Gout is a form of inflammatory arthritis caused by elevated levels of uric acid in the blood which crystallises. The crystals are deposited in joints, tendons, and surrounding tissues causing pain and inflammation.

Contributory factors to gout

High purine diet (see below)
Food intolerances
Diabetes and Insulin Resistance
Stress
Hypothyroidism
Excess weight
Over eating

Foods to include

Cherries
Celery
Apples
Blueberries
Low fat dairy foods e.g bio natural yoghurt, cottage cheese, semi skimmed milk.
Fruit and vegetables in abundance – ideally a variety of different colours. Especially kale, rocket, carrots, courgette, celery, kiwi, blackcurrants, apricots, bananas, mango and fresh parsley (herb), all of which are particularly alkaline forming. Fruit and vegetables are also rich in Vitamin C which can help to decrease uric acid levels, enhance kidney function and strengthen connective tissue.
Eggs
Nuts and seeds
Olives

Foods to reduce

Purines are natural compounds found in many foods. When purines are metabolised, they are broken down and their end product is uric acid. Therefore, eating purine rich foods can raise uric acid levels and exacerbate gout.

High purine foods:

red meats
organ meat (brain, liver, heart, kidneys, sweetbread, sausages)
dark fillet fishes (anchovies, sardines, mackerel, herring), fish roes,

Medium purine foods:

poultry
fish, shellfish
meat and fish extracts
gravies
mushrooms
peanuts
legumes (dried peas, lentils, soybeans, kidney beans)
oatmeal, wheat germ
yeast
asparagus, spinach, cauliflower, radishes, celery.

Other food/drinks to reduce:

alcohol
sugar foods e.g cakes, biscuits, chocolate, sweets
sugar sweetened fizzy drinks
fruit juice (except Cherry Active which does not contain sugar)
glucose fructose sugar found in some jams, biscuits and sauces

Staying hydrated

Drinking sufficient fluids such as water is essential. The water helps dilute the uric acid level and supports kidney function.
Coconut water can also be helping for hydration and balancing electrolytes.
Cherry Active is made from concentrated Montmorency cherries which are a rich source of anti inflammatory anthocyanins. The anthocyanins in cherries also help to maintain healthy levels of uric acid.

Other tips

During an attack add ¼ tsp of bicarbonate of soda to an 8oz glass of water. Mix well and drink it. You can do this 3 times daily. However, due to the sodium content this is not recommended if you have high blood pressure.

Homeopathic remedies

There are many homeopathic remedies for gout which are ideally prescribed by a qualified homeopath. However, the following are a few commonly used homeopathic remedies for gout which can easily be self prescribed. If available, buy a 30c potency and suck one pillule about 4 times a day for a couple of days during an attack. If there is no improvement within this time it is not the correct remedy and you may need a different one.

Colchicum:
Colchicum is a frequently used remedy for gout which can be anywhere but particularly in the big toe (especially the left). The affected area may be red, inflamed and extremely sensitive to touch. The person needing this remedy can’t bear to have the affected area touched or moved and is very wary of anyone coming anywhere near it. The pain is worse on motion and it can make them oversensitive and irritable. The person for which Colchicum is needed may also be prone to arthritis or rheumatism with swollen, inflamed joints which are excruciatingly painful to touch.

Benzoic Acid:
This remedy is indicated for gout of the joints of the hands and feet. The joints will be red and swollen and may crack on motion. The gout may start off in the toes and work its way up the body or it may start on the left side and travel to the right. Attacks of gout in a person needing this remedy may come on during the night. Another indication for this remedy is dark, strong smelling urine which is representative of the impaired uric acid metabolism.

Nux Vomica:
This is a remedy which is chosen more on its general indication than the specific gout symptoms. It is a great remedy for gout brought on by overindulgence in alcohol, rich food and coffee which may also upset the digestive system. The person needing Nux Vomica will almost always be irritable with the pain – irritability is one of the main guiding symptoms for this remedy. They may also be extremely stressed out and feel time pressured which is why they rely on coffee to keep going and alcohol to relax. They may have disturbed sleep, waking between 3am and 4am and lying awake for hours before finally dropping off to sleep shortly before they need o get up. This is one of my most frequently prescribed remedies for all sorts of complaints!

Narayani Gout Complex:
This is a combination of homeopathic remedies for gout. This remedy would need to be purchased from a qualified homeopath.

Supplements

There are a variety of supplements which may be helpful for managing gout, however, due to possible contraindications with medication or other health conditions I prefer to prescribe supplements personally.

Summary

Purines are found in a wide variety of foods, many of which have health promoting properties and it can be extremely restrictive to cut out purine containing foods completely. It is more about the balance of these foods in your diet. It is important to reduce meat and seafood as research shows that they are particularly associated with an increased risk of gout. The consumption of sugar sweetened fizzy drinks, fructose from fruit juices and fructose glucose syrup are also strongly associated with an increased risk of gout.

Moderate intake of purine-rich vegetables or protein is not associated with an increased risk of gout. Protein is really important for balancing blood sugar levels and thereby regulating insulin levels. Good sources of lower purine protein are eggs, chickpeas, beans, lentils, chicken, turkey and white fish.

Including a variety of vegetables is vital as they are alkaline forming which helps to neutralise the acid generated by eating protein rich foods.

As long as you are not dairy intolerant including low fat dairy products such as semi skimmed milk, bio yoghurt and cottage cheese can help to decrease episodes of gout.

This information is intended for general guidance only and is not intended to replace medical care.

If you would like to make an appointment with me I can help you put these recommendations into practice including personalised nutritional and supplement advice, meal ideas and complimentary homeopathic remedies.

Tanya Artus is a qualified and registered nutritional therapist and homeopath. She practices from Southbourne Physiotherapy clinic in Westcliff-on-Sea. For more information or to make an appointment with Tanya call 0793 253 5929, visit www.inspiringhealth.co.uk or email tanya@inspiringhealth.co.uk

References

Hyon K. Choi, M.D., Dr.P.H., Karen Atkinson, M.D., M.P.H., Elizabeth W. Karlson, M.D., Walter Willett,
M.D., Dr.P.H., and Gary Curhan, M.D., Sc.D, Purine-Rich Foods, Dairy and Protein Intake,
and the Risk of Gout in Men; n engl j med 350;11 www.nejm.org; March 11, 2004

Zhang Y., Neohi T; Chen C, Chaisson C, Hunter DJ, Choi HK; Cherry consumption and decreased risk
of recurrent gout attacks. Arthritis Rheum. 2012 Dec;64(12):4004-11. doi: 10.1002/art.34677.
Neogi T

ADEL G. FAM, MD, FRCPC ,Gout: Excess Calories, Purines, and Alcohol Intake and Beyond. Response
to a Urate-Lowering Diet, University of Toronto.

Hyon K Choi, Gary Curhan; Soft drinks, fructose consumption, and the risk of gout in men:
prospective cohort study; BMJ 2008;336:309