Gout

Article from Dr. Weil's newsletter.
Gout is a very painful condition that most commonly affects the joints in the big toe, though it can also occur in ankles, heels, knees, wrists, fingers, elbows and insteps. Being on your feet and walking all day can aggravate symptoms, but regular, daily exercise (especially biking and swimming, which put less pressure on the joints) can actually help in the long run.

Symptoms and Causes
In most cases, gout is an inherited metabolic disorder in which high concentrations of uric acid circulate in the blood. As it accumulates, uric acid can form needle-like crystals that deposit in joints, causing swelling and discomfort. Uric acid is a byproduct of protein metabolism, and people with gout should avoid a particular class of proteins called purines that occur in many foods, including organ meats, sardines, anchovies and lentils, as well as in alcoholic beverages.
Certain drugs can also increase your risk of gout because they affect the amount of uric acid in the system. These include salicylates (the active ingredient in aspirin), vitamin B3 (niacin), and diuretics that may be prescribed for high blood pressure, edema or cardiovascular disease. Cyclosporine, a drug used to prevent rejection of a transplanted organ, can also increase the risk of gout, as can Levodopa, which is prescribed for Parkinson's disease. Being overweight, drinking excess alcohol, and exposure to lead in the environment further raise the risk.
Gout is usually treated with non-steroidal, anti-inflammatory drugs or with injections of cortisone to reduce the swelling.

Nutrition and Supplements
While there are no herbs or supplements that can quell an attack of gout, acupuncture can be very effective in reducing symptoms. In addition, the following recommendations may minimize – or help to avoid – the need to take prescription drugs.

* Eliminate coffee and caffeine (caffeine and related drugs can raise uric acid levels).
* Reduce inflammation. Enjoying a cup of red or purple fruits a day, especially cherries, will provide antioxidants as well as help reduce inflammation and flare-ups. Omega-3-rich foods such as walnuts, freshly ground flax seeds and fish oil capsules are especially helpful.
* Drink plenty of water to help flush uric acid out of your system and prevent the deposit of urate crystals.
* Minimize alcohol consumption. It promotes development of uric acid crystals and can cause dehydration and irritate the urinary tract.
* If you're overweight, try to lose the excess pounds (reducing your weight sensibly may lessen your gout symptoms, but fad dieting may boost uric acid levels).
* Never take protein supplements.

As far as general diet is concerned, the best advice is to avoid foods high in purines (cut back on red meat, and choose protein sources with a low purine content such as poultry, dairy products and soy) and follow a balanced, low-fat diet with lots of fresh fruits, vegetables and whole grains.