It was once thought that gout, the so-called “disease of kings,” typically spared queens. But in the last 20 years, cases of gout have more than doubled among women. Today, 2 million women – and 6 million men – in the U.S. have this inflammatory form of arthritis that causes joint swelling and telltale pain at the base of the big toe.
If you have ever had back pain, you know how difficult it can be to pinpoint the cause. From bone spurs to overworked muscles to slipped discs, there’s no shortage of ailments that could be at the root of your aching lumbar.
And here’s one more. Over the last 10 years, rheumatologists have documented more cases of gout appearing in the spine. So if you are one of the 8 million Americans with this inflammatory form of arthritis – and you have unexplained back or neck pain, tingling sensations down your arm or leg, or numbness – there’s a small chance the culprit could be your gout.
Food choices plays an important role in managing gout, the most common form of inflammatory arthritis in the United States. Gout occurs when uric acid builds up in the blood (instead of being excreted) and gets deposited as crystals in one or more joints, triggering sudden swelling and pain. Uric acid is a by-product of the breakdown of purines, naturally occurring compounds in the body and in certain foods, which is why diet can be important for controlling gout attacks.
We asked rheumatologist Hyon K. Choi, MD, a gout expert and Professor of Medicine at Harvard Medical School, what people with gout should know about diet.
A swollen, stiff knee might immediately lead you to suspect you have osteoarthritis (OA), but the culprit could also be gout. Like many close relatives, the two conditions share common features. And because they often occur together, you might wonder which one is causing your symptoms.
“It’s definitely possible for people to have both conditions at the same time. They’re the two most common types of arthritis,” says Svetlana Krasnokutsky, MD, assistant professor of medicine in the Division of Rheumatology at NYU Langone Health. “They can affect the same joints.”
If you’re changing your diet to help lower uric acid levels and reduce your risk of gout attacks, meat choices can have a big impact. Some meats are high in purines. Purines are substances found naturally in the body as well as in in foods. They are broken down in the body to form uric acid. When excess uric acid in the bloodstream builds too quickly or can’t be eliminated fast enough, it is deposited as needle-shaped crystals in the tissues of the body, including joints, causing intense pain. So, a high-purine diet puts you at greater risk for uric acid buildup. And a 2012 study in the Annals of the Rheumatic Diseases showed that the risk worsens as more purines are included in the diet. But what if meats are your favorite food? Here’s what you should know about your options.
A diet that’s best known for promoting heart health may also help gout management. The Dietary Approaches to Stop Hypertension (DASH) diet, which emphasizes fresh fruits and vegetables, whole grains and low-fat dairy products, may lower serum uric acid (SUA) levels. In a study published in Clinical Rheumatology in March 2017, research findings showed that the diet reduced SUA [compared to the typical American (control) diet] within 30 days, with a sustained effect at 90 days. In an earlier study reported in Arthritis & Rheumatology in August 2016, researchers reported similar finding in some cases.
In addition to being treated with medication for symptoms of an acute flare, should a person with gout be put on long-term uric acid-lowering medication to reduce future flares? And is it safe to keep raising the dose of the medication until uric acid drops below a specified target? Rheumatologists and other physicians are currently grappling with those questions, and a new study may help lead to some answers.
What Is Gout?
Gout is the most common form of inflammatory arthritis in the United States, affecting more than 8 million adults. It develops in some people who have high levels of uric acid in the blood. Needle-shaped crystals form in and around joints – often beginning in the base of the big toe – causing episodes of severe pain, heat and swelling.
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A new study found that people with gout have a 25 percent greater likelihood of dying prematurely than people without gout. The findings also show that this increased mortality rate has not improved over the past 16 years, unlike the mortality rate for people with rheumatoid arthritis (RA).
Gout, which affects more than 4 percent of adults in the United States, is the most common form of inflammatory arthritis. It develops in some people who have high levels of uric acid in the blood. The acid can form needle-like crystals in a joint and cause sudden, severe episodes of pain, tenderness, redness, warmth and swelling. Gout is also associated with other illnesses, such as cardiovascular disease and metabolic syndrome.
Continue reading People with Gout at Risk of Premature Death
An international panel of leading gout experts has published new recommendations advising that doctors use a treat-to-target approach for managing gout, a painful form of arthritis that affects more than 8 million adults in the United States. Central to the recommendations is using medication to reduce and keep blood uric acid levels below 6 milligrams per deciliter (mg/dL) – and even lower in people with severe gout. The recommendations were published online in Annals of the Rheumatic Diseases in September.
Continue reading Panel Recommends Aggressive Treat-to-Target Approach to Gout
It may come as a surprise that gout is the most common cause of inflammatory arthritis among adults in the United States.1 It’s also very painful, but gout can be a management disease – meaning there are several things people with gout can do to reduce flares, or eliminate flares all together.
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