Gout: Dietary and Lifestyle Strategies to Avoid Flare-Ups

Gout is known as the “rich man’s disease” due to its association with high uric acid foods. However, anyone can develop gout from eating an unhealthy diet. The Standard American Diet, with all its grains, sugar, processed meats, and alcohol, can set us up for this painful condition. However, it’s not a life sentence. It’s possible to overcome gout pain with a healthy diet and lifestyle.

What is Gout?

Gout or “gouty arthritis” is a type of arthritis with sudden and severe attacks of pain, tenderness, and swelling in one or more joints. It most often affects the big toe. Gout occurs with the accumulation of uric acid crystals in joints, leading to inflammation and intense pain. This condition is primarily a result of high uric acid in the blood, or “hyperuricemia.” [1]

Purines are natural compounds found in certain foods and produced by the body as part of normal metabolism. Purines are essential for DNA, RNA, and energy-related molecules like ATP (adenosine triphosphate). While purines serve crucial roles in the body, their breakdown results in uric acid, a waste product normally excreted by the kidneys in the urine. [2]

High uric acid levels occur when uric acid is overproduced, or the kidneys cannot excrete it as they should. The buildup of uric acid in the bloodstream can create urate crystals that settle in the joints, tendons, and other tissues. The sharp crystals trigger an inflammatory response, leading to pain and swelling.

However, only some people who eat purine-rich foods will develop gout. Many factors influence gout risk, including genetics, diet, lifestyle, and the body’s ability to handle uric acid. High blood pressure, diabetes, obesity, kidney disease, and hypothyroidism can also increase risk. [3]

Symptoms of Gout

Gout typically begins with sudden and severe symptoms. Usually, they’re called gout attacks or flare-ups. The most common symptoms of gout include: [4][5]

Intense joint pain
Swelling
Tender joints
Limited range of motion
Warmth from inflammation
Recurrent attacks or flares
Nighttime attacks
Waking in pain
Fevers
A general feeling of being unwell

It’s important to note that gout symptoms can vary from person to person and may not always involve the same joint. The duration and severity of gout attacks can also vary. If you suspect you may have gout, seek medical attention for a proper diagnosis. Gout is manageable, and early intervention can minimize symptoms and prevent long-term complications. If left untreated, gout may also lead to joint damage, loss of mobility, osteoarthritis, kidney stones, or chronic kidney disease.

How is Gout Diagnosed?

Gout is typically diagnosed through medical history, physical examination, and laboratory tests. Here are some steps involved in diagnosing gout: [3]

Medical History and Physical Exam: Your practitioner will begin by asking for a detailed medical history. They’ll ask about your symptoms, including the location and duration of joint pain. Be sure to include any family history of gout or related conditions. They’ll also want to know about your diet, alcohol consumption, and recent illnesses. Listing current or past medications will also be important in the diagnostic process. The physical examination will assess the affected joint(s) for signs of inflammation, such as redness, warmth, and swelling.
Blood Tests: Blood tests help measure the level of uric acid in your blood. Elevated uric acid is a key indicator of gout. However, not everyone with high uric acid levels will develop gout, and not everyone with gout will have high uric acid levels. Blood tests also help rule out other conditions with similar symptoms, like infections or rheumatoid arthritis.
Joint Fluid Analysis (Arthrocentesis): Sometimes, a doctor might do a joint fluid analysis. This procedure involves drawing a small amount of fluid from the affected joint using a needle and examining it for signs of inflammation, uric acid crystals, or infections.
Imaging (Optional): In some cases, healthcare providers may order imaging studies such as X-rays, ultrasound, or MRI (Magnetic Resonance Imaging) scans to assess the extent of joint damage or to rule out other joint-related conditions.

Accurate diagnosis is crucial for proper gout treatment and management. Gout is a manageable condition, and with lifestyle changes and supplementation, you can reduce the frequency and severity of flare-ups. You may also be able to prevent long-term joint damage.

The Fireman vs. The Carpenter in Health

At The Wellness Way, we talk about the mainstream perspective on healthcare versus our perspective and methods as the “fireman approach” or the “carpenter approach.”

Mainstream “fireman” doctors have two tools (treatment options) for caring for people: an axe and a hose. The axe represents cutting things out in a surgical procedure. The hose represents using medications to extinguish inflammation, pain, and other symptoms.

The Wellness Way doctors are more like carpenters. They assess the current state of the body with testing and then create a personalized plan to rebuild using nutrients from foods and supplements. Sunshine, rest, and positive relationships are additional natural therapies that help with healing.

While these things are considered “complementary medicine” or even “alternative medicine,” scientific research backs up their effectiveness in healing.

Mainstream Medicine’s Approach to Gout

Mainstream medicine sees gout as a common condition associated with certain risk factors, including a diet rich in purine-containing foods (such as red meat, seafood, and alcohol), obesity, genetics, and certain medical conditions (like kidney disease). It’s more common in men than women.

