Gout: Alternative Healthcare
for Traditional Healthcare Professionals
Pre-edited version of a 2001 article published Advance for Respiratory Care Practitioners.
Desmond Allen, PhD, ND, RCP
Dr. Allen advises all readers to consult their physician before abandoning any pharmaceutical therapy or adding any natural remedy. He also encourages everyone to take responsibility for their own healthcare decisions, and to seek the opinion of an alternative healthcare professional.
Acute gout is an intensely painful, inflammatory, condition generally affecting the first joint of the big toe, the heel, ankle, instep, knee, wrist or even fingers--at least at first. As the condition progresses, other symptoms may evolve. Both arthritis and kidney stones are associated with gout. A flair-up can last from days to months and be so painful that even the weight of a sheet and blanket on the afflicted area is unbearable.
Some 90% to 95% of the sufferers are men over the age of thirty. Most women sufferers are generally postmenopausal. Historically, it is referred to as the rich man’s disease. There is good reason for this. It’s a metabolic disorder associated with hyperuricemia and a common cause for high uric acid levels is the excessive consumption of rich foods and alcohol. Meat is a high purine food. Purines breakdown to form uric acid. Alcohol inhibits the kidney’s secretion of uric acid. High uric acid levels produce monosodium urate monohydrate crystals. These urate crystals lodge in various tissues (cartilage, subcutaneous, periarticular, tendons, bone, kidneys, etc.) to create tophi. The subsequent inflammatory reaction to these nodular deposits is very, very painful.1-2
Aside form the acute inflamation, there may be long-term or reoccurring effects as well. After the initial onset, some 93% will generally suffer another bout within the first year. About 90% experience some degree of kidney dysfunction, and the risk for kidney stones increases considerably. Thus, from the naturopathic viewpoint, it’s best to get a handle on it from the get-go. But here, as is so often the case, the allopathic and holistic philosophies differ.
It’s not surprising that the allopathic treatment (i.e. drug therapy) concentrates on “the acute arthritis first and the hyperuricemia later, if at all….”1 The Current Medical Diagnosis and Treatment textbook (the allopathic physician’s bible) even questions the need to restrict foods high in purine, actually arguing that the abstinence from these foods cannot be expected to contribute significantly to the management of the disease. Given such blatantly ignorant advise, it is also not surprising that the outcomes of allopathic treatment as rather dismal.
Although the drug of choice--an anti-inflammatory called colchicine, does bring some improvement--due to gastrointestinal side effects, about 80% of the patients cannot tolerate the optimal dose. Furthermore, like so much of modern pharmacopeia, there is evidence of several detrimental side effects: bone marrow depression, hair loss, liver damage, depression, seizures, respiratory depression and even death.2
The holistic or naturopathic treatment takes a different, more effective, and certainly safer approach. Despite the “prevailing wisdom” of modern allopathy, diet definitely makes a difference. This was proven centuries ago and is no longer even worthy of debate.
What to Avoid
Despite the advise of the authoritative “Current Medical Diagnosis and Treatment,” definitely avoid foods high in purine (e.g. meats--especially kidney, liver and other organs, shellfish, sardines, anchovies, brewer’s and baker’s yeast). Purines breakdown into uric acid. Also limit the excess of other moderate protein foods such as dried legumes, spinach, asparagus, fish, poultry and mushrooms. Avoid alcohol. It inhibits the excretion of uric acid. Avoid saturated fats. They promote uric acid retention. Avoid refined carbohydrates. They increase uric acid production.
Limit foods that leave an acid ash (e.g. bread, eggs, cheese, yogurt, flour, wheat germ, honey, cow’s milk, noodles, oatmeal, peanuts, sunflower seeds, walnuts, a few fruits and vegetables, prunes, plums, peas, currants, barley, rice, squash, oat bran, and corn). Avoid high levels of vitamin C. It could increase uric acid levels. And avoid high levels of niacin. It competes with uric acid for excretion.
