When I recently ran into an old friend of mine named Terry I couldn't help but notice he was limping. The problem: He'd hurt his toe playing basketball. Or that's what he thought anyway. A few days later Terry called me to ask for some health references. Turns out, an intense game of pickup basketball wasn't the cause of the toe pain. At age 29 Terry had been diagnosed with gout, a health problem more common to people over the age of 40. I was able to steer Terry to several good sources of information about treating gout without the use of prescription drugs or non-steroidal anti-inflammatory drugs (NSAIDs). I'll have more on those sources in a moment, but first I'll tell you about a new study that examines factors that increase the risk of developing gout. This study won't be helpful for Terry, but it will for many others who may be able to fend off this condition that has no cure. By some estimates, as many as three quarters of all gout patients have inherited a genetic condition that inhibits the excretion of uric acid. Kidney failure and a high intake of diuretic drugs or diuretic foods (such as liver) can also cause this problem. The other precursor of gout - the excessive production of uric acid - is triggered by hereditary factors too, as well as excessive alcohol consumption and obesity. The last item on that list was the focus of researchers at Massachusetts General Hospital (MGH) in Boston who devised a study to evaluate the risk of gout associated with obesity and weight change. Hypertension and diuretic drug use were also considered. The MGH team examined 12 years of medical records for more than 47,000 men, aged 40 to 75 years, who participated in the Health Professionals Follow-up Study. At the outset, none of the men had gout. During the data-gathering period 730 cases of gout were diagnosed. When subjects whose normal weight was on the low side were compared to subjects with higher body weights, the risk of gout generally increased as weight increased. Other results:
- Gout risk was more than four times higher among obese subjects compared to those with normal weight
- Subjects who reported losing 10 or more pounds during the 12-year study period had nearly 40 percent lower risk of gout compared to those whose weight didn't change
- Subjects who took diuretic drugs had more than one and a half times higher risk of gout compared to those who didn't
- Subjects with high blood pressure had more than two times the risk of gout compared to those with normal blood pressure
The MGH study didn't examine the effects of weight gain or loss on subjects already diagnosed with gout, so the results won't have an impact on Terry's case. But given the fact that there's no downside to avoiding obesity, it's safe to say that Terry can only help his cause if he stays fit by continuing with the pickup basketball games.
In the e-Alert "Bowl of Cherries" (1/28/04), I told you about a colleague of mine here at HSI named Ramsey who has coped with gout for several years. When Ramsey was first diagnosed he did some research and came across what was described as an old wives tale: Cherries relieve gout. The source he found said to eat two pounds of cherries at the onset of an attack. That's a lot of cherries, but when he tried it, the duration of his gout attacks was cut in half. Ramsey also found helpful advice from a book, titled "Getting Rid of Gout: A Guide to Management and Prevention" by Bryan Emerson (Oxford University Press, 1996), which has information about foods that can trigger gout attacks (such as fish, broccoli, asparagus, coffee and orange juice), and tips for lessening the effects of an attack (such as drinking cherry juice, in addition to eating cherries). Drinking lots of water also helps flush uric acid from the system. Organ meat is another trigger that Ramsey has to steer clear of. In fact, high protein diets in general can increase uric acid production and aggravate gout symptoms. In a follow-up to that January 2004 e-Alert, I shared some e-mails I received from HSI members who had found other ways to treat gout. A member named Ernie wrote: "You missed the best one…Celery seed will stop gout attacks, and it has many other benefits." Several other members also wrote to suggest using celery seed, which can be taken in extract form. And Ernie is correct about celery seed benefits; in addition to gout relief, celery seed is also reputed to reduce inflammation, calm muscle spasms and fight bacteria. Another botanical used to reduce gout pain is extract of juniper, rich in antioxidant flavonoids. A member named Lee writes: "A friend who also has gout suggested Juniper. It works well for me and relief is usually within a few hours! I take 2,500 mg capsules 2 or 3 times the first day. I then take 1 cap. 3x/day until the pain is gone completely, rarely more that 3 days." A visit to the chiropractor was so effective for a member named Kris that she categorizes it as a cure. And practicing yoga might lead to relief, according to a member named CL who says, "I teach the Bikram Style of Hatha Yoga and I have seen many students heal their gout pain thru Yoga." Coincidentally, Terry's wife happens to be a yoga teacher. Maybe it's time to trade in the hoops for a Yoga mat. To Your Good Health, Jenny Thompson
Health Sciences Institute
Sources:
"Obesity, Weight Change, Hypertension, Diuretic Use, And Risk of Gout in Men" Archives of Internal Medicine, Vol. 165, No. 7, 4/11/05, archinte.ama-assn.org "Weight Loss Reduces Risk for Gout" Reuters Health, 4/15/05, reutershealth.com | 