Common Medications Given for Gout

While doctors usually recommend a gout diet that limits purines, they also recommend medications for pain and other symptoms.

Anti-inflammatory medications for gout flare-ups:

NSAIDs: Over-the-counter (OTC) Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil, Motrin IB) are often used for gout flares.
Corticosteroids: If patients cannot take NSAIDs, corticosteroids like prednisone are the next choice. Oral steroids or joint injections may be used.

Drugs to block or remove uric acid:

These medications work by either blocking or removing uric acid. They can help relieve pain and other symptoms associated with uric acid buildup:

Colchicine (Colcrys)
Allopurinol (Zyloprim)
Febuxostat (Uloric)

While medications may alleviate uncomfortable symptoms by synthetically suppressing inflammation, they all have side effects. Those side effects are often why people seek out natural remedies or home remedies for gout and other forms of arthritis.

Other Treatments for Gout

A gout-friendly diet – Exclude or reduce high-purine foods like processed red meat, game meat, certain fish (anchovies, herring, smelt, and sardines), yeast, shellfish, legumes, and alcohol.
Ice packs – Cold therapy, like ice packs or cold-water soaks, may help lower inflammation and reduce gout pain.

It’s crucial to consult a healthcare professional before adding OTC pain relievers, supplements, or other treatments. They can help you decide the right course of treatment based on your situation.

What Causes Gout? Traumas, Toxins, and Thoughts

The body isn’t programmed for illness. While specific genes may make you more likely to develop one type of illness or another, it’s only one factor. At The Wellness Way, we always return to the “three Ts” (traumas, toxins, and thoughts) as the environmental factors that stress the nervous system and lead to illness.

Genes “load the gun,” but the environment “pulls the trigger.” The chiropractic field describes those environmental factors as traumas, toxins, and thoughts.

Traumas (Physical Stressors)

Traumas or physical stressors can be acute or chronic. Chronic subluxations in the spine can inhibit nerve and blood flow to the joints, disrupting their ability to repair. Examples of traumas that may contribute to gout include:

A fall
A car accident
A sports injury
Physical abuse
Surgery

Traumas are more destructive to the body when coupled with toxins, which overwhelm the liver and make it more difficult to break down uric acid.

Toxins (Biochemical Stressors)

Gout is very much tied to toxicity and a stressed liver. When toxins overburden the liver, it may have difficulty breaking down uric acid. When uric acid doesn’t break down as it should, it can build up inside the joints, causing gout. Here are some toxins linked to gout:

Sugar (especially fructose) – Sugar increases inflammation throughout the body, including the joints. Researchers are finding more links between sugar and joint pain. [6]
Medications – Certain pharmaceutical drugs, like low-dose aspirin and high blood pressure medications (thiazide diuretics, ACE inhibitors, and beta blockers), can increase uric acid levels and cause gout. Anti-rejection drugs given with organ transplants can also lead to gout. Even niacin (vitamin B3) may contribute to gout if taken excessively over time. [1]
Food allergies – Foods can act like toxins, causing inflammation in the joints and elsewhere if you’re allergic to them. [7][8]
Purines – For those with gout, purines act like toxins because the body can’t break them down and eliminate them.
Metal toxicity – The accumulation of certain metals in the body can also contribute to inflamed joints and arthritis. [9] Lead, in particular, is associated with gout. [10]
Vaccines – In some people, receiving a vaccination can trigger gout. [11]

Anything compromising the integrity of the gut lining, leading to a “leaky gut,” can lead to chronic inflammation and increase the risk of gout. Traumas and toxins are made worse by negative thought patterns and emotional stress.

Thoughts (Emotional Stressors)

Don’t underestimate the power of your thoughts. Emotional stress is just as powerful (or more powerful) than physical and biochemical stressors in triggering pain and inflammation. The following can influence our emotional stress levels:

Relationship issues
Financial stress
Watching the news (fear/worry)
A feeling of overwhelm due to significant life changes, like a recent marriage, a new baby, graduation, a divorce, or even moving to a new city.
Holding a grudge/pent-up anger
Grief/feelings of loss

The cumulative effect of these traumas, toxins, and thoughts can create inflammation and increase disease risk.

The Wellness Way Approach to Gout

At The Wellness Way, we dig deeper to solve the health challenges others can’t. We don’t just address symptoms; we run tests to find out what’s going on behind the scenes.

Important Tests for Assessing Your Gut and Immune Health

When there’s joint inflammation and pain, it means the immune system is involved. Food allergies and gut health may be reasons for an elevated immune response. That’s why Wellness Way practitioners will often recommend these tests:

Food Allergy Test: Immuno Food Allergy Test
Gut Health Test: Genova GI Effects with Parasitology

Your Wellness Way practitioner will order more tests based on what he or she considers most relevant based on your health history.

