Get out gout
Waking up in the middle of the night with a painful, red, hot and swollen big toe is a common phenomenon for patients suffering with gout. Most patients describe the pain as being out of this world. Interestingly, in my clinic men rate the pain at 10+ out of 10 and women rate it 8 out 10. Nothing in our Rheumatology clinic causes more anxiety than a current gout attack or the thought of another gout attack. Gout is a common condition that affects about 8 million Americans every year. If you have it, you are not alone. Strangely, not a lot of people think about it. One reason why is because attacks of gout go away after a week and people assume they injured their foot doing something. Unfortunately, this leads to a delay in the diagnosis of gout and can lead to more problems with joint damage down the line.
What is the driver of gout? What do we mean by ‘driver of gout’ exactly? For instance, we know that high blood sugar drives diabetes and high cholesterol drives heart disease. Uric acid is the driver of gout; like blood sugar and cholesterol it belongs in your body. We all need blood sugar to produce energy, we need cholesterol to make hormones and we need uric acid to help us as an antioxidant. However, like the saying goes, too much of a good thing is a bad thing. Having too much cholesterol, blood sugar and uric acid are bad for your health.
Uric acid can be built-up in the body from diet, decreased kidney function, and even certain medications. When someone has high uric acid for many years, nightmare inducing gout attacks can start. Diet that is high in red meat like beef, pork, lamb, sugary drinks (regular sodas and juices) and alcohol can elevate uric acid and trigger attacks of gout. On the other hand, low fat dairy can reduce uric acid. There is no research demonstrating that eating vegetables can cause gout attacks.
There is a lot of bad information online about what to do for gout. From peculiar diets, magic pills, specialty one-of-a-kind cures to avoiding treatment purely, information is all over the place. As a quick rule of thumb, everyone who is experiencing gout attacks should modify their diet and lose weight. This helps lower uric acid. If someone has more than two attacks in twelve months, they are likely going to have more attacks in the future and should start treatment. Treatment involves lowering uric acid to safe levels to reverse effects of having high uric acid for many years. If you have more than two attacks of gout in a year and want to treat it, we recommend that you see your local friendly rheumatologist. Gout is terrifyingly painful with long-term impact and for most people, it is unnecessary.
Learn more about Hennepin Healthcare Rheumatology services at hennepinhealthcare.org/rheumatology
Make an appointment with a Rheumatologist by calling 612-873-6963
Linh Ngo, DO is a rheumatologist who specializes in autoimmune and connective tissue diseases. In addition, Dr. Ngo is certified for musculoskeletal ultrasound and uses ultrasound for both diagnostic and therapeutic procedures.