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Gout is a common form of inflammatory arthritis that is very painful. It usually affects one joint at a time (often the big toe joint). There are times when symptoms get worse, known as flares, and times when there are no symptoms, known as remission. Repeated bouts of gout can lead to gouty arthritis, a worsening form of arthritis. There is no cure for gout, but you can effectively treat and manage the condition with medication and self-management strategies. What are the signs and symptoms of gout?Gout flares start suddenly and can last days or weeks. These flares are followed by long periods of remission—weeks, months, or years—without symptoms before another flare begins. Gout usually occurs in only one joint at a time. It is often found in the big toe. Along with the big toe, joints that are commonly affected are the lesser toe joints, the ankle, and the knee. Symptoms in the affected joint(s) may include:
Top of Page What causes gout?Gout is caused by a condition known as hyperuricemia, where there is too much uric acid in the body. The body makes uric acid when it breaks down purines, which are found in your body and the foods you eat. When there is too much uric acid in the body, uric acid crystals (monosodium urate) can build up in joints, fluids, and tissues within the body. Hyperuricemia does not always cause gout, and hyperuricemia without gout symptoms does not need to be treated. Top of Page What increases your chances for gout?The following make it more likely that you will develop hyperuricemia, which causes gout:
Top of Page How is gout diagnosed?A medical doctor diagnoses gout by assessing your symptoms and the results of your physical examination, X-rays, and lab tests. Gout can only be diagnosed during a flare when a joint is hot, swollen, and painful and when a lab test finds uric acid crystals in the affected joint. Top of Page Who should diagnose and treat gout?The disease should be diagnosed and treated by a doctor or a team of doctors who specialize in care of gout patients. This is important because the signs and symptoms of gout are not specific and can look like signs and symptoms of other inflammatory diseases. Doctors who specialize in gout and other forms of arthritis are called rheumatologists. To find a provider near you, visit the database of rheumatologistsexternal icon on the American College of Rheumatology website. Once a rheumatologist has diagnosed and effectively treated your gout, a primary care provider can usually track your condition and help you manage your gout. Top of Page How is gout treated?Gout can be effectively treated and managed with medical treatment and self-management strategies. Your health care provider may recommend a medical treatment plan to
In addition to medical treatment, you can manage your gout with self-management strategies. Self-management is what you do day to day to manage your condition and stay healthy, like making healthy lifestyle choices. The self-management strategies described below are proven to reduce pain and disability, so you can pursue the activities important to you. Top of Page How can I manage my gout and improve my quality of life?Gout affects many aspects of daily living, including work and leisure activities. Fortunately, there are many low-cost self-management strategies that are proven to improve the quality of life of people with gout. For gout in particular:
CDC’s Arthritis Program recommends five self-management strategies for managing arthritis and its symptoms. These can help with gout as well.
Learn more about goutLearn more about arthritisMedically reviewed by Katherine Marengo LDN, R.D., Nutrition — Written by Amy Boulanger — Updated on August 16, 2019 What is gout? Gout is a type of arthritis caused by too much uric acid in the blood. Excess uric acid can lead to a buildup of fluid surrounding the joints, which can result in uric acid crystals. The formation of these crystals causes the joints to swell and become inflamed, resulting in intense pain. The good news is that you can control gout. In addition to taking medications, dietary and lifestyle changes can help prevent painful attacks. A gout-friendly diet is specifically designed to help you avoid painful gout attacks. Learn more about which foods to include — and which to avoid — to help prevent symptoms. Gout develops when there’s too much uric acid in the blood. This overabundance of uric acid may be the result of a diet high in purines, or your body may simply produce too much uric acid. In some cases, blood uric acid levels may remain normal, yet gout is still the correct diagnosis. This is due to inflammatory factors and the body excreting excess uric acid in the urine. Understanding purinesPurines are chemical compounds that are broken down into uric acid when metabolized. Purines are either made by your body or taken into your body through foods you eat. In a normal process, purines break down into uric acid. The uric acid is then:
