"Be temperate in wine, in eating, girls and cloth, or the gout will seize you and plague you both," wrote Ben Franklin (1706-1790). Gout, a form of rheumatoid arthritis caused by the buildup of uric acid, has been so well documented in literature over the ages that the mere word has a sort of archaic sound to it. To suffer from the gout seems kind of like coming down with consumption or scurvy.
Still, like tuberculosis, gout is alive and well. Men are more likely to contract this extremely painful affliction. Often associated with a lifestyle of debauchery, heavy drink and rich foods, gout often strikes the big toe and can be debilitating.
Flare-ups can be temporary or ongoing.
Diet is key, as is limiting consumption of the sauce. Get exercise and flush out the kidneys. But you have to stick to that regimen even after an attack, as "Madame Gout" warns Franklin in his Dialogue Between Franklin And The Gout
FRANKLIN: "Oh! Oh! For Heaven's sake leave me! And I promise faithfully never more to play at chess, but to take exercise daily and live temperately."
GOUT: "I know you too well. You promise fair, but after a few months of good health you will return to your old habits. Your fine promises will be forgotten like the forms of the last year's clouds."
What the experts say
"The main treatment for uric acid is to alkalize and use diuretic herbs like dandelion leaf , parsley , celery seed , nettle , alfalfa and goldenrod . I recommend making a soup with these. Make a vegetable soup and either make a very strong infusion with those herbs and add it to the soup broth or add the herbs directly to the soup. Nettle soup is quite tasty. It's also recommended that you drink a lot of water . Sufferers often drink a lot of alcohol or eat a lot of meat and cheese. When those proteins break down, the by-product is uric acid. A diet rich in fresh vegetables and fruits is very beneficial."
MARCIA DIXON, herbalist, Toronto
"Some people have a genetic tendency to make too much uric acid. Sometimes it's related to kidney problems. You can try changing your diet, but that doesn't usually work. You usually need a medicine. The most common is allopurinol . You will probably be on that for years. There are very few side effects. For acute episodes, we frequently use non-steroidal anti-inflammatory drugs like (ibuprofen, ASA) or colchicine . Unfortunately, herbal treatments have not been tested in good controlled trials, but that doesn't mean they're not effective. Devil's claw is an old remedy. I wouldn't say that it doesn't work, but I doubt it's been formally proven. We don't understand fully what precipitates an attack. We think it might be shifts in uric levels, possibly caused by diet and stress."
KATHERINE SIMINOVITCH, MD, professor of medicine, University of Toronto, Mt. Sinai Hospital
"You want to limit the amount of red meat , cream sauces , alcohol , scallops , sardines and other purine-rich foods. Also, regularly take anti-inflammatories like quercetin and vitamin C . Cherry juice extract, cherry juice or even fresh cherries, along with other dark-coloured fruit, are the folkloric remedy for gout. Anti-inflammatory fish oils like salmon and albacore tuna (omega-3s) are useful. You can also drink herbal tea made from nettle. Devil's claw is anti-inflammatory and reduces pain. Eat liver [cleansing] foods like beets . In acute attacks, bromelain , which is from pineapple, is good."
MILLIE LYTLE, naturopath, Toronto
"There are a couple of ways of alkalizing the body to assure it does not create any more acidity. A raw food diet can help. All types of liver and sweetbreads and pork are bad. Crab is the worst culprit among seafood. Sardines and avocados do create uric acid; however, they contain omega-3s that help reduce inflammation. Black cherries are supposed to dissolve the crystals. The folk remedy is cherry liquor . Alfalfa helps because of its alkalizing and anti-inflammatory effects. Sufferers who are overweight should lose weight . People with gout also tend to be deficient in B5 and vitamin A . Celery and carrot juice help. Turmeric and boswellia reduce inflammation."
VIVIAN LEE, holistic nutritionist, Toronto