Alcohol is known to have diuretic effects which can contribute to dehydration and precipitate acute gout attacks.
Alcohol can also affect uric acid metabolism and cause hyperuricemia. It causes gout by impeding (slowing down) the excretion of uric acid from the kidneys as well as by causing dehydration, which precipitates the crystals in the joints.
Gout is one of the most painful rheumatic diseases. It results from deposits of needle-like crystals of uric acid in connective tissue, in the joint space between two bones, or in both.
These deposits lead to inflammatory arthritis, which causes swelling, redness, heat, pain, and stiffness in the joints. The term arthritis refers to more than 100 different rheumatic diseases that affect the joints, muscles, and bones, as well as other tissues and structures. Gout accounts for approximately 5 percent of all cases of arthritis.
Signs and Symptoms of Gout
- Hyperuricemia (high level of uric acid in the blood)
- Presence of uric acid crystals in joint fluid
- More than one attack of acute arthritis
- Arthritis that develops in 1 day, producing a swollen, red, and warm joint
- Attack of arthritis in only one joint, usually the toe, ankle, or knee
Pseudogout is sometimes confused with gout because it produces similar symptoms of inflammation. However, in this condition, also called chondrocalcinosis, deposits are made up of calcium phosphate crystals, not uric acid. Therefore, pseudogout is treated somewhat differently and is not reviewed in this booklet.
Uric acid is a substance that results from the breakdown of purines, which are part of all human tissue and are found in many foods. Normally, uric acid is dissolved in the blood and passed through the kidneys into the urine, where it is eliminated.
If the body increases its production of uric acid or if the kidneys do not eliminate enough uric acid from the body, levels of it build up in the blood (a condition called hyperuricemia). Hyperuricemia also may result when a person eats too many high-purine foods, such as liver, dried beans and peas, anchovies, and gravies.
Hyperuricemia is not a disease, and by itself it is not dangerous. However, if excess uric acid crystals form as a result of hyperuricemia, gout can develop. The excess crystals build up in the joint spaces, causing inflammation.
Deposits of uric acid, called tophi (singular: tophus), can appear as lumps under the skin around the joints and at the rim of the ear. In addition, uric acid crystals can collect in the kidneys and cause kidney stones.
For many people, gout initially affects the joints in the big toe. Sometime during the course of the disease, gout will affect the big toe in about 75 percent of patients. It also can affect the instep, ankles, heels, knees, wrists, fingers, and elbows. The disease can progress through four stages:
Asymptomatic (without symptoms) hyperuricemia–In this stage, a person has elevated levels of uric acid in the blood but no other symptoms. A person in this stage does not usually require treatment.
Acute gout, or acute gouty arthritis–In this stage, hyperuricemia has caused the deposit of uric acid crystals in joint spaces. This leads to a sudden onset of intense pain and swelling in the joints, which also may be warm and very tender.
An acute attack commonly occurs at night and can be triggered by stressful events, alcohol or drugs, or the presence of another illness. Early attacks usually subside within 3 to 10 days, even without treatment, and the next attack may not occur for months or even years. Over time, however, attacks can last longer and occur more frequently.
Interval or intercritical gout–This is the period between acute attacks. In this stage, a person does not have any symptoms and has normal joint function.
Chronic tophaceous gout–This is the most disabling stage of gout and usually develops over a long period, such as 10 years.
In this stage, the disease has caused permanent damage to the affected joints and sometimes to the kidneys. With proper treatment, most people with gout do not progress to this advanced stage.
What Causes Gout?
A number of risk factors are related to the development of hyperuricemia and gout:
- Gender and age are related to the risk of developing gout; it is more common in men than in women and more common in adults than in children.
- Being overweight increases the risk of developing hyperuricemia and gout because there is more tissue available for turnover or breakdown, which leads to excess uric acid production.
- Drinking too much alcohol can lead to hyperuricemia because it interferes with the removal of uric acid from the body.
- Eating too many foods rich in purines can cause or aggravate gout in some people.
- Exposure to lead in the environment can cause gout.
Gout is a form of arthritis that develops when there is a build up of uric acid in the blood. When the uric acid levels get high enough, it collects in the joints. The joint that is usually first and most severely affected is the big toe joint.
As this uric acid collects in the toe joint, it forms crystals in the shape of a needle. These needle like crystals cause a stabbing pain, sometimes excruciating pain, plus swelling. The affected toe is like an inside out pin cushion. OUCH!!!
Gout is closely related to the foods you eat. The natural approach to Gout would be to change your diet and increase your fluid intake.
There are foods that cause an increase in uric acid and they should be greatly curtailed from the diet. These foods are:
- meats & gravies,
- alcoholic beverages,
- fried foods. They should also try to avoid rich cakes and pies.
Some studies have shown a vitamin deficiency of vitamin B5, vitamin A, and vitamin E contribute to the disease process of Gout.
Foods that can neutralize uric acid are celery and avocados, so these can be eaten freely.
It is necessary to increase water intake also as this will help flush the uric acid out.
Herbs that help to neutralize uric acid are alfalfa, burdock, hyssop and juniper. Alfalfa is the strongest of these herbs and the first choice.
Other Proposed Natural Treatments
Aspartic Acid, Bromelain, Celery Juice, Cherry Juice, Devil’s Claw, Fish Oil, Folate (folic acid), Selenium, Vitamin A, and Vitamin E.
Gout is an inflammatory condition that is caused by the deposit of uric acid crystals in joints (most famously the big toe) as well as other tissues. Typically, attacks of fierce pain, redness, swelling, and heat punctuate pain-free intervals.
Medical treatment consists of anti-inflammatory drugs for acute attacks and of uric acid-lowering drugs for prevention.
Proposed Treatments for Gout
The following herbs and supplements are widely recommended for gout, but they have not yet been scientifically proven effective.
Folate has been recommended as a preventive treatment for gout for at least 20 years. Some clinicians report that it can be highly effective.
However, what little scientific evidence we have on the method is contradictory.1,2,3 It has been suggested that a contaminant found in folate, pterin-6-aldehyde, may actually be responsible for the positive effects observed by some clinicians.
For more information, including dosage and safety issues, see the full folate article.
The herb devil’s claw is sometimes recommended as a pain-relieving treatment for gout based on evidence for its effectiveness in various forms of arthritis.4
For more information, including dosage and safety issues, see the full devil’s claw article.
Celery juice is a folk remedy for gout that is said to be widely used in Australia.
On the basis of interesting reasoning, but no concrete evidence of effectiveness, fish oil, vitamin E, selenium, bromelain, vitamin A, and aspartic acid have also been recommended for both prevention and treatment of gout.