Posted on May 19, 2020, 4 p.m.
Looking back into history, gout, or gouge as it is sometimes called, was once thought to be the rich man’s curse for their enslavement of the lower classes who did all the work for the rich men who did not enjoy the fruits of their labors.
As the rich became older and richer a fair portion of them were plagued with rapid onset of searing and swollen red large toes which was described as being so painful that even having a thin bed sheet placed on it was unbearable.
Hippocrates used to utilize the colchicum plant to help treat this painful condition, but this approach grew out of favor within the medical profession by the 1700s when it became more appropriate to bleed the victim as a treatment.
Modern medicine can help to shed a light on what was happening back in those early days; the wealthy having enough money to lounge around and dine on rich meat filled diets that were washed down with copious amounts of wine were lacking nutrition in their diets that the poor workers were getting as they ate their garden vegetables and primarily drank water, which is for the most part what is now recognized as the source of whether or not one develops gout or not.
The body recycles old and dying cells as it harvests the building blocks to make new cells, but the process declines with age. These building blocks are called purines, if they are produced in excess or not excreted through the kidneys efficiently they form needle shaped uric acid crystals. An autoimmune attack is triggered that causes impressive amounts of inflammation of the joints when the immune system detects these crystals accumulating on a joint.
Over time this process can cause destruction similar to the appearance of rheumatoid arthritis. One of the more common causes of this overproduction is alcohol intake and diets that are rich in purines such as those found in steak and lobster, which the rich back in the day had in excess in their diets while the poor workers had very low levels of in their diets.
Sometimes the body does not excrete uric acid efficiently, this is most often caused by medications such as diuretics used to treat high blood pressure. Additionally there are some genetic lines such as Polynesians who can lack enzymes that break down uric acid in purines to be used to make new cells, and in these cases the uric acid often causes gout.
One of the other myths surrounding gout is that a blood test for uric acid can either diagnose or disprove this form of arthritis; but research shows that most patients suffering with gout attacks will have normal blood uric acid levels, and most with elevated levels do not go on to develop gout though for this group the risk of developing kidney stones is elevated.
Advances in modern medical science allows for the detection of gout crystals to be seen in joints with painless musculoskeletal ultrasounds, but in the past the only way to check for the presence of gout versus other forms of arthritis was rather painful and involved sticking a needle into the joint to draw out fluids for microscopic investigation.
In today’s modern society there are many effective forms of treatment for gout, and it is now commonly thought of as the only curable form of arthritis. One of the quickest acting medications used to treat gout is colchicine, which interestingly enough was originally used by Hippocrates back in the day; history really does repeat itself in some cases.
Arthritis is a complicated condition, as such gout can happen along with other forms of arthritis simultaneously, and this can be confusing for the patient and physician alike. Fortunately there are many forms of diagnostics and treatment options available that make treating gout easier.
If a weight loss program is recommended to help treat gout, be sure to select the program carefully as some popular low carb fad diets also have a high fat content which can promote hyperuricemia by stimulating fat burning for energy producing a state of ketosis; the problem with this diet is that it can make the gout condition worse, especially in the initial phases of diet change and weight loss. The gout condition can also get worse with simple fasting or crash diets that can raise uric acid levels. Be sure to have a discussion with your physician or certified medical profession to work out a plan that works best for you to avoid any possibility of unwanted complications.
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This article is not intended to provide medical diagnosis, advice, treatment, or endorsement.