Avoid High-Purine foods



Avoid High-Purine foods

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🧠 Understanding Purines and Gout

Purines are natural substances found in certain foods. When your body breaks them down, they produce uric acid.
Normally, uric acid is filtered by the kidneys, but if it builds up, it can form sharp crystals in the joints — causing inflammation, swelling, and intense pain known as gout.

So, the best prevention is to limit or avoid foods high in purines.

🚫 FOODS HIGH IN PURINES (Avoid or Strictly Limit)

These foods have more than 150–800 mg of purines per 100 g and can raise uric acid levels quickly:

🥩 1. Organ Meats (Very High Purine)

Liver (beef, chicken, pork)

Kidneys

Sweetbreads

Heart

Brain

⚠️ These are the worst gout triggers — even a small amount can cause a flare-up.

🐟 2. Certain Fish and Seafood


Sardines

Mackerel

Herring

Tuna (especially canned)

Trout

Haddock

Mussels

Scallops

Crab, lobster, and shrimp (limit to small, occasional portions)

🐠 Choose low-purine seafood instead — salmon, flounder, or cod are better choices.


Beef

Pork

Lamb

Bacon

Deli meats, sausages, hot dogs

Game meats (venison, duck, rabbit)

🩸 High in purines and saturated fats — both contribute to inflammation and uric acid buildup.

🍺 4. Alcohol (Especially Beer)

Beer (regular or non-alcoholic)

Liquor (whiskey, rum, gin, vodka)

Wine (limit intake)

🍷 Alcohol dehydrates the body and interferes with uric acid removal — especially beer, which contains guanosine, a purine compound.

🍰 5. Sugary Foods & Drinks

Soft drinks with high-fructose corn syrup

Sweetened fruit juices

Candy, pastries, cakes

Processed breakfast cereals

🍬 Fructose increases uric acid production and should be minimized.

🍗 6. Fatty & Fried Foods

Deep-fried dishes (fried chicken, fries, onion rings)

Creamy sauces, gravies, and butter-heavy meals

Fast foods and processed snacks

🍟 These foods cause inflammation and can trigger gout flare-ups.

⚖️ FOODS MODERATE IN PURINES (Eat Occasionally)

These foods have 50–150 mg of purines per 100 g — safe in small portions:

Chicken, turkey

Duck


Mushrooms

Spinach


Peas, lentils, beans (in moderation)

🌿 Plant-based purines are less likely to trigger gout, but balance is key.

✅ LOW-PURINE FOODS (Best Choices for Gout)

These foods have less than 50 mg of purines per 100 g — safe and even beneficial:

🥦 Vegetables & Fruits:

Most vegetables (broccoli, carrots, kale, bell peppers)

Fruits like cherries, berries, apples, oranges, papaya, and bananas

🍞 Grains:

Brown rice, quinoa, oats, and whole-grain bread

🥛 Dairy:


🥚 Proteins:

Eggs, tofu, and nuts

💧 Drinks:

Water (2–3 liters daily)

Coffee and green tea (may help reduce uric acid)

💡 Lifestyle Tips

✅ Stay hydrated — water helps flush uric acid.
✅ Maintain a healthy weight — obesity increases gout risk.
✅ Exercise regularly but avoid overexertion during flare-ups.
✅ Avoid crash diets and fasting (they raise uric acid).
✅ Limit alcohol and sugar intake.

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Gout Foods: Avoiding Purines


Gout Foods: Avoiding Purines

GOUT FOODS: AVOIDING PURINES

If you suffer from gout, managing your diet is one of the most effective ways to prevent painful flare-ups. The key is to avoid foods high in purines, since purines break down into uric acid — the compound that crystallizes in joints and causes inflammation.

Below is a clear guide on which foods to avoid, limit, and enjoy to help control uric acid levels and reduce gout symptoms.

⚠️ Why Purines Matter

When you eat foods containing purines, your body converts them into uric acid. Normally, uric acid dissolves in the blood and exits through the urine.
However, when there’s too much uric acid or your kidneys can’t remove it efficiently, crystals form in joints — leading to gout attacks.

🚫 FOODS HIGH IN PURINES (Avoid or Strictly Limit)

These foods can dramatically raise uric acid levels and trigger gout attacks:

🥩 Organ Meats (Highest Purine Content)

🔴 These are the worst offenders — even small amounts can cause flare-ups.

