How to prevent gout symptoms (2022)

You wake one night to a stabbing pain in your big toe. The joint is swollen and stiff. When you went to bed, you felt fine. Now you’re in agony. What’s going on?

You might be one of the 8.3 million Americans with gout, a type of arthritis that can cause inflammation and severe pain. Gout is characterized by painful flares, often occurring at night, that can last a couple of weeks, with the worst pain usually occurring in the first 24 hours. Other symptoms of gout include warm, red skin around the affected joint.

Gout occurs when there’s a buildup of uric acid in the blood (a medical condition called hyperuricemia). Uric acid is a waste product that’s made when the body breaks down purine, a chemical produced by the body but that’s also found in a variety of foods. For most people, excess uric acid is excreted in the urine. But for some, uric acid builds up (either because its production is increased, its elimination is decreased, or a combination of both). That buildup leads to the formation of needle-like crystals that settle around the joints, particularly the big toe and lower limbs, causing inflammation and piercing joint pain. According to the Arthritis Foundation, keeping uric acid levels in the blood below 6 mg/dl is important to prevent gout attacks.

When it comes to preventing gout, recognizing symptoms, doing your best to avoid triggers, and getting treatment early are important first steps to take. “Hyperuricemia and gout are long-term medical problems,” says Lynn Ludmer, MD, medical director of rheumatology at Mercy Medical Center in Baltimore. “Over time, untreated gout can lead to chronic inflammation and joint damage, which may be permanent.”

8 common gout triggers

For centuries doctors thought gout was predominantly caused by diet. In fact, gout was often called “the disease of kings” because it was associated with a diet heavy on rich foods and meats as well as alcohol—a diet only the wealthy class could afford.

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Scientists now know that the main cause of gout is genetics and having a family history of the condition is your biggest risk factor. “People should understand that gout is genetic and not their ‘fault’ just because of their diet,” comments Theodore R. Fields, MD, FACP, a rheumatologist at New York City’s Hospital for Special Surgery. “Dietary and lifestyle changes will definitely help, but in only a small number of gout patients are they enough.”

But while genetics are the main risk factor for gout, there are other contributors, including:

1. Obesity

The more you weigh, the harder your kidneys have to work to eliminate waste products like uric acid from your body. In one study, published in the journal Arthritis and Rheumatology, people who were overweight had an 85% greater risk of having hyperuricemia (a precursor to gout) versus healthy-weight people. Obese people were up to 3.5 times more likely than normal-weight individuals to have too much uric acid. The researchers also found that 44% of hyperuricemia cases were attributable to excess weight alone.

2. Certain foods

Because of their higher purine content, some foods can raise levels of uric acid in the blood. They include:

  • Red meat
  • Fatty meats, such as bacon
  • Organ meats—for example, kidneys, liver, and tripe
  • Certain seafoods, including salmon, sardines, and anchovies; and shellfish, such as mussels
  • High fructose corn syrup (found in an array of products, particularly sugary drinks like sodas)
  • Alcoholic beverages, which contribute to gout not just because of their purine content, but because they also make it harder for the kidneys to excrete excess uric acid

How much of these foods is okay to have? “We don’t object to an occasional drink at a special occasion or a small amount of red meat or shrimp, but less is better,” Dr. Fields says. “It is a quantitative issue, so we advise having as little as you can. Fortunately, a gout diet is a healthy diet, so it’s a net gain in general health to follow a gout-friendly diet.”

(Video) Gout Diet Dos & Don'ts

3. High blood pressure

People with high blood pressure (hypertension) have a 2-to-3 fold increased risk of developing gout. According to the American Heart Association, uncontrolled high blood pressure can weaken, narrow, and harden the arteries that carry blood throughout the body, including the arteries found in the kidneys. That makes it harder for the kidneys to do their job excreting waste like uric acid from the body. What’s more, the diuretics (medications used to increase urination) that are often prescribed to treat high blood pressure can contribute to the problem by decreasing the amount of urate (a compound of uric acid) that’s excreted in urine.

4. Certain medications

In addition to diuretics, other medications that can increase the amount of uric acid or decrease their excretion include:

  • Low-dose aspirin
  • Immunosuppressant drugs—for example, those used to prevent organ rejection in transplant patients
  • Drugs used to treat tuberculosis
  • Nicotinic acid, used to treat niacin deficiencies (niacin is a B vitamin)

5. Diabetes

It’s a double-edged sword: The Gout Education Society notes that insulin resistance (a major risk factor for Type 2 diabetes) can lead to gout and having too-high levels of uric acid in your blood can lead to insulin resistance. The group reports that 26% of people with gout have Type 2 diabetes.

