Gout & Its Triggers

Learn about common gout symptoms

By Reshmy Ranee

Gout is a type of arthritis that causes uric acid crystals to accumulate at joint areas all over the body. These crystals are formed during the breakdown of foods in the intestine and they circulate in the blood waiting to be cleared by the kidneys. When the kidneys fail to clear these crystals efficiently, that’s when uric acid crystals deposit at joints and trigger gout flares. The main cause of gout is usually diet intake in particularly foods high in purine (purines eventually break down to uric acid crystals). However other factors, besides diet as listed below may also lead to gout attacks:

#1 Weight
Being overweight or obese means one has excess body fat. Excess body fats release a lot of inflammatory chemicals in the body which then increases the risk of having gout.
#2 Medical conditions
Medical conditions such as high blood pressure, diabetes, heart disease and many other chronic conditions affect the kidney function and result in poor clearance of uric acids.
#3 Certain medications
Medications to suppress the immune system and antihypertensive medications such as, angiotensin-converting enzyme (ACE) inhibitors and beta blockers can increase uric acid levels in the body.
#4 Family
It’s all in the genes. If a close family member has gout, the risk of one having gout is higher.
#5 Sex
Genetically, men tend to have higher uric acid levels in their blood as compared to women.
#6 Age
The older one gets, the less efficient the kidney becomes and the more difficult it is to clear uric acid from the blood.
#7 Recent surgery or trauma
Excessive bleeding during surgery causes an increase in acidity at the joints and this facilitates easy deposition of uric acid crystals leading to gout.

Gout may happen at any joint area however it is mainly seen at the toes, fingers, elbow and ankle. Symptoms usually appear within 24 hours of trigger food consumption. The most common symptoms are stiffness at the affected joint, hard red lump at joint area, inflamed and tender joint area and intense pain that cripples movement.

To avoid gout flares, the individual has to determine their food triggers and avoid consuming those foods.

A simple way to determine food triggers is to keep a food diary or observe what you have eaten in the past 24 hours.

TAKE HOME MESSAGE
As a dietitian, here are my recommendations to minimise flare-ups and reduce occurrence of gout attacks.

  • Be aware of the food that you eat. Check nutrition labels for ingredients that may trigger your gout flare and when eating out, ask the waiters/chef the ingredients that are used in the meals ordered.
  • Ensure adequate water intake (min. eight glasses a day) unless advised otherwise.
  • Lose weight by eating healthy and exercising daily.
  • If you do not know what is triggering your gout, go vegetarian until you figure out the trigger. Eat more low purine foods like fruits, vegetables, nuts and seeds.
  • Certain foods like chicken may have high purine but they are also high in protein. If they do not cause a flareup, you can have them in small to moderate amounts as they are a good source of protein. After all, the focus is to have a balanced lifestyle.
  • Limit alcohol intake as the kidneys tend to prioritise clearing alcohol first over uric acid.
  • Fructose found in most processed foods can elevate blood uric acid levels that cause flare ups. Hence, eat more whole natural foods and stay-away from processed and artificial foods.
  • Avoid medications that trigger flare-ups. See your doctor for other alternatives.

Reshmy Ranee
Reshmy is currently a corporate wellness dietitian who works with multiple GLC’s and MNC’s. Besides managing corporate companies, Reshmy also has experience in being a dietitian in community clinics, hospitals and dialysis centres. Her motto in life is “Let food be thy medicine and thy medicine be thy food”. This means you can heal your own body with your food choices.