🐟 Certain Seafood

⚠️ Fatty fish and shellfish are high in purines. Opt for low-purine fish like salmon or tilapia instead.

🍺 Alcohol

  • Beer (including non-alcoholic beer)

  • Spirits (vodka, rum, whiskey, gin)

  • Excessive wine

🍻 Alcohol interferes with uric acid removal and causes dehydration — both major gout triggers.

🍬 Sugary Foods and Drinks

🍭 Fructose raises uric acid levels by increasing purine metabolism — just like meat.

🍗 Red and Processed Meats

🩸 High in purines and saturated fats, which worsen inflammation.

🧈 Fatty and Fried Foods

🛑 These foods increase inflammation and make it harder for your kidneys to excrete uric acid.

⚖️ FOODS MODERATE IN PURINES (Eat Occasionally)

🟡 Plant-based purines are less harmful than animal-based ones, but moderation is key.

✅ LOW-PURINE FOODS (Safe for Gout)

These foods are low in purines and can actually help reduce uric acid:

  • Fresh fruits (especially cherries, oranges, berries)

  • Vegetables (except the few listed above)

  • Whole grains (brown rice, quinoa, whole-wheat bread)

  • Low-fat dairy (milk, yogurt, cheese)

  • Eggs

  • Nuts and seeds

  • Olive oil and avocados

  • Herbal tea, coffee, and lots of water

💧 Staying hydrated helps flush out uric acid naturally.

💡 Tips for Managing Gout

  1. Drink 8–12 glasses of water daily.

  2. Maintain a healthy weight — obesity increases uric acid levels.

  3. Avoid alcohol during flare-ups.

  4. Follow a low-purine, high-fiber diet.

  5. Limit sugary drinks and processed foods.

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GOUT Diet : Foods To Avoid



🦵 GOUT DIET: FOODS TO AVOID

If you have gout—or want to prevent flare-ups—what you eat makes a big difference. Gout is a form of arthritis caused by high levels of uric acid in the blood, which forms painful crystals in the joints (often in the big toe, ankles, or knees).

Many foods contain purines, compounds that break down into uric acid. The more purines you eat, the higher your uric acid level can climb.

Here’s a complete list of foods to avoid or limit to manage gout effectively 👇

🚫 1. Red Meats (High in Purines)

These are among the top gout triggers.
Avoid or limit:

  • Beef (especially liver and other organs)

  • Pork

  • Lamb

  • Veal

  • Game meats (venison, rabbit, etc.)

🩸 Why: Red meats are rich in purines, which increase uric acid production.

🐟 2. Certain Seafood

Some fish and shellfish are very high in purines.
Avoid or limit:

  • Anchovies

  • Sardines

  • Mackerel

  • Herring

  • Tuna (especially canned or bluefin)

  • Trout

  • Scallops

  • Mussels

  • Shrimp and crab (occasional moderate portions are fine for some people)

🐠 Better choices: Salmon, tilapia, and flounder are lower in purines.

🍺 3. Alcohol (Especially Beer & Spirits)

Avoid or limit:

  • Beer (including non-alcoholic beer)

  • Liquor (whiskey, rum, vodka, gin)

  • Heavy or frequent wine consumption

🍷 Why: Alcohol interferes with the body’s ability to remove uric acid and promotes dehydration.
💡 Tip: Light wine in moderation (1 glass occasionally) may be less harmful than beer or liquor.

🍔 4. Processed & Sugary Foods

Avoid or limit:

  • Soft drinks, especially those sweetened with high-fructose corn syrup (HFCS)

  • Candy, pastries, and cakes

  • Sweetened fruit juices

  • Sweet breakfast cereals

  • Fast food and processed snacks

🍬 Why: Fructose (a sugar) raises uric acid levels by speeding purine metabolism.

🥩 5. Organ Meats

Absolutely avoid:

  • Liver (beef, chicken, or pork)

  • Kidneys

  • Sweetbreads

  • Brain

🦴 Why: These are some of the highest-purine foods on Earth—top gout triggers.

🧀 6. Rich, Fatty, or Fried Foods

Avoid or limit:

  • Deep-fried dishes

  • Creamy sauces and gravies

  • Full-fat dairy (use low-fat instead)

  • Fast foods high in trans fats

🥛 Why: These foods raise cholesterol and inflammation, worsening gout pain.