6. Gender

Men have a fourfold increased risk of developing gout versus women. It seems that the female hormone estrogen helps women keep uric acid levels in check, but that protection starts to fade once menopause hits and estrogen drops. “There are theories about why estrogen may protect women, including that the kidneys may excrete more uric acid in the presence of estrogen,” explains Dr. Ludmer.

7. Age

Gout risk tends to rise with age. That’s probably because many of the risk factors associated with gout—diabetes, obesity, and high blood pressure—tend to also rise as we age. Men are most likely to develop gout between the ages of 40-60. For women, it’s 60-80 years of age. Women are able to stave off the disease a bit longer due to the aforementioned protective effects of estrogen.

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8. Trauma to joints

People who had an injury to or surgery on a joint are more likely to develop gout in that area. “We know that physical stress can set off gout flares,” says Dr. Fields. “For example, some people get a gout flare after running. It’s thought that trauma on the big toe actually releases some of the uric acid crystals in the joint lining into the joint fluid, causing inflammation.”

How to prevent gout attacks

There’s nothing you can do about your genetics, but you can make healthy lifestyle changes that may help reduce the likelihood of developing gout. They include:

  1. Losing weight if you need to: Research shows that a weight loss of just seven pounds can have a beneficial effect on gout. Another study showed 71% fewer gout attacks with weight loss.
  2. Exercise: Physical activity can help you control your weight, which in turn can reduce your risk of gout. One caveat: Don’t exercise during a gout flare.
  3. Stay hydrated: The Arthritis Foundation recommends drinking at least 8 glasses of nonalcoholic beverages (preferably water) per day. And if you’re in the midst of a gout attack, double that amount to help flush excess uric acid from your system.
  4. Limit alcohol: Especially beer, which is high in purines! One alcoholic beer can raise uric acid levels 6.5%; a nonalcoholic beer can up it 4.4%.
  5. Reduce stress: Experts aren’t really sure how, or even if, stress can lead to gout—but they do know that emotional stress can often lead people to eat and drink more, thus putting them at greater risk of gout.
  6. Re-evaluate your food choices: In addition to limiting foods that can trigger gout, consider adding foods that may help promote the excretion of uric acid and/or have anti-inflammatory properties. According to the Arthritis Foundation, some of those foods include:
    • Low-fat dairy
    • Coffee
    • Foods rich in vitamin C (choose those that also are low in the naturally occurring sugar fructose, such as citrus fruits and strawberries)
    • Non-meat-based proteins, such as peas, lentils, tofu, and leafy green vegetables
    • Tart cherries

Treating an acute gout attack

If you’re experiencing gout pain, see your healthcare provider. “Even if you don’t need medication, you can talk about diet and possible weight loss and discuss when gout needs more aggressive management,” Dr. Fields advises.

Home remedies

Self-help measures that may ease the pain of an acute flare include:

  • Ice and elevate the affected joint
  • Drink lots of water
  • Limit activity

Medication

“In people with two or more flares of gout in a year, or gout with a history of kidney stones or decreased kidney function, or gout with tophi [deposits of uric acid under the skin around joints that resemble knobby growths], then they need their uric acid lowered with medication,” explains Dr. Fields.

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To treat your symptoms, your healthcare provider may recommend:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce pain and swelling
  • Colchicine, which decreases swelling and the buildup of uric acid
  • Corticosteroids to reduce pain and inflammation. These may be taken by mouth or given via injection.

To help lower uric acid levels in your body and prevent future attacks, you might receive the following oral medications:

  • Probalan (probenecid)
  • Uloric (febuxostat)
  • Zyloprim (allopurinol)

Or you might receive Krystexxa (pegloticase), a drug for IV infusions.

“Patients should have an open mind when discussing the possibility of taking medication for gout with their doctor,” Dr. Fields advises. “The opportunity to be ‘cured’ of gout is very high, if you stay on a medication such as allopurinol.”

