Simple Gout Treatment

I know gout can be complicated, but let’s try the simple approach to gout treatment before we look for difficulties.

Gout treatment is the heart of finding gout freedom.

Gout treatment must be preceded by a proper medical diagnosis of your gout symptoms.

Gout treatment might  be followed by adjustment to your gout diet.

So for all of you making life difficult for yourselves by worrying about food and drink – stop now. Do not even think about diet until you have a good gout management plan.

1. Starting A Gout Treatment Plan

The best gout treatment plan starts with good diagnosis from your doctor(s). If you have a confirmed gout diagnosis then move to step 2.

Gout diagnosis can be difficult for a small minority of gout patients. For most people, it is very simple.

If your gout symptoms are not confirmed, see your doctor or rheumatologist today. If they are confirmed, a more complete analysis of possible causes is useful, but not essential. If you have it, it may give you more options for gout treatment.

I will announce a personal gout symptoms assessment tool soon. In the meantime read the Gout Symptoms section, which is first in the list of sections near the top and bottom of every page. If you still have questions, ask in the Gout Symptoms forum.

Continue to read your simple 3 step gout treatment plan

Find more (see gouty search hints for guidance).


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Are You Juicing For Gout?

There have been many discussions about juicing for gout.

To be clear, this is not about taking commercially prepared juices, such as cherry juice for gout. This is about juicing your own fruits and vegetables to provide fresh juice. Generally, these home-prepared juices have a higher vegetable content than most commercial juices. In essence, it is a way to get a concentrated serving of vegetables in order to maximize the benefits from them. In forum discussions, I have seen juicing related to lowering uric acid, alkalizing the body, and reducing (or preventing) iron overload.

In order to improve diet so that it is generally healthy, whilst also helping control gout, then juicing may well have a large part to play. I am currently researching various benefits of specific juices that you can prepare at home. However, besides the nutritional science, I would like my guidelines to include practical tips for preparing and using home-prepared fruit and vegetable juices.

Typical information includes:

  • What is the best juicing machine?
  • Are there any foods that are particularly useful?
  • Are there any foods to avoid when juicing?
  • Is juice best with meals, or as a snack between meals?

But I do not want to be restrictive. Please share any experiences and recipes that you think might help improve juicing for gout.

Read more about Juicing For Gout

Gout and Iron Revisited

An old discussion about gout and iron has been woken this week.

It is not really a topic that has ever gone away. Though not discussed in detail recently, I mention the relationship between excess iron and gout in many discussions. I also include it in many guidelines, including causes of gout in the Gout Symptoms guidelines, and gout foods to avoid in the Gout Diet guidelines.

For me, the turning point in recognizing the importance of iron for gout sufferers came when I heard about Facchini’s experiments with blood donation as a way to control gout. That research is cited in a more recent analysis of gout and iron. In a letter to the Rheumatology journal, Mascitelli, Pezzetta, and Goldstein offer a possible explanation of how iron affects uric acid and gout.

They believe that the key is inflammation, noting that it is the common link between iron overload and increased gout and heart disease. They refer to some interesting science explaining how uric acid binds with free iron, and exploring links between iron and inflammation. Their remarks include:

We propose that iron may represent a factor that triggers inflammation and heightens cardiovascular risk in gouty patients.

Accumulating evidence suggests that gout is a disease of iron overload. [...]

Therefore, iron may represent an important biological link between gout and cardiovascular disease.

This, in turn, leads me to an interesting conclusion.

Learn Vital Aspects Of Gout And Iron

Dangers Of Gout Triggers

Gout triggers get discussed every week in the gout forum. I wish they would go away, because they are dangerous.

I want to get rid of gout triggers. Yes, I want you to be able to stop gout attacks, but I also want you to stop talking about gout triggers.

To be clear, gout triggers are dangerous because they are misleading. They might also be bad for your health, but the biggest danger is confusion.

What Are Gout Triggers?

To avoid confusion, you must learn one thing.

There is only one gout trigger. The trigger for a gout attack is our immune system reacting to uric acid crystals.

There might be many reasons for that reaction, but the reaction is the thing that triggers a gout attack. Now that you know that, please let me explain why it is dangerous to be confused.