🍞 7. Refined Carbohydrates

Avoid:

  • White bread

  • White rice

  • Regular pasta

🥖 Why: Low in nutrients and fiber, they contribute to insulin resistance, which can raise uric acid levels.

⚠️ 8. Certain Vegetables (Moderate Consumption Only)

Although not as harmful as meat or seafood, some vegetables are moderately high in purines.
Limit (don’t eliminate):

  • Asparagus

  • Spinach

  • Mushrooms

  • Cauliflower

  • Peas

🌿 Why: These plant purines don’t raise uric acid as much as animal sources do.

💧 Tips to Help Prevent Gout Attacks

✅ Drink plenty of water – at least 2–3 liters per day.
✅ Eat low-fat dairy, which may help reduce uric acid.
✅ Load up on fruits & vegetables – especially cherries, berries, and citrus.
✅ Maintain a healthy weight – obesity raises uric acid levels.
✅ Limit alcohol and sugary drinks.

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Gout Diet : The Myths




GOUT DIET: THE MYTHS — AND THE REALITY

Myth 1: “Gout is caused only by eating too much red meat.”

Reality:
Red meat is high in purines, but gout is caused by high uric acid levels, which come from purines in food + your body’s own production + kidney excretion problems.
Genetics, obesity, kidney health, and certain medications play a bigger role than meat alone.

Myth 2: “Avoiding all purine-rich foods will cure gout.”

Reality:
You can’t avoid purines completely — your body makes them naturally. Diet helps lower attacks, but cannot cure gout. Medication is often still needed for control.

Myth 3: “Seafood is completely off-limits.”

Reality:
Some seafood (anchovies, sardines, mussels) are high in purines, but others (salmon, shrimp, crab) are moderate and usually fine in moderation. Portion size matters more than total restriction.

Myth 4: “Beer is bad, but wine is safe.”

Reality:
Beer is the worst for gout, but all alcohol can raise uric acid by interfering with kidney excretion.
Wine is better than beer, but still not “safe” during flare-ups.

Myth 5: “Sugar has nothing to do with gout.”

Reality:
Sugary drinks (especially fructose) rapidly spike uric acid.
Soda, sweet iced tea, energy drinks, and sweetened juices can trigger attacks more than some high-purine foods.

Myth 6: “You must give up vegetables high in purines.”

Reality:
Spinach, cauliflower, mushrooms, and beans have purines, but plant purines don’t increase gout risk because they break down differently.
Vegetables are safe and beneficial.

Myth 7: “Only overweight people get gout.”

Reality:
While excess weight increases risk, gout also occurs in:

  • people with kidney issues

  • those who drink alcohol

  • people with high blood pressure

  • individuals with a genetic predisposition
    Even thin, healthy individuals can get gout.

Myth 8: “Once you start gout medication, you must take it forever.”

Reality:
Many people do benefit from long-term medication, but it depends on severity.
Some can manage uric acid through lifestyle changes, weight loss, and reduced alcohol — but only under medical guidance.

Myth 9: “Gout only affects the big toe.”

Reality:
It commonly starts in the big toe, but gout can affect ankles, knees, wrists, fingers, elbows, and even the spine.

Myth 10: “If the pain goes away after a flare, the gout is gone.”

Reality:
Uric acid crystals remain even after pain stops.
Without control, they keep growing and can form tophi (hard lumps) or lead to joint damage.

OTHER SOURCES
How can an individual start distinguishing between myths and facts to make informed purchasing decisions at the grocery store? The University of Washington, Department of Orthopedics states:

* There is a correlation between obesity and elevated uric acid levels in the bloodstream. Individuals who are overweight are advised to consult their physician to establish a suitable weight-loss plan. Engaging in fasting or extreme dieting may inadvertently increase uric acid levels and exacerbate gout symptoms.

* Generally, individuals can consume a variety of foods within certain limits. Those who experience kidney stones caused by uric acid may need to completely remove purine-rich foods from their diet, as these can elevate uric acid levels.

