grumpy with gout...

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

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 by-product of protein metabolism, and people with gout should avoid a particular class of proteins called purines that occur in many foods, including animal 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), and diuretics that may be prescribed for high blood pressure, oedema or cardiovascular disease. 

Gout is usually treated with non-steroidal, anti-inflammatory drugs or with injections of cortisone to reduce the swelling, the following recommendations may minimise - 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, fish oil and flax supplements, as well as 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.

» Minimise alcohol consumption. It promotes development of uric acid crystals and can cause dehydration and irritate the urinary tract.

» If you are overweight try to lose the excess pounds (reducing your weight sensibly may lessen your gout symptoms, but fad dieting may boost uric acid levels).

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.

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