Ethanol And Uric Acid In Men Without Gout
T Nishimura et al. Influence of daily drinking habits on ethanol-induced hyperuricaemia. Metabolism 1994 43: 745-748.
Five healthy men who regularly consumed no alcohol, or less than 20 grams occasionally, and five health regular drinkers who consumed more than 60 grams of alcohol a day were given an oral alcohol load of 0.5 grams of ethanol per kg body weight. Blood samples were taken for up to four hours for measurement of xanthine and xanthine metabolites and for uric acid.
Medications That Can Cause Gout
You already know that eating foods rich in purines like dried beans and liver can lead to a buildup of uric acid in the blood. But those arent the only culprits that contribute to . Certain medications used to treat other conditions may increase uric acid levels, too.
If you take one of the medications listed below and experience gout, its worth asking your doctor if there could be a connection.
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Should I Take Calcium And Vitamin D Supplements
Q) I once was told the hard, arthritic lumps on my finger joints were caused by excess calcium sediments hardening. Why then do I take recommended calcium and vitamin D tablets? Wouldn’t this give me even more calcium in my body? Should I take them or not?
I’m 72 and have hip, knee, hands and feet problems but otherwise very healthy and happy.
Joyce – 2018
A) The lumps on your finger joints are called Heberdens nodes and usually affect the joints closest to the ends of the fingers . Heberdens nodes are caused by growth of bony spurs from the joint surface called osteophytes. They can happen when a joint is affected by osteoarthritis.
Heberdens nodes arent caused by an excess of calcium and vitamin D. Supplements of calcium and vitamin D are usually used to help keep the bones strong and prevent fractures, but if youre not clear why you’re taking these supplements it’d be a good idea to ask your GP or pharmacist for help in making a decision about whether or not it would be beneficial for you to keep taking them.
This answer was provided by Dr Tom Margham in 2018, and was correct at the time of publication.
So How Do You Avoid Or Limit Your Stress
Exercise, even some moderate exercise like taking a walk will do wonders. Intense or prolonged exercise may increase your cortisol levels besides putting excessive stress on your body low intensity exercise may actually reduce your cortisol levels. You can even meditate, prayer may also help if you are religious, yoga, practicing relaxation techniques and even talking to a friend or family member about what stresses you.
You can also take B complex vitamins supplement which may be effective in regulating stress and keeping cortisol levels in check. Other vitamins that may also help to control your cortisol levels are magnesium and vitamin C. Dont also forget omega 3 fatty acids such as fish oil and herbs may also help reduce cortisol and stress like green tea, valerian and ginseng.
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How Does Diet Impact Gout
Though diet isnt the only factor that leads to gout, it can play a role. To know why, its important to understand what causes gout in the body .
Gout occurs when an excess of uric acid in the body crystallizes in the joints, most commonly in the big toes, fingers, wrists and knees. These sharp crystals cause sudden swelling and are the source of the pain associated with a gout attack.
Uric acid is produced naturally when the body breaks down purines. Most purine is produced inside the body, though purines are also contained in some foods. Normally, uric acid doesnt cause problems because the body is able to secrete it easily through urine. However, some people produce too much uric acid or are unable to secrete enough of it. In these cases, the result is gout.
Though the body produces uric acid naturally, making gout largely unavoidable, consumption of foods rich in purines can exacerbate the problem. In fact, one study found that high purine intake was associated with five times greater risk of recurrent gout attacks .
In addition to foods rich in purine, those with gout should also avoid foods with lots of added sugars and refined carbs. Though more research needs to be done, reducing glycemic index seems to correlate with lower uric acid levels .
Who Is Affected By Gout
Gout can affect anyone. It usually occurs earlier in men than women. It generally occurs after menopause in women. Men can be three times more likely than women to get it because they have higher levels of uric acid most of their lives. Women reach these uric acid levels after menopause.
People are more likely to get gout if they have:
- Obesity, or a lot of extra weight.
You are also more likely to develop gout if you:
- Consume a diet high in animal proteins
- Consume a significant amount of alcohol
- Are on water pills .
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Which Type Of Alcohol Is The Worst For Gout
All types of alcohol affect gout, but the impact on flares and symptoms may vary by type of alcohol, depending on which studies you look at. Some research suggests that beer is especially bad for gout because it contains higher levels of purines that break down directly into uric acid.