* While drinking coffee and tea is generally acceptable, alcohol consumption can increase uric acid levels and trigger a gout attack. It is advisable for individuals, particularly those with kidney stones, to drink at least 10-12 eight-ounce glasses of non-alcoholic beverages daily to assist in flushing uric acid crystals from the system.
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How To Treat Gout With Diet and Medication


How To Treat Gout With Diet and Medication

How to Treat Gout with Diet and Medication

(A Complete Guide to Managing Pain and Preventing Future Attacks)

Gout is a type of arthritis caused by excess uric acid in the blood, which forms needle-like crystals in the joints — leading to inflammation, pain, and swelling.
While medication controls uric acid levels and diet helps prevent flare-ups, the best approach combines both for long-term relief and prevention.

⚕️ 1. Medical Treatment for Gout

Doctors use medications to manage gout in two main ways:

  • To treat attacks (short-term relief)

  • To prevent future attacks (long-term control)

🩹 A. Treating Acute Gout Attacks (Short-Term)

When a flare-up occurs, the goal is to reduce pain and inflammation quickly.

Common medications include:

  1. NSAIDs (Nonsteroidal Anti-Inflammatory Drugs)

    • Examples: Ibuprofen (Advil), Naproxen (Aleve), Indomethacin

    • Reduce swelling and pain during a gout attack.

  2. Colchicine

    • Specifically targets gout inflammation.

    • Works best when taken within the first 12–24 hours of an attack.

  3. Corticosteroids

    • Examples: Prednisone (oral or injection)

    • Used when NSAIDs or colchicine are not suitable.

    • Quickly reduce joint inflammation.

💡 These medicines treat symptoms — not the root cause (high uric acid).

💊 B. Preventing Future Gout Attacks (Long-Term Control)

Once the acute pain is managed, focus shifts to lowering uric acid levels to prevent recurrence.

Medications include:

  1. Allopurinol (Zyloprim)

    • Reduces uric acid production.

    • Most commonly prescribed for long-term gout management.

  2. Febuxostat (Uloric)

    • Works similarly to allopurinol; used if allopurinol causes side effects.

  3. Probenecid

    • Helps kidneys remove uric acid more efficiently.

  4. Pegloticase (Krystexxa) (for severe, chronic gout)

    • Breaks down uric acid rapidly in difficult-to-treat cases.

⚠️ Always start uric acid–lowering therapy after an acute flare has settled — starting during an attack may worsen symptoms.

🥦 2. Treating Gout Through Diet

Diet plays a vital role in managing uric acid levels and reducing flare frequency.
While medication keeps uric acid under control, food choices can make a huge difference in preventing new crystals from forming.

✅ A. Foods to Eat More Often (Gout-Friendly Foods)

🍽️ Food Group✅ Examples💪 Benefits
Low-fat dairyMilk, yogurt, cheeseLowers uric acid levels
VegetablesBroccoli, kale, spinach, cabbage, carrotsAlkalize the body and reduce inflammation
FruitsCherries, oranges, berries, citrusContain antioxidants and vitamin C
Whole grainsOats, brown rice, barleyRegulate metabolism and blood sugar
Lean proteinsChicken breast, eggs, tofu, legumesModerate purine levels
Healthy fatsOlive oil, avocado, nuts, flaxseedsAnti-inflammatory
WaterAt least 2–3 liters/dayFlushes out uric acid

🚫 B. Foods and Drinks to Avoid (High-Purine & Trigger Foods)

⚠️ Category❌ Examples⚡ Reason
Red meatsBeef, lamb, porkHigh in purines
Organ meatsLiver, kidney, heartVery high in uric acid–forming purines
SeafoodAnchovies, sardines, mussels, scallops, troutTriggers flares
AlcoholBeer, spirits, red wineInterferes with uric acid elimination
Sugary drinksSoda, fruit syrups, energy drinksFructose raises uric acid
Processed foodsFast food, salty snacksHigh sodium and unhealthy fats

💧 C. Lifestyle Tips for Managing Gout

  • Stay Hydrated: Aim for at least 8–10 glasses of water daily.

  • Maintain Healthy Weight: Even modest weight loss can lower uric acid levels.

  • Exercise Regularly: Gentle activity improves circulation and metabolism.

  • Limit Alcohol: Especially beer and spirits — they block uric acid excretion.

  • Avoid Crash Diets: Rapid weight loss increases uric acid temporarily.

