Q: My one ankle has begun getting swollen, painful and hot at times. My MD said it sounds like gout so I should come in for a look-see. What’s gout and what could cause it?
Dr. Myhill: Gout is one of those conditions that never really made sense to me until I learned that uric acid is an important antioxidant in the bloodstream. What this means is that if levels of other antioxidants fall low, then the body compensates for this by pushing out more uric acid.
That is absolutely fine, but the trouble is that if the level of uric acid gets too high, then, being rather insoluble, it precipitates out as 'spike-like' crystals in the joint to cause an acute attack of gout.
This is very tiresome because acute gout is extremely painful! The immune system does not like these gritty crystals in the joints and produces lots of inflammation to get rid of it, and it is this that causes the heat, pain, swelling, redness and loss of function.
The diagnosis is made by the characteristic clinical picture of acute severe joint pain.
But one can also get a low grade generalized arthritis from gout.
Blood tests will show high serum uric acid and it is this that gives the game away.
In the acute phase the priority is to stop the inflammation. Non-steroidal anti-inflammatories (NSAIDS)… are highly effective.
A drug which switches off inflammation in the immune system such as [the prescription drug] colchicine is also highly effective. Colchicine comes from the Autumn crocus.
Prevention of Attacks
This needs to be done by improving the antioxidant status in the bloodstream (See “Antioxidants and Free Radicals – What They are and What They Do”)
Improving antioxidant levels will bring the level of uric acid down.
This also explains why gout and running a high uric acid is said to be a risk factor for arterial disease. Actually I believe it is the other way round. Having poor antioxidant status is a risk factor for arterial disease and serum uric acid is symptomatic of this.
Acute attacks of gout are often triggered by dehydration for obvious reasons (uric acid more concentrated) and so drinking plenty of fluids helps resolve an acute attack.
* Dr. Sarah Myhill, MD, BS, is a widely recognized UK-based GP and nutritionist in private practice who specializes in preventive medicine, fatigue issues, and patient education. This information is reproduced with kind permission from her educational website (DrMyhill.co.uk)® Sarah Myhill Limited, Registered in England and Wales: Reg. No. 4545198. Registered Office: Upper Weston, Llangunllo, Knighton, Powys, Wales LD7 1SL, UK. Tel 01547 550331 | Fax 01547 550339
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