A 2004 study published in the medical journal The Lancet found that alcohol is strongly associated with an increased risk of gout, the study authors concluded. Risks varied according to type of alcoholic beverage:
- Two or more beers daily increased gout risk over non-beer drinkers two-fold
- Two shots of spirits daily increased gout risk over non-drinkers by 1.6 times
- Two four-ounce glasses of wine daily was not associated with a higher risk of gout
However, other research has found a link between wine consumption and gout risk. A study published in the American Journal of Medicine in 2014 looked at how much alcohol consumed over a 24-hour period was associated with a recurring gout attack. It found that all types of alcoholic beverages, including wine, were associated with an increased risk for recurrent gout attacks. Even though one drink didnt raise the subjects risk for a gout attack by that much, having one to two drinks in a 24-hour period was associated with a 36 percent higher risk of recurrent gout attack, compared with those who had consumed no alcohol in that time period.
Patients With Gout Who Use Diuretics
Patients with Gout who use Diuretics have a tendency to urinate a lot. You may become dehydrated as a result of this. When a patient is dehydrated, fresh urine becomes extremely concentrated, creating ideal circumstances for your acid to build up. Keep in mind that its one of the urines waste products.
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How Can An Attack Of Gout Be Treated
The management of an acute attack of gout is very different from the prevention of subsequent attacks.
Treatments used for prevention, such as allopurinol can actually make things worse if given during an attack, and so need to be held back until the attack has resolved for several weeks.
There are a number of measures that can help resolve an attack of gout. See Table 2 for summary of treatment strategies for acute gout. One principle is that treatment for an attack of gout should be instituted quickly, since quick treatment can often be rewarded with a quick improvement.
If an attack of gout is allowed to last more than a day or so before treatment is started, the response to treatment may be much slower.
Table 2: Medications to treat acute attacks of gout
Alcoholic Drinks To Avoid If One Has Gout
It is important to know how alcohol affects gout and what to drink and avoid, as well. Although experts advise that people with gout should limit intake of alcohol regardless of the type, one should also know that these drinks dont cause or trigger gout attacks equally.
Some drinks are associated with a much higher increase in uric acid accumulation and exacerbation of gout, while others may carry a minimal risk these ones are the gout friendly alcohols.
So what alcohol can you drink with gout? The answer is the alcohol with low strength, and some wines fall in this group.
Wine is associated with a lower risk of developing gout. However, it can also cause flare-ups just like other types of alcoholic drinks, but to a lower degree. That being said, wine may be considered the best alcohol for gout.
However, one should avoid drinking wine during pregnancy, as it poses a risk of several fetal abnormalities.
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Different Conditions But Similar Diet Plan
The National Institute of Health created the DASH eating plan to help lower blood pressure. Studies have shown it does lower blood pressure, LDL cholesterol and uric acid levels.
Does it help with gout? Yes. The DASH diet incorporates more fruits, vegetables, seeds, whole grains, low-fat/nonfat dairy and lean meats. The diet limits eating foods high in saturated fat, such as fatty meats, high-fat dairy products, and certain oils. Also, other recommendations include consuming less salt, sweets, sugar-sweetened beverages, and alcohol.
Theres nothing new to the DASH diet. It been around since 1992. However, it is a prudent starting point to improve your current crappy diet. Since the DASH diet recommends eating less gout-causing foods like meats, alcohol and high-fructose drinks, it is highly recommended to all gout sufferers.
When it comes to gout, the main issue is overeating those savory purine-rich foods like red meats and shellfish. For any diet, the biggest challenge is starting healthier habits like choosing more nutritional snacks and meals than unhealthy ones.
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Alcohol And Gout Risk
Although beer may be the worst drink for gout, any alcoholic beverage can trigger gout symptoms in people who are prone to the disease. “Alcohol causes the kidneys to excrete alcohol instead of excreting uric acid. That increases the amount of uric acid in the blood, which could provoke a gout attack in about one or two days,” warns David Freeman, MD, a rheumatologist at the Lahey Clinic in Burlington, Mass.
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Can Changing Your Drinking Habits Prevent Gout
When you have gout, its important to keep your uric acid levels as low as possible to avoid a flare-up. Because alcohol increases uric acid levels, many doctors will recommend drinking only in moderation or cutting back significantly.
If you enjoy alcohol, making simple changes to your drinking habits may help avoid future flare-ups. Even if you dont have gout, avoiding heavy drinking may even help prevent a first-time gout experience.