🧾 3. Combining Diet and Medication

🩺 Approach💬 Goal
MedicationsQuickly relieve pain and reduce uric acid production
Diet changesPrevent uric acid buildup and future flares
Hydration & exerciseHelp kidneys flush uric acid naturally
Regular monitoringBlood uric acid should be below 6 mg/dL (360 µmol/L)

🌿 4. Natural Aids (Optional Support)

  • Cherries / Cherry Juice: Reduces flare frequency.

  • Vitamin C supplements: (500 mg/day) may lower uric acid.

  • Coffee (moderate): May help reduce gout risk.

Always discuss supplements with your doctor before use.

🩸 Key Takeaway

The best gout treatment combines doctor-prescribed medication + a low-purine, anti-inflammatory diet.
Managing both uric acid levels and lifestyle factors can help prevent painful flares and joint damage for life.


Gout Diet....ANOTHER SOURCE
Typically, gout predominantly affects men, with approximately 95% of patients being male and 5% female. An initial gout attack, which often involves the big toe in 50% of cases, can last for several days and may resolve on its own without treatment. Subsequent episodes may not manifest for weeks, months, years, or may not occur at all. In severe instances, repeated attacks over an extended period can lead to joint damage and reduced mobility. The big toe is ultimately impacted in 90% of cases. Understanding how to manage gout is crucial for preventing future attacks.

Gout is frequently associated with a genetic predisposition that affects the body's ability to process uric acid. Elevated uric acid levels can result from a diet high in purine-rich foods, such as meats, excessive production of uric acid by the body, or inadequate elimination of uric acid by the kidneys.

The objectives of treatment include halting acute gout attacks, providing rapid and safe relief from pain and inflammation, preventing future episodes, and avoiding complications such as the formation of tophi, kidney stones, and joint damage.

While gout is typically managed successfully without complications, treatment can become more complex if other medical conditions coexist or if there is poor adherence to recommended lifestyle modifications or medication regimens.

Dietary changes are advised, including the avoidance of a purine-rich diet. Additional preventive strategies encompass ensuring sufficient fluid intake, weight loss, reducing alcohol consumption, and utilizing medications to lower hyperuricemia.

Medications used for gout include:

* non-steroidal anti-inflammatory drugs (NSAIDs)
* colchicine
* corticosteroids
* adrenocorticotropic hormone (ACTH)
* allopurinol
* probenecid
* sulfinpyrazone

NSAIDs, particularly indomethacin, are often the first line of treatment for acute gout. Other NSAIDs may also be equally effective. These medications are typically prescribed at maximum dosages initially and then tapered as symptoms improve. Treatment should continue until pain and inflammation have been absent for at least 48 hours. COX-2 inhibitor NSAIDs may also provide beneficial effects. for patients with gastrointestinal concerns but their use for acute gout has not been specifically reported yet.

Colchicine is utilized for the management of acute episodes of gouty arthritis and for the prevention of recurrent acute episodes. It is important to note that colchicine does not provide a cure for gout nor does it replace other medications that reduce uric acid levels in the body. Its mechanism of action involves the prevention or alleviation of gout attacks through the reduction of inflammation. Colchicine can be administered in two distinct manners: some individuals may take small doses consistently over months or years, while others may opt for larger doses over a brief duration (spanning several hours).

Corticosteroids or adrenocorticotropic hormone (ACTH) may be prescribed for patients who are unable to tolerate NSAIDs or colchicine. Typically, patients experiencing acute gout are given daily doses of prednisone (ranging from 20 to 40 mg) or its equivalent for a duration of 3 to 4 days, followed by a gradual tapering over one to two weeks. ACTH is delivered via intramuscular injection, with an initial dose followed by additional doses as required over several days.

Allopurinol (marketed under the brand name Zyloprim) is indicated for chronic gout or gouty arthritis and functions by influencing the system responsible for uric acid production in the body. It is intended for the prevention of gout attacks rather than for the treatment of attacks once they have occurred.

Probenecid (available under the brand names Benemid and Probalan) is prescribed for chronic gout and gouty arthritis. Its purpose is to prevent gout-related attacks, not to treat them once they manifest. Probenecid operates on the kidneys to facilitate the elimination of uric acid from the body.

Probenecid is classified as a uricosuric agent.

ColBenemid (also known as Col-Probenecid and Proben-C) is a medication for gout that combines Probenecid, a uricosuric agent, with Colchicine, which possesses anti-gout properties.

