Doctor’s Tip: Cherries (and other treatments) for gout
Gout is a painful, acute arthritis, more common in men than women, that classically affects the joint at the base of the big toe, although it sometimes affects other joints. If gout recurs over several years, it can produce chronic degenerative arthritis. The prevalence of gout in the United States is 3.9 percent, which translates to 8.2 million people.
Gout occurs when uric acid, something we all have in our blood, crystallizes in joints, followed by redness, swelling and acute pain. It can have a hereditary component, and gout is usually but not always associated with high uric acid levels. Some people have high uric acid levels but never get gout, so exactly why an attack of gout occurs when it does is not completely understood. Certain drugs can bring on gout, though, such as niacin, diuretics and aspirin.
For an acute attack of gout, anti-inflammatories such as indomethacin, ibuprofen or naproxen are often used. For people who can’t take these drugs (they can cause stomach bleeding and hypertension), cortisone or colchicine are often used. For people who just have one or two attacks of gout a year, it makes sense just to treat the attacks as they occur. However, if attacks occur more often, or if they occur in joints other than the big toe, it is wise to do something to prevent future attacks. Typically, allopurinol, which lowers uric acid levels, is used for this. Allopurinol should not be started during an acute attack, and often a low dose of daily colchicine is given with it during the first month, since allopurinol can actually bring on an attack during the first month a person is on it. The other problem with this drug is that it can have rare but serious side effects.
Michael Greger, M.D., on his website nutritionfacts.org, cites studies showing that cherries lower uric acid and work just as well as drugs for treatment of acute attacks of gout and to prevent attacks. Sweet, red cherries work better than tart or yellow cherries, and the dose is 15 cherries a day. When cherries are not in season, frozen cherries work as well, as does a tablespoonful twice a day of cherry juice concentrate.
Uric acid is a breakdown product of purines, and people with recurrent gout should avoid purine-containing food, such as seafood and meat (particularly sardines and organ meat). People with recurrent gout should also avoid alcohol, particularly beer. A few vegetables also have purines, such as mushrooms and asparagus, but Dr. Greger says that for whatever reason, vegetable sources of purines don’t seem to bring on gout attacks, and gout is rare in people who are on a total plant-based diet.
Dr. Feinsinger, who retired from Glenwood Medical Associates after 42 years as a family physician, now has a nonprofit Center For Prevention and Treatment of Disease Through Nutrition. He is available for free consultations about heart attack prevention and any other medical concerns. Call 970-379-5718 for an appointment. For questions about his columns, email him at firstname.lastname@example.org.
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