Malady Makeover, Oct 05

Taming the Toe Monster
Gout. It makes you want to shout—in pain. How you can cope.

By Stephen Hanks

    The attack came without warning, in the middle of the night while I was asleep. It left a pain the intensity of which I hadn’t experienced since having some teeth removed with pliers when I was a child. The area of this excruating ache centered on the joints in my right big toe and made the spot so sensitive even a sheet slithering across it engendered a blood-
curdling scream.
    That morning, I somehow managed to hobble to a local podiatrist and told him my amateur diagnosis was that I had a stress fracture. Foot doctor scanned the surface of my toe, noticed that it was red, shiny and felt hot to the touch. “No doubt,” he said. “You have gout.”
    Gout? Wait a minute, I thought. Isn’t gout a member of that ancient malady pantheon right up there with rickets and scurvy, ailments people just don’t get anymore? Apparently not. According to the Mayo Clinic, more than 2 million people are afflicted with this form of arthritis and 95% of those are men over 30. I had been unceremoniously welcomed to this dubious club.

Root Causes of Intense Pain
    Hundreds of years ago, gout was called “the disease of kings” because it was associated with wealthy men who overindulged in rich food and drink. Organ meats, shellfish, scallops, peas and beans, and liquids such as beer and wine contain purines. When the body breaks down purines it produces a lot of uric acid in the blood, the main culprit in what causes gout.
    Uric acid isn’t harmful. In fact, it’s a powerful antioxidant that protects cells from damage. It’s just that when uric acid levels rise too high, sharp, needle-like, monosodium urate crystals can form in connective tissue, in the joint space between two bones, or in both. (Besides the big toe, ankles, knees, hands or wrists can also be affected.) While these crystals are very pretty under a microscope, the way they inflame your joints isn’t too attractive. (A condition called pseudogout is sometimes confused with gout because it produces similar symptoms of inflammation, but the crystals are made up of calcium phosphate, not uric acid.)
    Gout can also be caused by obesity, high alcohol intake and high blood pressure, and tends to run in families. I had never heard any quaint family histories involving gout so I was more than a tad skeptical about having the problem.
    And I turned out to be right. My family doctor took a blood test and determined that my uric acid level wasn’t high enough to indicate a gout attack. Foot doctor took another x-ray and confirmed that his initial diagnosis was off, that I was developing a kind of osteo-arthritis. However, by the time I received this new assessment, I’d done enough research on gout to, say, write a magazine article.

How To Treat Gout
    When something so profoundly painful strikes, there is little alternative than to take nonsteroidal anti-inflammatories to relieve the immediate pain. Some people may have to embark on a long diet of medicines such as allopurinol or probenecid to treat hyperuricemia and reduce the frequency of gout attacks. But a healthy diet and regular exercise can also be helpful in diminishing gout episodes and minimizing their pain.
    Gout sufferers should drink eight or more glasses of water daily to flush uric acid from the body. They should also eat a hearty amount of vegetables and fruits. Cherries (or cherry extract) have shown to be especially effective in preventing gout attacks.
    A nutrition strategy that incorporates some natural herbs and supplements can also be effective in lessening discomfort from gout. Among them are:
   • Bilberry: As an extract, the leaf of the blueberry bush stabilizes collagen (the most abundant protein in the body), which gout can destroy.
   • Bromelain: Extracted from pineapple, this enzyme speeds decomposition of uric acid crystals, relieving pain.
   • Burdock: Taken as a tea, this relative of the sunflower can reduce swelling around joints and help rid the body of calcified deposits.
   • Celery seed extract: Reduces uric acid levels and inflammation.
   • Devil’s claw: An herb that can lower uric acid levels and relieves short-term pain and inflammation.
   • Olive leaf: Olive has had a reputation as a diuretic since biblical times. It increases output of urine, thereby lowering uric acid levels.
   • Omega-3 fatty acids: Helps reduce inflammation and swelling in joints.
   • Quercetin: An antioxidant that is abundant in black tea, broccoli, onions and red apples inhibits the buildup of uric acid.
    I didn’t have a bout with gout, but if the pain is anything like I felt with my particular arthritic ailment, I suggest taking anything you can to tame the toe monster.

Back To Top