Sulfinpyrazone (branded as Anturane) is recognized as a uricosuric agent and is utilized in the treatment of gouty arthritis. It functions by decreasing the concentration of uric acid in the bloodstream, thereby preventing gout attacks. While it aids in the prevention of attacks, it is not intended for the treatment of an attack once it has commenced. Currently, sulfinpyrazone is not available in the United States.

Losartan, known commercially as Cozaar and Hyzaar, is not explicitly approved for the treatment of gout; however, it is categorized as an angiotensin II receptor antagonist and an antihypertensive medication that may assist in regulating uric acid levels. Fenofibrate, marketed under the brand name Tricor, is not a dedicated gout treatment but serves as a lipid-lowering agent that may also aid in managing uric acid levels.

Analgesic pain relievers are frequently employed to alleviate the severe pain associated with gout. The previously mentioned medications can be utilized in conjunction to manage symptoms, avert future episodes, and sustain optimal uric acid levels.
Gout Diet...
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What Are Gout Attacks?



What Are Gout Attacks? 

ChatGPT said:

💥 What Are Gout Attacks?

(Understanding Sudden Joint Pain and Inflammation)

A gout attack — also called a gout flare-up — is a sudden and severe episode of joint pain, swelling, and redness caused by the buildup of uric acid crystals in the joints.
These attacks often happen without warning, usually at night, and can be extremely painful.

⚙️ What Causes a Gout Attack?

Gout occurs when your body has too much uric acid — a waste product made from breaking down purines, which are found in many foods and produced naturally by your body.

Normally, uric acid dissolves in the blood and is removed by the kidneys through urine.
But when:

  • Your body produces too much uric acid, or

  • Your kidneys can’t eliminate enough of it,

the uric acid builds up in your bloodstream.
Over time, it forms sharp, needle-like crystals in the joints — leading to inflammation and intense pain.

⚡ Symptoms of a Gout Attack

A gout attack typically develops suddenly — often overnight — and can last from a few days to two weeks.

Common symptoms include:

  • 🔥 Intense joint pain (often starting in the big toe, but also in ankles, knees, wrists, or fingers)

  • 🌡️ Swelling and warmth around the affected joint

  • 🟥 Red or shiny skin over the joint

  • ⚡ Extreme tenderness — even a bedsheet touching it can hurt

  • 😣 Limited movement during a flare

After the first attack subsides, symptoms may disappear completely for weeks or months, but without treatment, future attacks can become more frequent and more severe.

📍 Most Common Joints Affected

  • Big toe (most classic location) 🦶

  • Ankles

  • Knees

  • Elbows

  • Wrists

  • Fingers

🧪 What Triggers a Gout Attack?

Certain factors can suddenly increase uric acid or cause crystals to release from joint tissue, triggering an attack.

Common triggers include:

🩺 Treatment During an Attack

A gout attack needs quick management to relieve pain and reduce inflammation.
Doctors typically recommend:

  • NSAIDs (like ibuprofen or naproxen)

  • Colchicine (a gout-specific anti-inflammatory)

  • Corticosteroids (for severe inflammation)

  • Rest, ice, and hydration

⚠️ Avoid taking medications that raise uric acid during an active flare unless advised by your doctor.

🌿 Preventing Future Attacks

Once the acute pain is controlled, focus on long-term prevention:

💡 In Summary

🔍 Aspect💬 Explanation
What it isA sudden, painful inflammation of a joint caused by uric acid crystals
Main causeHigh uric acid from purine buildup
Common sitesBig toe, ankle, knee, wrist
DurationA few days to 2 weeks
TreatmentAnti-inflammatory drugs, hydration, rest
PreventionHealthy diet, weight control, medications if needed

ANOTHER SOURCE
Gout Diet Gout usually attacks a single joint suddenly and intensely. Gouty joints show the most visibly red signs of inflammation of any type of arthritis. An initial attack of gout may last several days and disappear even if untreated. Subsequent attacks may not occur for weeks, months, years, or not at all. In severe cases, repeated attacks occurring over a long period may cause damage to the joints and loss of mobility. A definitive diagnosis of gout can be made by examination of aspirated joint fluid with a polarizinglight microscope for evidence of crystals. 

Approximately one million people in the United States suffer from gout. It is nine times more common in men than women, predominantly after puberty with a peak age of 75. Gout attacks in women usually occur after menopause. Gout Diet

What Are Gout Attacks Video :



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