FAQs

How do you prevent gout when you feel it coming on? ›

5 Steps to Stop a Gout Attack or Gout Flare Up
  1. Take Your Medication. ...
  2. Ice Down The Affected Area. ...
  3. Call Your Doctor. ...
  4. Increase Your Fluid Intake. ...
  5. Stay Away from Alcohol.
22 May 2017

What is the best preventative for gout? ›

Allopurinol and febuxostat are first-line medications for the prevention of recurrent gout, and colchicine and/or probenecid are reserved for patients who cannot tolerate first-line agents or in whom first-line agents are ineffective.

What helps prevent gout flare ups? ›

5 Tips for Preventing a Gout Flare-Up
  • Stop drinking beer. Limiting alcohol in general can lower the amount of uric acid in your bloodstream, but when you really want to drop the level, considering giving up beer. ...
  • Watch what you eat. ...
  • Munch on bananas, cherries, and celery. ...
  • Stay hydrated. ...
  • Get moving.

What triggers gout the most? ›

Eating a diet rich in red meat and shellfish and drinking beverages sweetened with fruit sugar (fructose) increase levels of uric acid, which increase your risk of gout. Alcohol consumption, especially of beer, also increases the risk of gout.

What is the fastest way to flush gout? ›

Drinking water may flush uric acid crystals out of your system. Preliminary research suggests that adequate water consumption during the 24-hour period before a gout flare can decrease recurrent gout attacks.

Can you get rid of gout once you have it? ›

Patients can never be cured of gout. It is a long-term disease that can be controlled by a combination of medication to control the uric acid level, and anti-inflammation drugs to treat a flare-up. “Lowering the level of uric acid is key to treating gout, and patients must understand this.

How can I fix gout permanently? ›

There is no cure for gout, and the condition can worsen over time without proper treatment. Treatments focus on reducing symptom severity during a flare-up and preventing future flare-ups. Doctors typically aim to reduce the amount of uric acid in the blood, which contributes to gout symptoms.

Why did I suddenly get gout? ›

What causes gout? Gout is caused by a condition known as hyperuricemia, where there is too much uric acid in the body. The body makes uric acid when it breaks down purines, which are found in your body and the foods you eat.

Does soaking in hot water help gout? ›

The key hypothesis is that these urate crystals dissolve on warming. Hence, by warming the joint concerned in hot water, and moving the joint around to encourage diffusion, the urate concentration is reduced and crystals no longer form, provided the treatment is continued.

Can gout go away in 2 days? ›

An acute gout attack will generally reach its peak 12-24 hours after onset, and then will slowly begin to resolve even without treatment. Full recovery from a gout attack (without treatment) takes approximately 7-14 days. An accurate and colorful discription of a gout attack was elegantly written in 1683 by Dr.

Should I walk with gout? ›

It is safe for people to walk with gout. In fact, doing joint friendly activities such as walking can help improve gout-related pain. Gout is a form of arthritis that usually affects the big toe joint, but it can also affect the lesser toes, ankles, and knees.

What fruit is good for gout? ›

Eat: Citrus Fruits

Grapefruit, oranges, pineapples, and strawberries are all great sources of vitamin C, which lowers your uric acid levels and helps prevent gout attacks.

What foods bring out gout? ›

Foods and drinks that often trigger gout attacks include organ meats, game meats, some types of fish, fruit juice, sugary sodas and alcohol. On the other hand, fruits, vegetables, whole grains, soy products and low-fat dairy products may help prevent gout attacks by lowering uric acid levels.

What are the 4 stages of gout? ›

Gout progresses through four clinical phases: asymptomatic hyperuricemia, acute gouty arthritis, intercritical gout (intervals between acute attacks) and chronic tophaceous gout. Demonstration of intra-articular monosodium urate crystals is necessary to establish a definitive diagnosis of gouty arthritis.

What not to eat if you have gout? ›

Foods to Avoid if You Have Gout

Beer and grain liquors (like vodka and whiskey) Red meat, lamb, and pork. Organ meats, such as liver, kidneys, and glandular meats like the thymus or pancreas (you may hear them called sweetbreads) Seafood, especially shellfish like shrimp, lobster, mussels, anchovies, and sardines.

Is lemon good for uric acid? ›

Lemon juice may help balance uric acid levels because it helps make the body more alkaline. This means it slightly raises the pH level of blood and other fluids. Lemon juice also makes your urine more alkaline.

Are bananas good for gout? ›

Bananas are low in purines and high in vitamin C, which makes them a good food to eat if you have gout. Changing your diet to include more low-purine foods, like bananas, can lower the amount of uric acid in your blood and reduce your risk of recurrent gout attacks.