Read the Dangers of Gout Triggers

New Therapies For Treatment Of Gout

I looked at new therapies for gout when I reviewed Arcalyst as a potential new treatment of gout pain.

When I first became aware of gout, over 15 years ago, there were two different approaches to gout management: treat the pain, or treat the excess uric acid. Now we know that simply treating pain is not enough. It is good to be pain free, but dangerous if your gout is getting worse.

We now understand a lot more about how uric acid crystals destroy joints and damage other tissues. Professional medical advice is clear. We must lower uric acid to a safe target, and we will probably need pain relief for a few months until all crystals are gone.

There is a simple basic formula for medical treatment of gout that works for most gout patients. You take enough allopurinol to reach a safe target uric acid level, and take colchicine for a few months to prevent gout attacks. There are one or two complications in that approach, but for most people it is very simple. However, I explained in the Arcalyst article that some people cannot tolerate mainstream gout pain medication. Similarly, some people cannot tolerate mainstream uric acid lowering medication.

For people who cannot tolerate either allopurinol or Uloric (febuxostat), or find they are ineffective, scientists are seeking new alternatives. Earlier this year, Crittenden and Pillinger reviewed the current situation in New therapies for gout, published in January 2013 by Annual Review of Medicine. They review three new pain relief therapies that I mentioned in my Arcalyst feature (canakinumab, rilonacept, anakinra). They also review three new therapies for lowering uric acid.

I have already written about Krystexxa (pegloticase), and I will write about lesinurad soon. That leaves BCX4208, which I will review here.

Read more about new therapies for gout

Arcalyst – A Winner For Gout Pain Relief

I’m delaying updates to my Gout Treatment For Pain Guide until I have completed my personal gout management guidelines. However, that guide touches on Arcalyst for gout, and recent developments make it important for me to publish an interim update.

Arcalyst (the brandname for rilonacept) is included in my gout pain relief guide, and despite getting rejected last year by the FDA, it remains a potential treatment. Though colchicine, NSAIDs (Non-Steroidal Anti-Inflammatory Drugs), and steroids remain as the main forms of gout pain relief, some gout patients cannot tolerate these. Arcalyst is touted as a fourth option, together with similar drugs in the pipeline.

Inflammation Blockers For Gout

In my gout pain relief guide, I included pipeline drugs: rilonacept (Arcalyst); canakinumab (ACZ885); infliximab (Remicade); and anakinra (Kineret). Arcalyst was turned down last year, but the option to re-submit an amended application has remained. I have no knowledge of a pending application, but when I see 5 studies on rilonacept published so far this year, my crystal ball starts twitching. Do not be surprised if a new application is submitted soon. I will wait until that happens before reviewing gout studies in detail, but here are a couple of recent reports relating to inflammation blockers for gout.

I’ll look at the most recent first, as this looks at inflammation blockers in general.

Read about the latest inflammation blockers including Arcalyst for gout

Get To The Heart Of Gout & Angina Risks

Two things have prompted me to write about gout & angina today. Bob mentioned hyperuricemia risks in his recent post about natural ways to lower uric acid. Now, we have an investigation into hyperuricemia risks associated with angina.

Hyperuricemia, the medical term for high uric acid, is usually related with gout. However, in recent years, there is increasing evidence to suggest that high uric acid is associated with other health risks. Over time, as relationships become clearer, I will summarize these in my Gout & Disease guidelines.

Angina is a specific form of heart disease marked by sudden spasms of chest pain due to reduced oxygen to the heart. Here I present a layman’s review of the abstract of an investigation into uric acid and angina.

Read about the Uric Acid & Angina Report

Casein For Healthy Uric Acid

Regular readers who have waited patiently for more information on natural gout cures will be pleased to see the return of guest writer, Bob Coburn, inventor of PURIXA. Here is another article from Bob, explaining casein, a milk protein, and it’s role in gout control.


Casein Protein as a Potent Natural Agent to Support Healthy Uric Acid Levels

The key to avoiding gout and other related diseases like kidney stones and heart disease is to address the underlying issue of high uric acid. High uric acid is referred to “hyperuricemia”. As you can see from the graph below, there is a high correlation between UA levels and several life threatening diseases.

There are two approaches that physicians can take to reduce UA levels – promote excretion or block its formation.

Read more about Casein For Healthy Uric Acid