Gout - hyperuricemia, vatrakta

What is gout?
What are the causes of gout?
What are the signs and symptoms of gout?
Ayurvedic insight- do’s and don’ts

What is gout?

Gout is a common, painful form of arthritis. It is a metabolic disorder associated with abnormally high
uric acid levels in the blood. This precipitates to form crystals in joint spaces and sometimes in
kidneys too

It causes swollen, red, hot and stiff joints.









Gout occurs when uric acid builds up in your blood. This happens if your body produces extra acid or
does not eliminate enough, or if you eat too many foods with purines.

Uric acid excreted out mainly by the kidneys.  Whenever the normal balance is disturbed by
decreased excretion by the kidneys or increased production, the blood level of uric acid increases
and crystals of uric acid get deposited at different sites. The defense cells engulf these crystals
following which pain causing substances are released in the joint space.

In most cases, gout is associated with a condition known as hyperuricemia.  Hyperuricemia occurs
when the blood contains raised levels of uric acid sustained over long periods.

Common areas for these deposits are the ankles, feet and ball of the large toe. Less common areas
of uric acid deposits include the ears and eyes. Tophi, areas of hardened uric acid, may also be
seen under the skin around the fingers and toes.
Uric acid crystals (monosodium urate crystals) can accumulate over the years in the joint and
tissues around the joint, intermittently triggering repeated bouts of inflammation. Repeated "attacks"
of gouty arthritis can damage the joint and lead to chronic arthritis.

Pseudo gout has similar symptoms and is sometimes confused with gout. However, it is caused by
calcium phosphate.

What are the causes of gout?

•Family tendency (genetics)
•Purine rich diet
•Diuretic medications
•Excessive alcohol consumption
•Excessive caffeine consumption
•Obesity
•Insulin resistance
•hypertension
•Renal insufficiency
•Heart disease
•Psoriasis
•Hypothyroidism 
•Certain diseases include leukemia’s, lymphomas, and hemoglobin disorders
•Certain drugs, such as thiazide diuretics, low-dose aspirin, niacin, cyclosporine, tuberculosis
medications, some immune-suppressing drugs
•excessive eating
•Certain conditions can precipitate acute attacks of gout. These include dehydration, injury to the
joint, fever and recent surgery
What are the signs and symptoms of gout?

Gout can progress through four stages.Asymptomatic gout -There is elevated uric acid levels in the
blood but no other symptoms.
Acute gouty arthritis - The intense symptoms of pain and inflammation are experienced.

Interval gout - The period between acute gout attacks when there are no symptoms and there is
normal joint function.
Chronic tophaceous gout - The most disabling stage of gout which occurs after many years,
associated with permanent damage to the affected joints and sometimes the kidneys.

The small joint at the base of the big toe is the most common site of an acute gout attack of
arthritis.

Other joints that are commonly affected include the ankles, knees, wrists, fingers, and elbows.

Acute attack present with following symptoms:

•Rapid onset of pain in the affected joint
•Warmth
•Swelling
•Reddish discoloration
•Marked intense tenderness
•Fever
•Severely restricted joint movement
Chronic (tophaceous) gout presents with:

Hard nodules (uric acid crystals - tophi) around the fingers, at the tips of the elbows, in the ears,
and around the big toe

Tophi nodules can appear in unexpected areas such as in the vocal cords or (rarely) even around
the spinal cord.
When tophi appear in the tissues, the gout condition is felt to represent a substantial overload of
uric acid within the body.
Untreated gout can cause permanent joint and kidney damage.

Ayurvedic insights - do’s and don’ts

There are two key concepts essential to treating gout.
First, it is critical to stop the acute inflammation and pain of joints affected by gouty arthritis.

Second, it is important to address the long-term management of the disease in order to prevent
future gouty arthritis attacks and shrink gouty tophi crystal deposits in the tissues.

Don’ts

•Dietary changes- purine rich foods are avoided. Examples of foods rich in purines include shellfish
and organ meats such as
liver, brains, kidneys, and sweetbreads.
•Non vegetarians should also avoid the consumption of high purine foods such as pork, beef, lamb
and organ meats such as kidney, liver, brain or meat extracts. Seafood such as anchovies, fish
eggs, mussels, sardines etc
•Avoid foods like legumes, mushroom, lentil, beans, spinach, cauliflower and asparagus as they tend
to have high purine content.
•Avoid crash diets
•Avoid afternoon sleep
•Avoid alcohol, tea , coffee in excess
•Avoid (lentil), horse gram, curds and certain recepies made of curds
•Avoid sour , salty, spicy food
•Avoid milk shakes , sweets
•Avoid  sedentary lifestyle
•Avoid carbonated soft drinks, fizzy drinks
•Avoid bakery products and fermented foods
•Avoid chilled water
•Avoid sugars, fried foods and saturated fats
•Avoid excess use of sprouts
•Avoid cold compression over affected joint
•Avoid excess use of steroids or pain killers and OTC drugs

Do’s

•Maintain adequate fluid intake
•Maintain your weight
•Include high protein content in your diet e.g. dairy products such as buttermilk added with dry
ginger powder or grated ginger, milk and cheese
•Use Spices and salts in moderate amount
•Do regular exercise
•Maintain your blood pressure
•Keep cholesterol levels under control
•In diabetes keep sugar levels under control
•Consult your doctor if you have Heart disease, chronic kidney disease
•Inform doctor about your medications
•Do regular pranayam and yoga to overcome stress and tensions
•Include foods high in potassium such as potatoes, bananas, leafy green vegetables, beans and raw
vegetable
•Pineapples as they are high in bromelain which is beneficial
•Vitamin C helps in breaking down the uric acid crystals that cause inflammation around the joints.
Consume foods that have high vitamin C content such as red bell peppers, red cabbage, oranges,
and potatoes, celery, tomatoes, fresh strawberries, blueberries, cherries, Indian gooseberry (amla)
etc.
•Keep the affected joint elevated and at rest
•Apply hot fomentation with hot water bag or electric heating pad to minimize pain and swelling
•You can apply some local applications over tender joint e.g. dry ginger paste, dashang lepa etc
•In acute condition apply leeches over joint for immediate relief in pain and swelling under doctor’s
supervision
•You can apply certain oils over the joint e.g saindhavadi oil, vishagarbha oil, murivenna and pinda
oil
•Can take Triphala  powder 1 tbsp every morning and evening with lukewarm water
•Do regular panchakarma to detoxify your body e.g virechana (induced purgation) and basti (enema
therapy) in gout
•Some ayurvedic formulations are extreamly usefull in acute condition as well as to prevent the
disease are kaishor gugulu, amrutadi gugulu, rasna saptak kadha, vaishwanar churna, ajmodadi
churna, pimpali rasayan, saptawimshati gugulu , avipattikar churna, punarnavasava, sarivadyasava,
manjishthadi kadha, bruhat vat chintamani rasa, vatawidhwansan rasa etc. this should be use as per
doctors prescription only

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gout remedies, uric acid gout , primary gout, secondary gout, gouty arthritis, podagra, tophi,
arthritis, pseudogout, crystals, uric acid, inflammation, monosodium urate crystals, joint pain, joints,
gout, purins, purine rich foods, vatrakta, leech , basti , ayurveda, ayurvedic medicines for gout, do’s
and don’ts of gout






Dr. Prashant Sawant's Ayusanjivani Chikitsa
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Maharashtra, India

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