One of the most common symptoms I see in clinic when treating clients with kidney disease, is the complaint of excruciating pain in one or many joints. They can even find it unbearable to the point that it immobilises them, and prevents them from working. In the past this was associated with kings and royalty, due to the excess consumption of certain foods and drinks. Now it is simply known as gout – and now it is very easy for all of us to over indulge. Gout and kidney disease unfortunately go hand in hand.
Gout can often seem, to begin with, a pretty innocuous condition; random joint pains lasting a few hours or days at best. But soon, very soon, the gout “attacks” seem to be unrelenting, causing joint specific inflammation, pain, heat, and decreased movement. But don’t worry… I have a tool kit of natural medicines to help reverse this condition easily a little further down.
If you are currently suffering from joint pain but are unsure if it is gout or not, here is a good diagnostic checklist:
- Rapid onset, of classically one joint in the fingers or toes (most often the big toe – 50% of cases), occurring frequently at night
- Swelling, heat, stiffness of joint
- Shiny red or purple coloration of joint
- During attacks body temperature may rise to 39°C (102.2°F)
- Occurs commonly together with uric acid kidney stones
- Periods of being asymptomatic, followed by acute attacks
- Gout is a familial disease. A familial disease is hereditary, passed on from one generation to the next
- Monosodium urate monohydrate (a crystalline substance) builds up in and around the joints of extremities, causing gout
- Increased uric acid levels in the blood
- 95% of cases are males
- 30 years of age or greater
So what is the cause of this condition?
Well I am glad you asked… essentially gout is the deposit of monosodium urate crystals in and around the joints, which are caused by increased levels of uric acid. Uric acid is formed when purines are broken down. Purines are found in certain foods such as meat, peas, and alcohol, and also occur naturally in our cells. High levels of uric acid cause inflammation and damage to joints and soft tissues. So gout can be either caused by the overproduction or under excretion of uric acid, such as in kidney disease. Gout can be a very common occurrence in those suffering from under functioning kidneys.
Here is a list of the major contributing factors, and risk factors, of gout:
- Kidney failure
- Family history of gout
- Diet high in purine-containing foods
- Alcohol: alcohol has two mechanisms that induce gout attacks 1. alcohol increases uric acid production 2. alcohol reduces kidney function, thereby reducing the removal of uric acid via the urine
- Diabetes mellitus
- Thiazide diuretics
- Bone fracture or surgical procedure
- Polynesian background
- High blood pressure
- Lead crystal glasses: Lead toxicity is a cause of gout (“saturnine gout”). Leaded crystal decreases renal urate excretion.
One of the best ways to reduce the severity of gout attacks and make sure that it is healed completely, is to eliminate all possible risk factors and causes… simple right?
To some degree yes. Though if we glance back up the page we will notice a collection of 11 major contributing factors (and there are umpteen more minor contributing factors) some of which we cannot control, such as genetics. So we need to be realistic … But also HONEST with ourselves. What are YOUR major contributing factors for developing gout? And don’t just say kidney disease, as that will not cut it, I am sure you have at least one other contributing factor that can be improved on. That little extra weight maybe? How about that glass (or two) of wine each night, or the over consumption of meat? Whatever it is, I am not here to judge, I am just wanting to see you well, and help you to stay well. And to do that we need to ease the pressure off your kidneys as much as possible while they are trying to heal.
So let’s go through some of these tips shall we?
Diet and Food
1. Avoid alcohol – beer especially, as it has the most purine content out of alcoholic drinks
2. Reduce excess weight
3. Consume 225 grams (half a pound) of Cherries each day for two weeks. This will help lower uric acids levels naturally. You may use either fresh or frozen cherries. You may also like to try 250 mLs of cherry juice a day instead. After the two weeks, lower the dose to 100mLs for maintenance and prevention.
4. Drink plenty of water – dehydration can aggravate gout
5. Avoid sugars, refined carbohydrates, and reduce glycaemic load of diet. Insulin is produced in response to sugars and carbohydrates. This production of insulin in turn inhibits uric acid breakdown, thus higher levels in your blood.
6. Limit purines in diet – Foods with a very high purine content are: Anchovies, Beef, Bouillon, Brains, Broth, Consommé, Dried legumes, Goose, Gravy, Heart, Herring, Kidneys, Liver, Mackerel, Meat extracts, Mussels, Organ meats, Partridge, Roe, Sardines, Scallops, Shrimp, Sweetbreads, Yeast (baker’s and brewer’s), Yeast extracts (e.g., Marmite, Vegemite). Foods with a high amount of purines include meats, poultry, fish, and shellfish. Foods with a moderate purine content include: asparagus, cauliflower, legumes, lentils, mushrooms, oatmeal, peas, soy, spinach, tripe.
Avoid alcohol, eat a low-purine diet, achieve your ideal body weight, eat an abundant supply of complex carbohydrates (vegetables, fruits, and un-refined carbohydrates e.g. rye, millet, buckwheat, spelt, kamut, quinoa, rice), low saturated fats (i.e. animal fats), low protein, and keep well hydrated with pure, fresh water (helps eliminate uric acid and prevents kidney stones).
7. Amino acids: Alanine, aspartic acid, glutamic acid, and glycine: help increase the excretion of uric acid via the kidneys
8. Bromelain: reduces inflammation via enzymatic properties; take between meals. Naturally occurs within pineapple
9. Fish oil: reduces inflammation. Make sure it is high quality, highly filtered fish oil to eliminate heavy metals
10. Folic acid: inhibits the enzyme that produces uric acid in the body
11. Quercetin: inhibits the enzyme that produces uric acid in the body. Best taken with Bromelain, in between meals. Found with the skins of fruits
12. Serrapeptase: natural enzyme that reduces inflammation
13. Vitamin B6 & B12: reduces uric acid levels
14. Vitamin E: reduces inflammation
15. * Avoid Vitamin B3 (Niacin) in gout: lowers excretion of uric acid
16. * Avoid megadoses of Vitamin C in gout: megadoses can increase uric acid levels in some individuals
17. Epsom salts (magnesium sulphate) are also very beneficial for relief. Add 250 gm – 500gm of epsom salts to warm water, and soak feet for 15 minutes twice a day.
The pharmaceutical world does offer treatments, though I say ‘treatments’ lightly. And that is because they are not treating the cause, they are relieving the symptoms. The other paradoxical effect of these treatments is that one of the side-effects of the drugs is to cause a lowering of kidney function, and in the very worst cases, have caused acute kidney failure. So it comes as a shock to me that so many people are put on these medications without a second thought by many doctors. Are they not aware? But please do not take this to mean I am against all western medicine, definitely not. In fact if a condition calls for a very quick solution to get it under control, by all means, use them. But I am just more favourable to a true long-term healing that comes from nature.
- Allopurinol: helps reduce uric acid levels. Use especially with caution in kidney disease
- Colchicine: helps reduce uric acid levels, though only for short term relief (1-2 days). Can cause nausea or diarrhoea
- Corticosteroids: a steroidal anti-inflammatory, proving very fast relief from gout attack symptoms. Use if you cannot take NSAIDs
- NSAIDs: reduces pain and inflammation
- Uricosuric agents: helps reduce uric acid levels. Can cause fever, rash, diarrhoea and nausea
- * Avoid aspirin as salicylates may aggravate your gout
I hope this post arms you with all the necessary tools to control your gout kidney disease, and live a pain-free life.
To Your Happiness,