However, this isn’t usually the case in gout. Complications occur when the kidneys don’t get rid of uric acid fast enough or if there’s an increased amount of uric acid production. These high levels build up in the blood, leading to what’s known as hyperuricemia. Though not classified as a disease, hyperuricemia can be dangerous if it leads to the formation of uric acid crystals. Gout can develop when these crystals build up around the joints. A gout-friendly diet will help to control uric acid levels in the body while promoting overall health. According to the American College of Rheumatology, a diet that has an excessive amount of the following foods can lead to gout:
All of these foods have a high purine content. With that in mind, a gout diet should avoid or limit these foods:
If you want to include some animal protein in your diet, only a moderate amount is recommended. It’s advised to avoid eating large portions of purine-rich meats. A typical serving of meat is 3 ounces and fish is 4 ounces. Gout-friendly recipes either contain none of these animal proteins or have amounts that are small enough to help you stay close to only 1 to 2 servings daily or include meatless days. Animal proteins are high in purines. Since the buildup of purines can lead to elevated levels of uric acid, which in turn may result in gout, it’s best to avoid or strictly limit these foods. These foods are somewhat high in purines and should be eaten in moderation:
While these proteins are lower in purines than the ones in the previous list, you should still attempt to limit your intake of all animal protein to 3 to 6 ounces per day, which is 1 to 2 servings. Alcohol disrupts the removal of uric acid from the body. It’s thought that high levels of purine in alcoholic beverages lead to this disruption. Normally, purines would break down into uric acid and get flushed out of the body through urine. However, this process is interrupted when uric acid levels get too high. Crystals form around the joints, and gout develops. To prevent further gout attacks, stick to these guidelines:
Keep in mind that you should avoid alcohol altogether unless your doctor says otherwise. Gout-friendly recipes take these alcohol restrictions into account as well. High intake of fructose and sugary foods may have an effect on uric acid levels in the body. One reason is sugar and sweets are higher in calories and linked to obesity, a known risk factor for gout. In addition, although fructose-rich beverages, such as soft drinks, don’t contain high amounts of purines, they have been shown to increase the risk of developing gout. This is because uric acid is one of the byproducts of fructose metabolism. Evidence has shown consuming high amounts of fructose may increase uric acid levels in the blood. Increasing your daily water intake and cutting soft drink and soda consumption will help to flush your body of uric acid and prevent the formation of kidney stones. Though they’re tempting, sweets are better left untouched. Make room instead for healthier, gout-friendly foods such as plant-based proteins and low-fat dairy products. Avoid or limit refined carbohydratesRefined carbohydrates include:
All gout-friendly recipes either have no refined carbs or only include them in very small amounts. A low-purine diet can help lower uric acid levels and work to prevent symptoms of gout. Foods and beverages to consume daily include: Plant proteinsBeans and legumes are excellent protein sources. Eating these plant-based sources can help you meet your daily protein needs, while cutting the saturated fat found in high-purine, animal-based proteins. Dairy and non-dairy substitutesSome people find that dairy may increase their gout symptoms, while others experience a decrease in uric acid levels with low-fat dairy intake. Many plant-based milk alternatives are available if you need to avoid dairy. Fruits and vegetablesVitamin C-rich foods, such as cherries, show some evidence of potentially reducing gout attacks. Interestingly, studies have not shown high-purine vegetables to increase gout attacks. Furthermore, vegetables are high in fiber and low in calories, which can help you manage your weight. However, being mindful of iron intake may be beneficial for those with gout. Most bioavailable iron is found in meat sources, but plant-based iron foods may have a negative effect on gout. It’s always important to pay attention to your individual symptoms and modify your diet based on your specific needs. You may safely indulge in these high-purine veggies:
It’s important to understand that a gout diet isn’t a treatment. Rather, it’s a lifestyle change that can help reduce or eliminate gout symptoms. In addition to following a gout diet, your doctor will likely recommend regular exercise and weight loss. In many cases, this can help to control gout more than a low-purine diet can. Unlike other types of arthritis, gout can be cured. Treatment options will vary and depend on a variety of factors, such as:
In addition to taking prescribed medications, acute gout attacks can be managed through:
A large part of your success in managing your condition depends upon your eating and lifestyle habits. Be sure to discuss all nutritional concerns with your doctor and dietitian before getting started. Last medically reviewed on August 16, 2019 |