Dietary Changes for Those with Gout

When considering the dietary impact on gout, we must first focus on reducing the toxic load on the liver and lowering inflammation so the gut can heal. That means avoiding food allergies and following a personalized nutrition program, as the Wellness Way practitioner recommends. Here are some additional guidelines for those with gout:

A Gout diet – A gout-friendly diet is as much about what you include in your diet as it is about what you exclude.
- Exclude or reduce high-purine foods like processed red meat, game meat, certain fish (anchovies, herring, smelt, and sardines), yeast, shellfish, legumes, and alcohol. While organ meats are high in purines, they’re also nutrient-dense. Avoid sugar and other high-purine foods and try to keep some organ meat. However, some people will also need to avoid all organ meats.
- Include cherries and cherry juice were shown to reduce gout attacks [12] and lemon juice reduces uric acid in the bloodstream. [13] The spice turmeric, found in curry, may help block crystal-induced inflammation. [14]
No sugar or processed foods – Both increase inflammation and contribute to gout.
Gluten-free, mostly grain-free – Gluten is known to aggravate the gut lining, contributing to chronic inflammation. A gluten-free diet may help lower joint pain and inflammation. [15]
Consume an overall low carbohydrate, non-inflammatory diet of organic whole foods, which supply nutrients, antioxidants, and fiber to support a healthy gut microbiome.
Avoid high omega-6 vegetable oils, like corn, canola, soybean, cottonseed oil, sunflower, grapeseed, and others, which can alter the omega-6 to omega-3 balance to be more inflammatory. [16 ] Instead, use fruit oils like olive, coconut, avocado, and palm oil or animal fats like beef tallow, bacon grease, and duck fat.
Follow a Personalized Nutrition Program based on your food allergy test results.
Focus on antioxidants – Beyond cherries, include botanicals like turmeric, green tea, berries, dark chocolate, and other botanicals high in polyphenols to help keep inflammation under control. [17]
Eat omega-3-rich foods – Wild-caught salmon, herring, sardines, walnuts, and ground flaxseeds provide omega-3s and help lower inflammation and gout flares. [18]

A healthy diet helps reduce inflammation, but supplements can support gut healing and joint repair.

Supplements for Those with Gout

Herbal medicine and other dietary supplements can support healing in those with gout. They can help the body lower pain and inflammation and improve a person’s overall sense of well-being. Here are some natural gout remedies to consider:

Turmeric – Curcumin is the main active constituent in turmeric, known for its anti-inflammatory properties. [19] A review study found that curcumin is a potent anti-gouty arthritis compound. [20]
Nettle – Nettle leaf is an excellent source of quercetin, a flavonoid with antioxidant properties, which research shows is a valuable remedy for gout. [21]
Japanese Knotweed – Japanese knotweed is an excellent source of resveratrol. It’s been used in Traditional Chinese Medicine (TCM) for centuries for treating gouty arthritis. Beyond resveratrol, quercetin and luteolin in Japanese knotweed also help reduce the inflammatory response seen in gout. [22]
Resveratrol – Resveratrol supplements may directly reduce inflammation and symptoms in gout patients. [23]
Potassium – Potassium supplementation may help balance the pH of the urine, reducing the likelihood of uric acid crystal formation. [24]
Vitamin C – A Higher vitamin C intake is associated with a lower risk of gout [25], and supplementing 500 mg for 2 months reduced uric acid in the bloodstream. [26]
Cherry extract – Cherries are associated with fewer gout attacks. [27]

Each person is different – herbal remedies that work for one individual may not work for another. Part of that is due to body chemistry, including genetics and allergenic responses, and part is due to differences in the contributing causes of gout.

Lifestyle Changes & Complementary Therapies for Those with Gout

Adequate hydration – Drinking plenty of water can help the body flush excess uric acid from the system, reducing the chances of a gout attack.
Regular chiropractic care – Regular chiropractic care can support normal blood and nerve flow, promoting joint repair.
Weight loss – Obesity is a risk factor for gout [28] and losing excess weight may reduce uric acid in the bloodstream, taking the stress of inflamed joints. [29]

Be a well-informed patient! Here are some resources for learning more about gout.

Educational Resources for Those with Gout

Videos & Webinars Related to Gout

Inflammation: Top 4 Secrets Revealed | A Different Perspective | Episode 10

Articles to Support Those with Gout

How Can Nutrition Influence Your Joint Pain and Muscle Soreness?
Different Strategies to Manage 5 Types of Severe Joint Pain

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We invite you to connect with us! Find an event at a clinic near you! Follow us on social media. Tune in to A Different Perspective each Saturday morning LIVE to get cutting-edge training directly from Dr. Patrick Flynn. Please set up a no-obligation health consult with one of our doctors today. The best is yet to come! Think differently – and THRIVE. To learn how best to support your body in overcoming gout, reach out to a Wellness Way clinic today. We are here to help!

Gout: Dietary and Lifestyle Strategies to Avoid Flare-Ups

What is Gout?

Symptoms of Gout

How is Gout Diagnosed?

The Fireman vs. The Carpenter in Health