowik M, et al. Serum uric acid correlates in elderly men and women with special reference to body composition and dietary intake (Dutch Nutrition Surveillance System). J Clin Epidemiol 1990;43(12):1297-1303.
2. Ralston SH, Capell HA, and Sturrock RD. Alcohol and response to treatment of gout. BMJ 1988;296:1641-2.
3. Scott JT. Alcohol and Gout. BMJ 1989;298:1054.
4. Emmerson BT. Effect of oral fructose on urate production. Ann Rheuma Dis 1974;33:276.
5. Blau LW. Cherry diet control for gout and arthritis. Tex Rep Biol Med 1950;8:309-11.
6. Oster KA. Xanthine oxidase and folic acid. Ann Intern Med 1977;87:252-3.
7. Boss GR, Ragsdale RA, Zettner A, et al. Failure of folic acid (pteroylglutamic acid) to affect hyperuricemia. J Lab Clin Med 1980;96:783-9.
8. Stein HB, et al. Ascorbic acid-induced uricosuria: a consequence of megavitamin therapy. Ann Intern Med 1976;84:385-8.
9. Bindoli A, Valente M, Cavallini L. Inhibitory action of quercetin on xanthine oxidase and xanthine dehydrogenase activity. Pharm Res Comm 1985;17:831-9.
10. Busse W, Kopp D, Middleton E. Flavonoid modulation of human neutrophil function. J Allerg Clin Immunol 1984;73:801-9

 

Copyright © 1998 Virtual Health, LLC

The information presented in HealthNotes Online is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. For many of the conditions discussed, treatment with prescription or over-the-counter medication is also available. Consult your physician, nutritionally-oriented health care practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications.