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Gout Treatments

A common cause of gout is the accumulation of a chemical called uric acid. Uric acid is a normal breakdown product of another chemical called purines. The treatment involves controlling the inflammation, which causes the pain and swelling and ultimately damage to joints. Also, lowering the uric acid level is a logical means to controlling gout.


Warnings, Interactions, and Side Effect Gout attacks can be cured by following the dietary changes suggested here. However, please keep in mind that it is easier to prevent gout attacks than intervene in the middle of gout attacks. So it is best to use the suggested dietary changes proactively rather than reactively.


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 Pseudogout, or CPPD, is a disease very similar to gout. Gout and CPPD are often confused due to their similarities in onset. The cause of CPPD is unknown and seems to effect both men and women equally.

The laboratory should also be notified if the patient has had recent x-ray tests requiring contrast dyes. These chemicals increase uric acid levels in urine and decrease them in blood.

The treatment includes medicines like allopurinol, which decrease the level of uric acid, or there are other medicines like colchicine, which decrease inflammation. Also there are medicines called uricosuric agents that increase the removal of uric acid in urine. Colchicine works best if taken really early in the attack and sometimes repeat does may need to be taken periodically such as every two hours or so till there is pain relief or a maximum dose is reached or there are side effects like gastrointestinal upset.

Summary

Though prescription drugs such as allopurinol prevent gout attacks, some people prefer a more natural prevention. This article outlines a gout prevention plan, consisting of protein substitution, alcoholic beverage substitution, and taking high-dose vitamin C supplements. This article proposes that dietary changes alone can prevent gout attacks.

The following foods contain peanuts, and can be served without meats and seafood: peanut candy, salted nuts, peanut butter, peanut butter sandwiches, vegetable salads mixed with peanut sauce, peanut-based dipping sauce, peanut butter crackers, mandelonas (peanuts soaked in almond flavoring), some health food bars, some breakfast cereals, peanut butter cookies, celery sticks filled with peanut butter, honey peanut steamed tea bread, cherry peanut granola, peanut squares, peanut butter crisps, trail mixes, some spaghetti sauces, boiled peanuts, peanut butter spread on toast, gorp (good old raisins and peanuts), Cajun flavored peanuts, peanut soup, peanut rolls, peanut muffins, peanut cake, peanut pudding, baked peanuts with rice, and peanut stuffing.

People prone to gout tend to have high uric acid levels in their blood. The high uric acid levels may be caused by the kidneys' failure to adequately remove uric acid from the blood.

Luckily, there are high-protein foods that don't cause gout attacks. They are listed below categorically. Eggs and Dairy Products: High in protein are milk, cheese, cottage cheese, yogurt, and eggs.

Treatment of CPPD The most significant consideration in the treatment of CPPD is controlling the frequency of attacks. Frequent attacks (more than one a year) will result in progressive erosion of the joint, leading to painful chronic arthritis. Isolated attacks (less that one a year) lead to minimal destruction of the joint. The frequency of CPPD attacks determines whether treatment is merely for each attack, or whether daily medication should be taken to lower levels of inflammation.

The Internet Guide: Gout - http://gout.smartadsscrets.com The Internet Guide: Purines - http://gout.smartadssecrets.com/purines

Most of the time the symptom can be controlled by anti-inflammatory medications like naproxen or indomethacin. In severe cases steroids like prednisone may be needed. Some people even need injections into the joints. Fluid from the swollen joints can be removed and analyzed for the uric acid crystals.

If you wish to learn more about Gout, Purines, or Uric Acid, check out Steve's s The Internet Guides. The Internet Guide: Uric Acid: http://gout.smartadssecrets.com/uric_acid

There is some benefit to avoiding foods that cause gout but most people who get gout will need medication to prevent joint damage and also prevent future attacks which often happen sooner and are more severe. They can also cause permanent damage to the kidney and joints. The crystals can also deposit on the skin and are then called tophi.

The uric acid tests are used to evaluate the blood levels of uric acid for gout and to assess uric acid levels in the urine for kidney stone formation. The urine test is used most often to monitor patients already diagnosed with kidney stones, but it can also be used to detect disorders that affect the body's production of uric acid and to help measure the level of kidney functioning.

Urine test

Patients should be checked for the following medications before the urine test: diuretics, aspirin, pyrazinamide (Tebrazid), phenylbutazone, probenecid (Benemid), and allopurinol (Lopurin). If the patient needs to continue taking these medications, the laboratory should be notified.

Treatment of acute attacks includes the use of non-steroidal anti-inflammatory medications such as Indocin or Clinoril. Control of pain may require a mild narcotic such as codeine. Recurrent attacks may be contolled by the use of an NSAID.

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Definition

Uric acid tests are tests that are done to measure the levels of uric acid in blood serum or in urine.

Purpose



X-ray findings are similar with one exception. Individuals with CPPD with show small islands of calcium deposition in the lining of the joint referred to as calcinosis.

A dose of 500 mg per day significantly reduces uric acid levels in most gout sufferers. But before you begin a vitamin C regimen, you should get your physician's approval; because high-dose vitamin C might possibly eliminate uric acid from your body too quickly, causing kidney stones.

Since red wine doesn't elevate the body's uric acid level, it doesn't cause gout attacks. In fact, red wine may even lower uric acid levels! And certainly red wine is just as effective as beer in helping you to unwind.

Gout is a very painful inflammatory condition of the joints, caused by crystallized uric acid collecting around the affected joint. The most common joint affected is the big toe; however, gout can affect the ankle, instep, heel, knee, spine, elbow, wrist, and finger. In severe cases, gout can deform the affected joint.

High-Dose Vitamin C Not only may red wine reduce uric acid levels, vitamin C may also do likewise. High-dose vitamin C reduces uric acid levels in most gout sufferers. However, for some gout sufferers, high-dose vitamin C worsens their condition.

Uric Acid Level You say, "Okay, my kidneys aren't working properly. So what can I do to cure my gout?" The answer is you can do a lot. First of all, certain foods and beverages heighten the body's uric acid level, and certain foods and beverages don't. So if you avoid the foods and beverages that heighten your uric acid level, and partake in the foods and beverages that don't, you will never get a gout attack - thus curing your gout condition!

Abnormally low uric acid levels may indicate that the patient is taking allopurinol or probenecid for treatment of gout; may be pregnant; or suffers from Wilson's disease or Fanconi's syndrome.

Some foods suggested here can dangerously interact with some prescription drugs or medical conditions. For example, eating cheese while taking monoamine oxidase inhibitors (MAOIs) can kill you. Also, drinking red wine while having liver cirrhosis can worsen your condition. So to be on the safe side, you should get the approval of your physician and pharmacist before following the suggested dietary changes.

Diagnosing CPPD may only be made by testing a small sample of the synovial fluid from the affected joint. Gout and CPPD can be differentiated by specific testing and identification of the type of crystal.

Symptoms: The symptoms of pseudogout are similar to gout showing an abrupt onset and significant pain. Xray finding may resemble gout with juxtachondral (immediately next to the joint) erosions of the bone.

Attempting brevity, I only brainstormed gout-safe high-protein foods containing cheese, buckwheat, peanuts, and tofu. If I were to include gout-safe high-protein foods containing milk, cottage cheese, yogurt, eggs, amaranth grain, quinoa, almonds, cashews, pecans, sunflower seeds, pumpkin seeds, flax seeds, soy milk, beans, soy beans, and split peas, I would end up writing a novel. Though I only focused on foods containing cheese, buckwheat, peanuts, and tofu, you can see that there is plenty of variety.

The following foods contain buckwheat, and can be served without meats and seafood: buckwheat pancakes, buckwheat breads, buckwheat muffins, buckwheat crackers, buckwheat bagels, buckwheat cookies, buckwheat tortillas, some breakfast cereals, buckwheat grits, kasha, buckwheat porridge, buckwheat salad with mushrooms and parsley oil, kasha varnishkes, buckwheat noodles, Japanese soba noodles, California buckwheat chapati, kasha knishes, and some blini.

Grains and Cereals: High in protein are buckwheat, amaranth grain (usually sold in health food shops), and quinoa. Nuts and Seeds: High in protein are peanuts, almonds, cashews, pecans, sunflower seeds, pumpkin seeds, and flax seeds.

What are the foods and beverages that heighten the body's uric acid level, causing a gout attack? Meats and seafood promote gout attacks. Do you like beef, pork, lamb, liver, bacon, fish, lobster, mussels, scallops, or shrimp? Sorry, you have to pass on these. To a lesser degree, chicken, turkey, and duck promote gout attacks. Do you like beer? Well you don't anymore, because beer promotes gout attacks.

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About the author:
Jeffrey A. Oster, DPM, C.Ped is a board certified foot and ankle
surgeon. Dr. Oster is also board certified in pedorthics. Dr.
Oster is medical director of href=http://www.myfootshop.comMyfootshop.com and is
in active practice in Granville, Ohio.

 
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Steve Warshaw - Certified Personal Trainer and Nutritionist With over 15 years expereience developing training and nutrition programs for top level executives from companies such as Microsoft, Boeing, and Symetra Corp, Steve has established himself as a health and wellness expert.

If you wish to learn more about Steve or to request training or nutrition information, please check out his website: http://www.bodybuiltbyvictoria.com

Beans including Soy: High in protein are tofu, soy milk, beans, soy beans, and split peas. Red Wine So all you have to do is substitute these high-protein foods for the meats and seafood that you usually eat. "But what about beer? Is there a substitute for that? I need to have a beer to unwind after work," you say. Once again, you are in luck.

Description

The uric acid blood test is performed on a sample of the patient's blood, withdrawn from a vein into a vacuum tube. The procedure, which is called a venipuncture, takes about five minutes. The urine test requires the patient to collect all urine voided over a 24-hour period, with the exception of the very first specimen. The patient keeps the specimen container on ice or in the refrigerator during the collection period.

Risks

Risks for the blood test are minimal, but may include slight bleeding from the puncture site, a small bruise or swelling in the area, or fainting or feeling lightheaded.

Increased production of uric acid may result from eating foods that are high in purine. Increased uric acid levels due to overproduction may also be caused by gout, by a genetic disorder of purine metabolism, or by metastatic cancer, destruction of red blood cells, leukemia, or cancer chemotherapy.

The following foods contain cheese, and can be served without meats and seafood: pizza, cheese ravioli, baked ziti, mozzarella sticks, eggplant Parmesan, cheese omelette, lasagna, muffin egg and cheese sandwich, macaroni and cheese, baked potato with cheddar cheese sauce, stuffed shells Italiano, cheese manicotti in marinara sauce, salad with blue cheese dressing, cheesecake, broccoli cheese soup, asparagus with Parmesan cheese, smoked mozzarella fonduta, fettuccine alfredo, penne with goat cheese, and ricotta gnocchi.

Normal results

Blood test

Reference values for blood uric acid vary from laboratory to laboratory but are generally found within the following range: Male: 2.1-8.5 mg/dL; female: 2.0-6.6 mg/dL. Values may be slightly higher in the elderly.

Precautions

Blood test

Patients scheduled for a blood test for uric acid should be checked for the following medications: loop diuretics (Diamox, Bumex, Edecrin, or Lasix); ethambutol (Myambutol); vincristine (Oncovin); pyrazinamide (Tebrazid); thiazide diuretics (Naturetin, Hydrex, Diuril, Esidrix, HydroDiuril, Aquatensen, Renese, Diurese); aspirin (low doses); acetaminophen (Tylenol); ascorbic acid (vitamin C preparations); levodopa (Larodopa); or phenacetin. These drugs can affect test results.

Uric acid is a waste product that results from the breakdown of purine, a nucleic acid. (Nucleic acids are the building blocks of DNA.) Uric acid is made in the liver and excreted by the kidneys. If the liver produces too much uric acid or the kidneys excrete too little, the patient will have too much uric acid in the blood. This condition is called hyperuricemia. Supersaturated uric acid in the urine (uricosuria) can crystallize to form kidney stones that may block the tubes that lead from the kidneys to the bladder (the ureters).

