Even though it was 15 years ago, I still remember the pain. I stepped out of my mom’s car and collapsed on the ground in agony. The pain was so intense I thought I had stepped on a scorpion and actually looked around for the poor creature. (This was in Hawaii, where people often wear sandals and where those critters can roam the pavement.)
I wasn’t stung, yet my left big toe grew flaming red and hot, to the point where a slight breeze brushing against it could cause me agony. I made an appointment with my doctor, and he suspected I had gout, a form of arthritis that is caused by a buildup of uric acid in the body. It usually zeros in on a joint of the big toe. Gout is a disease that affects more than 3 million Americans each year.
Now I was a slim, pretty healthy young guy, so I thought this couldn’t be happening to me. I discovered that gout can sometimes affect healthy younger men or women, although it is rare in children. It can be prevented or treated by following a diet low in purine (which breaks down into uric acid) and an overall healthy lifestyle.
I spoke with VM rheumatologist Stanford Peng, MD, PhD, who provides some tips below to prevent gout and treat a flare up if you’ve been diagnosed.
Can I enjoy corned beef and beer this St. Patrick’s Day?
Dr. Peng: Stick to something else if you’re at risk for gout or have been diagnosed. Beef and beer are some of the foods that have the highest purine content and can be very bad for gout. Beef and other red meats are especially high in purine [a byproduct of protein], and beer contains more purines than spirits and wines.
What other foods can cause gout flare ups?
Dr. Peng: Avoid shellfish, as it contains very high purine content – there’s a reason gout is referred to as “the rich man’s disease.” Some veggies are moderately high in purine. This list includes some green vegetables, such as spinach and asparagus, beans, broccoli and artichokes. However, clinical research suggests they are not major factors in causing gout and that the benefits of eating vegetables outweigh the risks.
How do you treat gout?
Dr. Peng: Some medications are highly effective in lowering the amount of uric acid in your body, and your doctor can help determine if that is an appropriate option for you. Also, anti-inflammatory medications, like ibuprofen, can reduce pain. If you have concerns, you can also lower your uric acid levels by changing your diet. Research suggests adding dairy to your diet may reduce gout.
Any other advice for preventing gout?
Dr. Peng: In addition to diet changes, maintain a healthy body weight. If you need to lose weight, lose it gradually. There’s evidence that losing weight too quickly can actually cause a gout attack and increase the level of uric acid in your system in the short term. As an added benefit, you’re more likely to stay on a weight loss routine if you lose weight at a moderate pace. Research suggests that gout is a cardiovascular risk factor, so losing weight has many added benefits in maintaining a healthy lifestyle.
Dane Fukumoto is the patient communications manager at Virginia Mason Medical Center.