Gout: Dr. Rosemary Leonard advises on symptoms and treatment
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Arthritis describes a host of conditions characterised by painful inflammation in the joints. Few of these ailments are treatable, but gout is an exception. Fortunately, gout also happens to be one of the most preventable forms of arthritis. The aim is to avoid increasing levels of urate crystals in the blood, which certain supplements have been known to do.
Gout describes a specific type of arthritis caused by the deposits of uric acids in the joints, mainly around the elbows, knees and hands.
According to the AAFP, men have a higher risk of developing the condition than women, primarily because women tend to have lower uric acid levels.
This changes after menopause, however, when a women’s uric acid levels tend to approach those of men.
Uric acid is the main culprit that drives gout as it coalesces into crystals that inflict intense episodes of pain in the joints.
According to Harvard Health, “its needle-shaped crystals are the root cause of the inflammation, redness and pain” seen in gout.
Medicines linked to the condition primarily include diuretics and drugs to treat cancer, but natural supplements have also proven problematic.
Vitamin A and niacin have both been identified as culprits in the development of gout due to their interference with uric acid levels.
People often use vitamin A to preserve eye health and niacin – also known as vitamin B3 – to control cholesterol levels and boost brain health.
It should be noted that complications from this supplement are only likely to arise when the kidneys are unable to filter out the excess uric acid from the body, which would require high doses of supplements.
The Mayo Clinic cautions: “Niacin can cause an excess of uric acid in the blood, (hyperuricemia), putting you at risk of gout.”
Research published in the Journal of Lipid Research in 2013 confirmed this after finding the supplement increased levels of uric acid in the blood.
The effects were put down to the inhibitory effect of niacin on oxidising enzymes, or alternatively due to a decrease in the excretion of uric acid.
In 2015, research published in the journal Nutrition Research yielded similar findings while investigating the effects of vitamin A.
The meta-analysis found that concentrations of uric acid in the blood tended to be positively associated with concentrations of vitamin A.
The researchers concluded their study by highlighting the need for further experimental studies to confirm their findings.
Due to their suspected involvement in gout, however, Mount Sinai advises anyone at risk to avoid taking niacin and vitamin A.
Both vitamins can be found in food, but the main dietary contributors to gout tend to be rich in purine.
Harvard Health notes: “Some seafood contains high amounts of purines. People with gout don’t have to steer completely clear of fish.
“But try to limit the amount of shellfish, sardines and anchovies you eat, because they have the highest amounts of purines.”
Once inflammation is triggered, it may cause “serious discomfort and should be treated by a doctor when there’s a flare-up”, explains WebMD.
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