Key Terms

Fanconi's syndrome
A rare disorder caused by vitamin D deficiency or exposure to heavy metals.
Gout
A metabolic disorder characterized by sudden recurring attacks of arthritis caused by deposits of crystals that build up in the joints due to abnormally high uric acid blood levels. In gout, uric acid may be overproduced, underexcreted, or both.
Hyperuricemia
Excessively high levels of uric acid in the blood, often producing gout.
Purine
A white crystalline substance that is one of the building blocks of DNA. Uric acid is produced when purine is broken down in the body.
Uric acid
A compound resulting from the body's breakdown of purine. It is normally present in human urine only in small amounts.
Uricosuria
Increased levels of uric acid in the urine.
Wilson's disease
A rare hereditary disease marked by the buildup of copper in the liver and brain, causing loss of kidney function.

Further Reading

For Your Information

    Books

  • Laboratory Test Handbook, edited by David S. Jacobs. Cleveland, OH: Lexi-Comp Inc., 1996.
  • Mosby's Diagnostic and Laboratory Test Reference, edited by Kathleen Deska Pagana and Timothy James Pagana. St. Louis: Mosby-Year Book, Inc., 1998.
  • Springhouse Corporation. Handbook of Diagnostic Tests, edited by Matthew Cahill. Springhouse, PA: Springhouse Corporation, 1995.

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The following foods contain tofu, and can be served without meats and seafood: tofu with vegetable medley, tofu muffins, tofu and cheese omelet, sauteed tofu steak, tofu caramel custard, tofu anmitsu (traditional fruit salad), broiled tofu steak, tomato and olive tofu spread, braised cubed tofu steak with eggplant and zucchini, tofu steak with teriyaki butter sauce, tofu steak sandwich, tofu steak with salsa sauce, tofu steak nuggets, tofu steak fajita, tofu steak with Asian mushroom sauce, tofu and egg burger, tofu and vegetable burger, tofu burger, tofu quesadilla, oriental tofu salad, split pea soup with tofu, creamy oriental tofu dressing, tofu broccoli lasagna, grilled tofu and cheese, tofu spaghetti sauce, Spanish rice with tofu, tofu and vegetable stir-fry, zesty Italian pasta and tofu, spicy tofu chili, spicy tofu burritos, Tex-Mex tofu lasagna, pita stuffed tofu salad, tofu custard filled cake, pineapple tofu pie, and tofu custard with sesame flavor.

Certain foods that are high in purine may increase the patient's levels of uric acid. These include kidneys, liver, sweetbreads, sardines, anchovies, and meat extracts.

Urine test

Reference values for 24-hour urinary uric acid vary from laboratory to laboratory but are generally found within the following range: 250-750 mg/24 hours.

The specific dose and the manner of taking these medicines are best discussed with your healthcare provider. Common side effects of these drugs include stomach upset and ulcers from prednisone and ibuprofen type of medications, diarrhea from colchicine and sometimes gout can get worse from allopurinol especially if the person is not on colchicine first during an acute attack.

Is Protein Substitution Practical? Some of you may be saying right about now, "Okay, this all makes sense, but it's impractical. This protein substitution lacks variety; there's no way I can follow it." Lack of variety? Let's see. I'll attempt to brainstorm a variety of gout-safe high-protein foods.

Preparation

The uric acid test requires either a blood or urine sample. For the blood sample, the patient should be fasting (nothing to eat or drink) for at least eight hours before the test. The urine test for uric acid requires a 24-hour urine collection. The urine test does not require the patient to fast or cut down on fluids. Some laboratories encourage patients to drink plenty of fluids during the collection period.

High-Protein Foods Avoiding meats and seafood puts you in a dilemma. You avoid these foods to avoid gout attacks, but your body cannot function properly without protein - meats and seafood are common sources of protein! What do you do?

Gout-prone people can have a side effect from aspirin. Though normal people can take aspirin without having a side effect, gout-prone people can have the side effect of a gout attack. So if you are gout-prone and have a headache, it is best that you take Motrin (ibuprofen) instead of Bayer (aspirin).

Differential Diagnosis: The differential diagnosis for this condition should include;- fracture gout osteoarthritis infection of the joint

Abnormal results

The critical value for the blood test is a level of uric acid higher than 12 milligrams per deciliter (about 3.4 ounces).

Decreased excretion of uric acid is seen in chronic kidney disease, low thyroid, toxemia of pregnancy, and alcoholism. Patients with gout excrete less than half the uric acid in their blood as other persons. Only 10-15% of the total cases of hyperuricemia, however, are caused by gout.




 
 
     
 
 





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