WHAT IS IT?
An increase in blood serum uric acid level – this is the final breakdown of purine (found in high protein foods) metabolism in biologic fluid. Purines are natural substances found in all cells/virtually all foods and provide part of the chemical structure of genes.
Urate crystal, needle-like deposits in joints, tendons, kidneys and other tissues causing inflammation and damage.
Causes: lead toxicity, alcohol excess, high purine diet, obesity, metabolic stress, low fluid intake.
Although uric acid will normally dissolve in the blood and pass through the kidneys with no damage, it is possible for the body to produce too much uric acid or to excrete too little in the urine.
Besides gout, elevated uric acid is related to a variety of other health conditions, including:
High blood pressure
Eliminate alcohol whilst having an attack – in particular beer – alcohol inhibits uric acid excretion by kidneys.
Weight loss – excess weight worsens gout due to nerve endings being further irritated by the stress of extra weight.
Low-purine diet (see list of foods below).
High complex carbs – wholegrain products / vegetables and fruits.
Low refined carbohydrates such as cakes, biscuits, sweets, white bread/pasta etc. – increases urate production.
Low fat/protein – protein should comprise of no more than 0.8g/kg of body weight /day during an attack. Saturated fats increase urate retention.
Increase fluids, especially pure water.
Eat liberally: cherries, blueberries and other berries as they are shown to lower uric acid.
Teaspoon of apple cider vinegar (with the mother) on rising, mid morning and lunchtime has shown to be effective in decreasing and then eliminating pain in some people.
Eating pineapple between meals (include the harder middle part) – enzymes and an anti-inflammatory (due to the bromelain in the pineapple).
Avoid soft drinks and juices– these will increase uric acid.
No vitamin C supplements whilst having an attack – may increase urate in a small number of people.
No Niacin (Vitamin B3) above 50mg/day. It competes with urate for excretion.
Immediate pain relief naturally – try cayenne/capsaicin cream. It helps to alleviate pain by depleting your body’s supply of substance P, a chemical component of nerve cells that transmits pain signals to your brain.
Although exercise is not recommended whilst having an acute gout attack, once it is under control exercise is beneficial as it will help to prevent further attacks by increasing circulation and normalising uric acids levels, primarily by balancing insulin levels.
LOW PURINE FOODS – include liberally
0-50mg purine per 100g
· Vegetables: green including beans, green string beans, French beans, mange-tout, celery
· Whole grains in moderation
· Dairy in moderation due to fat content
· Raw unsalted nuts (not peanut or cashew)
MODERATE – minimise
50mg – 150mg per 100g
· Poultry: turkey, chicken, duck and goose
· Red meat: veal, beef, lamb, pork, bacon
· Fish excluding caviar and taramasalata, cray fish, lobster, herring, mackerel, trout and scallops
· Oysters, mussels and most shellfish, prawns, shrimp, scampi
· Whole grain bread and pasta
· Oatmeal, brown rice tahini
· Lentils, soya beans, soya flour, bean curd, tofu, tempeh, miso, hummus
Peanuts, peanut butter, cashew nuts
Peanuts, peanut butter, cashew nuts
· Cauliflower, broccoli, kale, Brussels sprout
· Spinach, asparagus, avocado and mushrooms
HIGH – Avoid
150-1000mg purine per 100g
· Wild or farmed game: pheasant, quail, grouse, rabbit/hare, venison), mincemeat
· Organ meats: kidney, heart, sweetbreads, liver, pate, liver sausage, foie gras
· Meat extracts Bovril, oxo, marmite, vegemite
· Fish roe, scallops, herring, mackerel, trout
· Crayfish, lobster
· Small fish eaten whole or processed: anchovies, sardine, sprats, whitebait, anchovy paste, Thai fish sauce
For a more detailed table of foods, follow this link: