Gout - painful joint pain can be stopped

gout - painful joint pain can be stopped

Gout is a metabolic disease in which the level of uric acid in the blood is increased, which leads to painful inflammation of the joints and kidney damage.

20% of the population have an elevated uric acid level and are therefore at risk. 80% of those affected are men. A new drug on the market can effectively lower uric acid levels.

Uric acid is produced in the metabolism from "purines". These substances are contained in almost all foods. If the organism produces too much uric acid or, as is usually the case, too little uric acid is excreted via the kidneys, an increased uric acid level occurs. The German Gout League has found that over 1 million people in this country are affected.

The big toe is usually the first to be affected

At the onset of gout, elevated uric acid levels can be detected in the blood for several years. Pain symptoms in the joints are still rare.

Then the first acute attack of gout occurs. So many uric acid crystals have already been deposited in the joint that the surfaces begin to rub. The first attack of gout usually affects the joint of the big toe. The metacarpophalangeal joints of the toes and thumb are often affected at night. The joints are red, swollen and very painful. Fever attacks also occur.

If the uric acid concentration in the blood is permanently too high, the tiny uric acid crystals are deposited in joints, tendons, skin or kidneys. The consequences are painful inflammation and gout attacks.

In the third stage, gout becomes a chronic disease with long-lasting joint pain and severe deformities.

Factors that increase the risk of gout:

• inherited tendency
• lack of exercise
• unfavorable Nutrition: lots of meat, sugar (fructose) and alcohol
• overweight
• Kidney disease
• Diabetes

Gout primarily affects the joints. Gout patients are also at risk for Stroke increased by 71% and that for a Heart attack by as much as 82%. The kidneys can also be damaged.

Diet has less influence on gout than previously thought

In October 2018, scientists at the University of Otago/New Zealand examined the influence of diet on uric acid levels in 16.760 people. Although some "problematic foods" were found, the effect of diet was much smaller than previously assumed: With a diet the uric acid level could only be reduced by an average of 1%.

Medications can also increase the risk of gout

A British study has shown that calcium antagonists (verapamil, amlodipine, nifedipine) and the AT1 blocker losartan have been shown to be safe medications. For those who suffer from gout or elevated uric acid levels and also have high blood pressure, it is important which blood pressure lowering medication they take. This is because most blood pressure lowering medications also increase your uric acid level and increase your risk of gout.

A new active ingredient could double the success of gout treatment

To reduce uric acid levels, the active ingredient allopurinol is currently prescribed. It inhibits the enzyme in the body that converts purines into uric acid. If allopurinol is not sufficient, it can be combined with another active ingredient: benzbromarone. It increases the excretion of uric acid. However, it should not be taken if you have weak kidneys (renal insufficiency).

However, it is possible that allopurinol is also excreted more frequently via the kidneys and is therefore less effective. The new active ingredient lesinurad can bring about a significant improvement here. It also increases the excretion of uric acid and can also be used in cases of mild to moderate kidney failure.

During two large international studies, the uric acid levels of more than 1000 gout patients fell by around 25% with allopurinol alone. In combination with lesinurad, the success rate increased to 55%!

People at risk or affected by gout can contribute to relief themselves

• Foods that increase uric acid levels, such as meat and sausage, sweets, sugary sodas, alcoholic beverages should be avoided
• Foods such as cereal products, fruit (except citrus fruits) and vegetables can be consumed without concern
• Legumes, spinach, potatoes, mushrooms, nuts, pumpkin and sunflower seeds, eggs, dairy products can be consumed in smaller quantities or every now and then
• Meat should not be eaten more than two small portions (about 150 g each) per week. Lean poultry meat and poultry sausage are preferable. On the other hand, offal and fatty meat (including fatty poultry from goose and duck) are very harmful.
• 2 liters of fluid per day is the minimum amount to support the kidneys. We recommend water and unsweetened herbal teas instead of sugary sodas. Coffee is conditionally recommended, but it even lowers the uric acid level
• Excess weight should be reduced. When losing weight, it is important to ensure that you consume enough protein, otherwise muscle mass will also be reduced. This releases purines, which can trigger a gout attack.
• Regular exercise helps joint inflammation to subside more quickly, even if gout-related joint pain makes exercise difficult.