10 8 月 KNOW ABOUT GOUT
Ever had the experience of being attacked by the joint-pain while sleeping in the middle of night, and felt too painful to go back to sleep? Is this gout flare or other types of arthritis? TAIZAKU will give you a full introduction about gout, its symptoms, how to prevent and treat gout, to help you step by step manage your gout problem.
What’s the causes of GOUT?
Hyperuricemia is responsible for gout development. Our body generates uric acid when breaking down purines, which are naturally in your body or from the foods. And if there’s too much uric acid in your blood, uric acid crystals may build up in the joints. When the crystals accumulate in the joints, the white blood cells attack these intruders, and it causes inflammation and intense pain.
Gout attacks usually happen during the mid night, because water consumption is not enough, or the uric acid dissolution rate is lower due to lower temperature, and wake people up through a sudden intense pain.
The cause of hyperuricemia
Hyperuricemia is defined as uric acid > 7 mg in every 100 ml of your blood. 2 main causes that lead to hyperuricemia are producing too much uric acid, and getting rid of too little of uric acid. The reasons of producing too much uric acid include excessive diet and genetic factors. And the reasons of getting rid of too little uric acid are mainly metabolic disorders. Bad lifestyle, drinking too much alcohol, drinking too much sugary beverages can also affect the metabolic functions, make the body difficult to excrete uric acid and then the uric acid level exceeds the standard range.
Higher the uric acid is, more possible gout attack will occur
Even having hyperuricemia, some people might not have gout attack in their whole life. But uric acid level is still highly related to gout attack possibilities. Generally speaking, a male with uric acid between 7.0 ~ 7.9 mg/dL, his gout attack possibility is about 17.3%, and if uric acid is between 8.0 ~ 8.9 mg/dL, the gout attack possibility rises to 27.5%, and if uric acid is higher than 9.0 mg/dL, the gout attack possibility rapidly jumps to 90%.
Gout symptoms, and 4 phases of gout
The problem of gout is not just about the moment when it attacks. There are different symptoms before and after the attack, we’ll walk you through the 4 phases of gout attack.
1st phase of gout: Blood uric acid level gets high
During this phase, a patient’s uric acid is too high, but no pain occurs in the joint. Even though the uric acid is higher than 7.0 mg/dL, there’s only 17.3% possibility gout attack will happen. Regular body tests are necessary, and if uric acid keeps go up, consulting a doctor is highly suggested.
2nd phase of gout: Acute gout attack happens
When the acute gout attack is happening, the joint (especially the first joint of big toe) feels pain and swollen, high fever may occur in worse cases, going to hospital in 24 hours is suggested.
3rd phase of gout: The interval or chronic crystallization
It usually enters a no-symptom interval after an acute gout attack, if the high uric acid problem doesn’t get improved, gout attack will continue to happen.
4th phase of gout: The formation of gout stone
While gout attack happens recurrently, the high uric acid problem is not getting any better, the uric acid crystals will accumulate in the joint becoming a gout stone, and in some worse cases it even deforms the joint, affecting normal activities. Besides taking the prescribed medicines to lower the uric acid, some may need to have a surgery to take out the gout stone.
What are common gout places in the body?
Gout mainly happens in the joints of end points of the limbs, such as finger joints, wrists, elbows, knees, foot hills, ankles, instep joints, toes, etc. These places have relatively poorer blood circulation, and uric crystals could build up easily in these places. The first gout attack usually happens at the first joint of the big toe, and then followed by other places as time goes on.
Who is at risk of gout? 8 lifestyles and eating habits to be avoided!
1. Offal and seafood lovers
Uric acid produced from breaking down the food accounts for 20% in a day. Most offal and seafood carry rich puring, and eating offal and seafood increases uric acid and makes the higher risk of gout.
2. Excessive diet, people who eat too little
Balanced diet is important. Enough nutrition can maintain good metabolism and avoid poor uric acid excretion.
3. People who’re under great working pressure
Being under high pressure makes people nervous, and may cause endocrine disorder, increasing uric acid production. This can lead to hyperuricemia development and higher possibility of gout.
4. People who love to drink alcohol
Alcohol consumption can increase lactate level, and affect uric acid metabolic rate.
5. People who do intense anaerobic exercise a lot
Anaerobic exercise such as weight training sometimes causes gout easily. There are 3 reasons: 1. During intense exercise, our body burns ATP and our cells directly produce purine. 2. Lactate is also produced to lower uric acid metabolic rate. 3. Sweating may also reduce urine formation, and less uric acid can be taken out. Above 3 reasons can lead to the rise of uric acid.
6. Sugary beverage lovers
According to some statistics, people who drink 2 sugary beverages everyday have 85% higher possibility of developing gout than those who don’t drink sugary beverages. It’s because the sugar in the beverage may cause metabolic disorder. If the body can’t get the uric acid out easily, it leads to the rise of uric acid and possibility of gout.
Obesity can lead to bad metabolism and have the uric acid stored in the body. To improve this problem, doing aerobic exercise for 30 minutes, 3 times every week as a regular, moderate habit, such as walking, swimming, can help the body burn calories and fat, and get the metabolism back to its normal state.
