Destined to Reign

Gout

The agony of gout can start very quickly. Your first instinct might be to reach for aspirin-bad move. Aspirin slows down the excretion of uric acid, which only makes things worse. A much better bet is ibuprofen. Like aspirin, this is an anti-inflammatory pain-killer, but it does not aggravate the condition. Then you can turn to these home remedies to further reduce pain. Be strict with yourself about drinking plenty of water, as this will dissolve uric acid crystals.


What's wrong?

When too much uric acid (produced in the liver and excreted in the urine) builds up in your system, needle-sharp crystals of the compound can form in the fluid that cushions your joints. You may feel as though you have shards of glass jammed into your joints. This painful inflammatory condition, known as gout, usually occurs in men over the age of 40 (it takes years for uric acid crystals to build up).

Although it most often affects the big toe, gout can strike the wrist, knee, elbow or another joint. Besides pain, gout can cause severe swelling.


Lift off and ice down

During an acute attack, try to stay off your feet as much as possible and keep the affected joint elevated. This probably won't be a problem; when gout is at its worst, most people can't even bear the weight of a sheet on the painful joint.

If you can stand it, apply an icepack for 20 minutes or so. The cold will dull the pain and bring down the swelling. Wrap the ice in a cloth to protect your skin. Use the icepack three times a day for two or three days.



Try the cherry remedy

Cherries are an old folk remedy for gout. They contain compounds that help to neutralize uric acid in the blood. Cherries are also a source of anti-inflammatory compounds. So if you feel an attack of gout coming on, try eating a handful or two of cherries straight away. If they aren't in season, buy canned cherries. Studies suggest that you need about 20 cherries to get the same pain-relieving effects as aspirin. Fresh-frozen or dried cherries also work well. Or try strawberries, blackcurrants, cranberries and raspberries, which have a similar effect, although you'll need to eat a lot more of them.


FOODS TO AVOID

High-protein foods, as well as foods that contain chemical compounds kwown as purines, can raise levels of uric acid in the body. If you have gout, the list of foods to avoid includes meat-based gravy, offal, such as liver, kidneys and sweetbreads; shellfish, such as mussels, anchovies, sardines and herring; game-meats; fried foods; refined carbohydrates, such as white flour, oats; yeasty foods, such as beer and baked goods; and certain vegetables, including asparagus, peas, beans, spinach and cauliflower.

Supplement to the rescue

Daily dose of fish oil or flax-seed oil can ease inflammation in joints. These oils are rich sources of a potent anti-inflammatory agent known as eicosapentaenoic acid (EPA). The recommended dose of flaxseed oil is 1-3g a day (1 g of oil is about a table-spoon). But flaxseed oil rather than capsules- more than a dozen capsules are needed to equal 1 tablespoon of oil. The recommended dose for fish oil is 6000 mg a day in capsule or oil form. (Caution it must be fish oil, not fish liver or cod liver oil. This amount of fish oil would contact the right level of anti-inflammatory agents but too much of vitamins A and D.)

Another way to ease inflammation is with pills containing bromelain, an enzyme found in pineapple. The dosage for acute gout attacks is 500 mg three times a day between meals. Fresh celery, or celery tablets containing celery seed extract, may also help to eliminate uric acid. Take according to the manufacturer's instructions.

Long advocated by herbalists to treat joint inflammation, nettle leaf also helps to lower uric acid levels. Experts usually recommend 300-600 mg of a freeze-dried extract a day. Don't use nettle for any longer than three months at a time. (Caution: Avoid nettle in tincture form. Tinctures contain alcohol, which aggravates gout.) Another way to use nettle is topically. Soak a clean cloth in a tea brewed from the leaves of nettle and apply it to the tender joint.

Live on water, not beer

Drink lots of water- at least eight 250-ml glasses a day. Fluids will help to flush excess uric acid from your system. As a bonus, the water may help to discourage kidney stones, which disproportionately affect people with gout.

Avoid Alcohol

As it seems to increase uric acid production and inhibit its excretion. Beer is out- it contains more purines than other alcoholic drinks.



Have a cuppa or three.

Anecdotal evidence suggests that drinking ordinary black tea can help ward off an attack of gout, possibly due to the flavones it contains, which inhibit xanthine oxidase, an enzyme that is involved in the synthesis of uric acid. Studies indicate that several other herbs also have a valuable inhibitory effect on xanthine oxidase, namely milk thistle, centaury and turmeric. Take tablets, capsules or tea according to manufacturer's instruction. Practitioners of traditional Chinese medicine (TCM) prescribe a little-known herb called perilla ( Perilla frutescens) for all arthritic conditions, including gout. Preliminary research confirms that it does, indeed, regulate uric acid levels, and it is yet another plant with the specific ability to inhibit xanthine oxidase. Consult a TCM practitioner to see whether perilla could help you.


Check your Medicines

If you take diuretics- for high blood pressure, for instance- ask your doctor about alternatives. Diuretics eliminate excess fluids from the body; as a side effect they reduce the amount of uric acid that passes in the urine. Less passes, more remains in your body- and the worse your gout.

Gout can also be triggered by niacin or nicotinic acid, which is sometimes prescribed for high cholesterol. If your doctor has prescribed niacin for you, ask about alternatives.

Fast not, hurt not

Losing weight can help to keep gout at bay, but going on a crash diet or fasting is a big mistake. Drastic dieting causes cells to release more uric acid. If you're overweight, lose weight slowly and sensibly- a kilo a week at most.