There are a number of things to do proactively, to help avoid acute flare-ups. Drink plenty of fluids. This will dilute and promote the excretion of the uric acid. Thus, it will decrease the risk of kidney stones. If overweight, shed a few pounds. This will decrease serum uric acid. Eat foods with an alkaline ash (e.g. molasses, almonds, apples–unpeeled, cherries, cucumbers, carrots, oranges, limes, raisins, grapes, figs, dates, apricots bananas, onions, potatoes, radishes, tomatoes, lettuce, celery, most fruits and vegetables, etc.).3 This will promote uric acid solubility. Celery juice diluted in distilled water is another of natures simply remedies that can bring relief.4
There are two nutritional supplements that top the list. Many individuals have reported great success with either of these two simple remedies. Indeed, if you suffer from gout the next few paragraphs could change your life.
Eat cherries! Lots of them, as many as half a pound a day. They have proven themselves over and over again. Relief has even been reported with frozen cherries and cherry extract. Cherries help lower uric acid, thereby relieving acute attacks and helping to prevent future bouts. They are rich in flavonoids--as are other dark reddish-purple berries such as hawthorn berries, strawberries and blueberries. These flavonoids have several benefits. They have unique, positive affects on collagen metabolism, promoting the formation of connective tissue and inhibiting effects of enzymes released during inflamation. They prevent free radical damage. And they prevent the release and synthesis of compounds such as histamine, serine protease, prostaglandins and leukotrienes, that promote inflammation.2
Another of nature’s simple remedies for this painful condition is apple cider. It has especially proven effective when combined with hydrangea root–which has natural stone-solvent properties. Apples, on the other hand are rich in various phosphates and cell salts. Dr Snook suggests placing 2 oz of hydrangea root in 1 quart of apple cider. Let it stand for twelve hours, then bring to a boil and simmer for 30 minutes. When it cools, bottle it and keep it in a cool place. Drink about 4 oz three of four times a day.5
A number of other supplements can be beneficial as well. Folic acid can inhibit the enzyme “xanthin oxidase,” which is responsible for producing uric acid. Studies have shown that it does a better job than does the allopathic drug “allopurinol,” which is designed for this purpose. Both EPA (eicosapentaenoic acid) and vitamin E, inhibit the production of pro-inflammatory leukotrienes. Bromelain, the proteolytic enzyme of pineapple is a potent anti-inflammatory. Quercetin, is a bioflavonoid that has many of positive affects. It inhibits also xanthine oxidase, leukotriene synthesis and release and neutrophil accumulation. The amino acids alanine, aspartic acid and glutamic acid can also lower serum uric acid levels by promoting its excretion.2 It has also been suggested that a deficiency in vitamin B5, A, and or E, can provoke an attack.4
Certain herbs have a long history as effective treatments for Gout. Devils Claw, is an anti-inflammatory and it lowers uric acid levels. Alfalfa is rich in minerals and nutrients, and also helps to lower uric acid content. Horsetail is used for joint inflammations and is a urinary tract astringent and diuretic used to purge toxins. Dandelion root is a laxative, tonic and diuretic used for various liver and spleen ailments, as well as gout and rheumatism.6 A paste made of cayenne powder and wintergreen oil is suggested as a topical remedy for pain relief. It may take several, repeated applications to the affected area.4
There are viable alternatives for gout victims. This condition is too painful and too easily controlled to settle for the ill-informed advice of modern medical wisdom.
1. Lawrence M Tierney, Jr, Stephen J McPhee, and Maxine A Papadakis, eds. Current Medical Diagnosis and Treatment. Appleton & Lang, 1995, 3rd edition) pp 698-702.
2. Murray Michael and Pizzorno Joseph. Encyclopedia of Natural Medicine. Rocklin, CA: Prima Publishing; 1991.
3. Morter Ted. Health and Wellness. Hollywood, FL: Fredrick Fell Publisher, Inc.; 2000.
4. Balch James F and Balch Phyllis A. Perscription for Natural Healing. 2nd ed.; Garden City Park, NY: Avery Publishing Group; 1997.
5. Edward Shook. Advanced Treatise in Herbology. Warsaw, IN: Wendell W. Whitman Co.; 1999.
6. Pederson Mark . Natural Herbology. 4th ed.; Warsaw, IN: Wendell W. White Company; 1998.
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