8. People with family history of gout
According to some statistics, people who have family-history of gout have 40% of high possibilities to develop gout, because gout can be inherited from parents. If your relatives have gout, then you should be more careful and avoid having too much alcohol, sugary beverages, high purine foods, and keep a good lifestyle.
Is it a gout attack? How to tell the difference between gout and other arthritis
Common joint pain situations can not only be caused by gout, but also other types of arthritis like pseudogout, osteoarthritis, rheumatoid arthritis, rheumatic disease
Caused by high uric acid crystallization, and usually happens in the joint of end point limbs, and mostly on male. Females are protected by female hormone and the gout possibility will go up after menopause.
It’s caused by calcium pyrophosphate deposition (CPPD), happening in cartilage, synovial membrane, ligament, and tendon, mostly in big joints like knees, ankles, wrists, shoulders, elbows.
Osteoarthritis is because, through a longtime overuse of ligaments and muscles that damages the bones. It usually happens to people of ages more than 50 and could lead to bone spur if this condition is ignored.
Due to the infection of β-hemolytic group A streptococcus, and the body’s immune system overreacts to the infection and then attacks other tissues in the body, causing inflammation, pain, and suppuration.
Other than rheumatic disease, rheumatoid arthritis is caused by the immune system attacking the joint for unknown reasons. The pain of this type of arthritis is the most severe among these 5 arthritis types. It could deform the joint greatly and affect basic activities of everyday life if not taking any treatment.
How to treat gout? Common medicines for gout treatment
When a gout attack happens, clinically we often see 3 common medicines prescribed to patients to treat the pain:
Colchicum seed extracts
Colchicum seed extracts is the primary medicine in terms of gout treatment. Its main purpose is to ease the pain, but some people may have diarrhea as a side effect, so should be careful of the dosage.
It also can be used to ease the pain, but it’s not suitable for people who have cardiovascular disease, kidney dysfunction, or peptic ulcer disease.
Can be treated by oral or local injection, but not suitable for people who have diabetes.
How to prevent gout attack?
2 kinds of medicines to lower uric acid you should know
To reduce the gout attack possibility, the point is to reduce the uric acid. After the gout attack peak, one should follow doctor’s instructions to take medicines for inhibiting the production of uric acid, or boosting uric acid excretion. The purpose is to control the uric acid, make it gradually go back to the standard level, and decrease the gout attack rate.
Common medicines for lowering uric acid are:
1. Uric acid inhibition medicine – Xanthine oxidase inhibitor
黄嘌呤氧化抑制酶（Xanthine oxidase inhibitor），main medicines are Allopurinol, Febuxostat, can inhibit puring, reduce the production of uric acid, lower the gout attack rate.
2. Uric acid metabolism booster – URICOSURIC AGENT
Uricosuric agent can inhibit the reabsorption of uric acid in the body, increasing the metabolism, helping lower the uric acid in the blood. And there are 3 medicines of this kind: Benzbromarone, probenecid, and sulfinpyrazone.
Besides the medication, developing a good lifestyle is also important for uric acid control.
Five good habits of healthy lifestyle to ease gout
To remain in a healthy condition, try to keep 5 habits below that are helpful to lower gout attack rate:
1. Take moderate protein
Take protein moderately to avoid protein taking up too much of metabolism rate, causing the rise of uric acid.
2. Take less fat
Too much fat stacked in the body can also inhibit the uric acid excretion.
3. Balanced diet
Nutritions should be balanced, and the diet of whole grains, vegetables, and meats (fish, eggs, meats) should be 2:2:1.
4. Drinking more than 2000ml water everyday
Enough water consumption can help the body excrete the uric acid, and also can avoid developing kidney stones.
5. Regular exercise, keep the body in good shape
60% of the gout patients are overweight, it may cause insulin resistance and reabsorption of uric acid could happen, increasing gout attack rate. Therefore, regular exercise is highly suggested to improve the body shape and avoid gout.
Four common questions about gout
1. Can bean products cause gout?
Bean products contain higher purine, but according to some research that has confirmed vegetal purine doesn’t affect our uric acid level. It’s fine to take some bean products moderately.
2. Is gout an inherited disease?
It’s found that about 10 ~ 25% of patients’ gout cause is related to the genes. The mutation of their HPRT gene makes the body unable to excrete uric acid properly. And if one’s immediate family members have gout, then his possibility to develop gout is twice higher than regular people.
3. Can gout be cured?
Gout can be cured through medication control, lifestyle change, diet change. If the hyperuricemia problem can be improved, one can get back his healthy body and say bye to gout.
4. What hospital department should I go to see a doctor for gout?
Gout is one of the arthritis diseases, and should be dealt with by professional doctors from rheumatology department.
New option to prevent gout attack－
Besides taking prescribed medication from doctors, for routine maintenance, take some supplements that contain the “ANTI-CRYSTAL Biotech.” ingredients. “ANTI-CRYSTAL Biotech.” is a Japanese patented ingredient that has been under the research for many years aiming to lower the uric acid. It activates the HPRT and LDH enzyme, to adjust production of uric acid and improve the uric acid excretion. Through 9 clinical experiments, it is confirmed effective for uric acid control.