Is gout a lifelong disease? ›

Gout is considered a chronic disease, meaning it does not have a cure and will usually last your whole life. Gout comes in sudden, and sometimes severe attacks, also called flares, or flare-ups.

Does apple cider vinegar help cure gout? ›

There is no proof that consuming or using apple cider vinegar can help prevent or treat gout. However, certain chemicals in apple cider vinegar, namely acetic acid, may lower the risk of developing conditions that can increase the likelihood of gout, such as obesity, diabetes, and high blood pressure.

Can gout lead to kidney failure? ›

This allows uric acid to build up, which may cause an attack of gout. Recent studies have found that compared with people who do not have gout, people with gout are: 29 percent more likely to suffer from advanced chronic kidney disease (CKD). 200 percent more likely to have kidney failure.

Can stress bring out gout? ›

Stress may trigger a gout attack, and it can exacerbate symptoms of a gout attack. While it's impossible to completely eliminate all of your stress, there are a number of ways to help minimize it. If you're experiencing a gout attack, reducing your stress can also help you focus on things other than the pain.

How long does gout take to heal? ›

An attack of gout usually lasts 5 to 7 days, then gets better. It may not cause lasting damage to joints if you get treatment immediately. Ask for an urgent GP appointment or call 111 if: the pain is getting worse.

Can stress trigger your gout? ›

Gout attacks may be triggered by any of these: Drinking alcohol. Eating a lot of protein-rich foods. Emotional stress.

Can turmeric help with gout? ›

If you have gout, try turmeric as a home remedy. Its most active chemical, curcumin, has potent anti-inflammatory and antioxidant properties. This may help ease gout-related inflammation and pain. When eaten in foods, turmeric is generally safe.

What vitamins to avoid if you have gout? ›

Avoid taking extra niacin and vitamin A. Both may play a role in gout.

Is raising your foot good for gout? ›

Elevate your foot – When you are experiencing gout pain, keep your foot elevated with pillows so that it is higher than your chest. Do this as much as possible to help reduce swelling and relieve pain.

Are eggs good for gout? ›

Eggs are a good protein source for people with gout, because eggs are naturally low in purines.

Can you stop gout before it starts? ›

Lowering uric acid levels with medication can prevent future gout flares and long-term complications that go with them.

What helps early onset of gout? ›

Colchicine. If you're unable to take NSAIDs or if NSAIDs are ineffective, a medicine called colchicine can be used instead. Colchicine reduces some of the swelling and pain associated with a gout attack. It's best to have it with you at all times so you can use it at the first sign of a gout attack.

What causes a sudden flare-up of gout? ›

What causes a sudden gout flare-up? Gout flares are the result of too much uric acid in the blood. This is often the result of eating purine-rich foods, taking certain medications, some health conditions, consuming alcohol, and becoming dehydrated.

Does drinking water prevent gout? ›

You can also help reduce the number of gout attacks you have by drinking plenty of fluids, especially water, but you should avoid drinks sweetened by sugar or too much fruit juice as these can trigger an attack. Diet drinks are fine.

What foods help gout go away? ›

Eat more fruits, vegetables and whole grains, which provide complex carbohydrates. Avoid foods and beverages with high-fructose corn syrup, and limit consumption of naturally sweet fruit juices. Water. Stay well-hydrated by drinking water.

Does gout ever fully heal? ›

An acute gout attack will generally reach its peak 12-24 hours after onset, and then will slowly begin to resolve even without treatment. Full recovery from a gout attack (without treatment) takes approximately 7-14 days.

Can dehydration trigger gout? ›

Dehydration. When you're dehydrated, your body doesn't have enough water and your kidneys can't get rid of excess uric acids as well as they normally do. This can give you more gout symptoms. One reason alcohol is not good for gout is that it's dehydrating.

Does dehydration flare up gout? ›

Water intake: Dehydration is also another potential cause of gout flares, as your kidneys can't function properly and rid the body of the excess uric acid without water.

What can I drink to fight gout? ›

Drink: Water and Coffee

Chug your water to help flush uric acid out of your system. Down eight glasses a day, or 16 if you're having a gout flare. And coffee can help, too. Regular, caffeinated coffee can help lower gout risk.

Does lemon water get rid of gout? ›

Lemon juice might help lower uric acid levels. However, it can't cure gout or any other illness. Get medical treatment for gout and any health conditions that may make you more likely to get gout.

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