What Is The First Sign Of Gout
Symptoms including swelling, redness, and tenderness in affected joints are usually noticeable before a painful gout attack happens. People with a history of gout should check the base of the big toe for changes that can alert them to a flare-up.What foods should I avoid during a gout flare-up?When managing a gout flare-up, it is important to discontinue consumption of beer and liquor right away. Other foods that should be reduced or eliminated include red meat, shellfish, liver, mackerel, and anchovies. All these foods contain a compound that leads to uric acid production.
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Can Stress Actually Cause A Gout Attack
Stress has been around since the beginning of man, as long as there is uncertainty there will be stress unfortunately and it does produce consequences. Not as much to people who are relatively good health as much as to those who have a disease or a condition already. Stress may be caused by a divorce, employment, altered finances, self-image, depression, accident, disability, social life problems etc
Unfortunately, stress doesnt make an exception towards gout sufferers since there seems to be a correlation between stress and gout attacks. This correlation seems more prevalent when stress is long-sustained, meaning it is not a one day stress episode but more long term stress that may harm the gout sufferer by raising his uric acid levels. That is why a gout sufferer must learn to manage their stress cause remember that stress may also cause muscle tension and increased pain along with worsening gout symptoms.
There have been no studies done in regards to gout and stress but studies on arthritis which studied laboratory ratshave proven a definite connection between stress and the development of arthritis. Many arthritis patients connect their disease with a stressful incident in their lives which they claim triggered it for them.
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How Much Alcohol Can People With Gout Drink
Each gout patient is different, so its hard to determine what the safe limit for alcohol is. Its best to monitor your alcohol consumption and limit yourself to amounts that work best for you.
Lifestyle is an important factor for living with gout along with diet, medical condition, family history, age, and sex. If you find that beer is a common trigger for you, consider lowering your dose to minimize instances of gout attacks.
If taking alcohol out of your lifestyle is not an option, you should still lower it to avoid those crippling gout attacks. Thankfully, there are medications now that can help prevent and treat gout symptoms. Aside from maintaining a rigid diet low in purines, you should also be taking gout medications such as allopurinol.
Make sure to speak with your doctor about taking medications while drinking alcohol.
There is no hard evidence to prove that alcohol reduces the efficacy of allopurinol, but its still best to get the proper dosage to help you achieve low enough uric acid levels. If you still cannot lower your uric acid levels, then you may need to make drastic lifestyle changes such as cutting out alcohol altogether.
During a gout flare up, you should be avoiding alcohol as it could make it worse. Your gout is already experiencing a buildup of uric acid crystals. By drinking alcohol, you are only adding to the buildup and overworking your kidneys resulting in kidney stones and lumps under the skin.
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Can Protein Supplements Cause Arthritis
Q) Is there any evidence to show that taking protein supplements can cause or worsen arthritis?
Antony – 2017
A) If you’re at risk of gout, excessive protein intake may be problematic. Gout is the most common inflammatory arthritis and is caused by having too much uric acid in your bloodstream. Uric acid is the waste product created when the body breaks down purines a type of protein found in many foods and all your cells.
Gout is a metabolic disease which is mainly influenced by our genes, age, gender and ethnicity. However, levels of uric acid are also affected by what we eat. If you’re at risk of gout, eating a lot of protein in the form of red meat, soya or shellfish, all high in purines, makes attacks more likely. So, eating lots of protein is bad news for people with gout.
Protein supplements in the form of whey proteins contain gycomacropeptide, a component of milk that appears to reduce the risk of attacks of gout. However, people with gout should be careful about increasing their protein load with whey. The burden on the kidneys to excrete or clear the extra whey products might become excessive, so its always worth getting a blood test to check your kidney function if you have gout and are considering using whey protein supplements.
This answer was provided by Dr Tom Margham in 2017, and was correct at the time of publication.
Tips For Following A Low
- Avoid or limit alcohol. Alcohol increases purine production. This leads to higher uric acid levels in your blood and urine.
- Limit meat to 3 oz. per meal.
- Limit high-fat foods. Fat holds onto uric acid in your kidneys.
- Eat enough carbs. They help your body get rid of extra uric acid.
- If youre overweight, lose weight gradually. Rapid weight loss can increase uric acid levels.
- Drink 8 to 12 cups of fluid every day to help reduce kidney stone formation.
- Dont take bakers or brewers yeast as a supplement.
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