I am always taken aback at the number and persistence of gout myths. Just read a few Internet web pages on gout and gout treatments and it won’t take you long to find contradicting information - even from supposedly reputable sites. These myths are one of the key reasons why the quality of gout care for gout has fallen so much over the past few decades. Bad information keeps getting passed on - over and over. This article will help you understand some of these myths and learn the truth.
Myth #1: Gout is curable. There are tons of websites out there that promise “gout cures” if only you send them some amount of money. The truth is, that for 90% of cases, gout is a genetic condition. This is why gout often runs in families. Genetic conditions cannot be cured, only managed. The other 10 % of cases are called secondary gout. These are usually caused by some underlying medical condition. Some of these conditions can be very serious such as lymphoma or kidney disease. Only a small number of cases are truly ‘curable’. These cases are usually caused by high blood pressure medications called diuretics or extreme obesity. If you have gout, your doctor should check for a secondary cause of gout, if none is found, then you have a genetic condition that can only be managed.
Myth #2: “Natural” or “Herbal” treatments are better than all those scary gout drugs. Colchicine, a drug commonly used to treat gout is made from the bulb of the autumn crocus flower (scientific name: Colchicum autumnale) and is a “natural” treatment that has been used for over 2000 years. Despite this, Colchicine is a highly toxic substance that causes nausea, vomiting and/or diarrhea in 100% of people that take it at a high dose. Fact is, that more than half of the modern pharmacopeia are “natural” substances but may not be healthy to take, however, they do have the benefit of having their safety and use closely monitored by the FDA. Natural treatments can also make things worse if you are not careful. For example, vitamin C has been shown to lower uric acid levels and reduce gout attacks but they can also increase the risk of kidney stones and if you start then suddenly, it can actually cause more attacks. The truth is that many of the prescription drugs used to treat gout can be dangerous, but if taken properly, they can be very safe and are highly effective. Most gout attacks can be stopped in minutes or hours, not days or weeks. And if you properly manage gout’s underlying cause, hyperuricemia, there is no need to suffer from gout attacks at all.
Myth #3: Gout medications will make your attacks stop right away. Actually, uric acid lowering medications can increase gout attacks in the short run but eventually, over the course of 6-12 months, they will usually stops them completely. Most people experience more attacks when they first start taking these medications, then stop taking them, figuring that they are not working. This is because we know that sudden changes in uric acid levels, even drops in uric acid levels, can trigger attacks. Most doctors do not prescribe uric acid lowering medications at the right doses and do not also prescribe prophylaxis medications to prevent these attacks. If you are starting to take uric acid lowering medications, make sure you are starting at a very low dose and increase slowly over a period of several weeks to full strength - never start or stop them suddenly. Also make sure your doctor has given you medications to prevent attacks during the first 6-12 months of treatment.
Myth #4: If you stay way from seafood and beer your gout will go away. Of all the gout myths, myths about diet are the most presistant. But like all good myths, there is some truth it. Seafood and beer have both been shown to be powerful foods to cause a sudden increase in uric acid, which can trigger an attack but in most cases staying away from these foods or eating a strict “low purine diet” will only reduce the number of attacks you have, not eliminate them completely. 90% of gout cases are genetic and diet cannot overpower genetics.
Myth #5: If you have gout, you should stay away from all alcohol. Again, like with all good myths, there is some truth here. Beer has been shown to be very bad for gout. People with gout should not drink beer at all - this advice doesn’t make me very popular, but it is true. Spirits such as vodka and whiskey also raise the risk of gout but only about half as much as beer. Red wine on the other hand, can slightly decrease your risk of gout if you drink no more than one glass per day. With two glasses, the risk is about the same as for those that do not drink at all. So the key here is if you want a drink, stick to red wine and limit yourself to, at most, two glasses.
Myth #6: Other then the pain of gout attacks, gout really doesn’t cause any other problems. This one is dead wrong, and I mean dead. Improperly treated gout can be a crippling disease. Regular gout attacks can damage and even destroy joints, and tophus (large growths of uric acid crystals in the body) can disfigure hands, feet and form in other parts of the body, including the heart (this is where the ‘dead’ comes in). Also, the underlying cause of gout, hyperuricemia, have been shown to be strongly associated with heart disease, high blood pressure, kidney disease, liver disease, diabetes, stroke and obesity. All of which are very deadly. Gout can and does kill!
Myth #7: I am overweight but that doesn’t have anything to do with my gout. Absolutely wrong! Excess body weight is strongly connected with hyperuricemia and gout. Probably the best thing you can do for your gout as well as your health is to loose weight and keep it off! Of course, no one wants to hear that, but if you have gout and are significantly overweight, you are all but guaranteed to get one of the deadly diseases I mentioned in the previous myth. Loosing weight and exercising regularly are the best ways to avoid these diseases.
Myth#8: Once an attack starts, there is nothing you can do by wait it out. Actually, if you act quickly, you can stop an attack an hour or so. How? Take some of the powerful non-steroidal anti-inflammatory drugs (NSAIDs) your doctor has given you at the very first sign of symptoms (see gout basics). If you have medical reasons why your can’t take NSAIDs, don’t worry, there are many other options including corticosteroids, ACTH and others. However, you should avoid colchicine in you can.
Myth #9: Food high in proteins are bad for gout. Food high in proteins actually lower uric acid levels and is good for gout. What matters is where the proteins come from. Meat proteins have been shown to raise uric acid levels while vegetable proteins have been shown to lower uric acid levels - even those that are high in purines.
Myth #10: Medical science knows little about gout. Actually, of all the thousands of diseases out there, gout is one of the best understood diseases. Doctors and scientists know exactly what causes the disease and how it progresses. What has happened over the years is that science has become bored with gout and little research has occurred since the 1970’s and 80’s. Doctors have collectively “forgotten” how to properly manage the disease correctly. Recently one research study showed that as many as 78% of doctors are managing gout improperly. Lately however, there has been a resurgence of interest, new medications are being developed and new research is being conducted to fill in the holes that remain.
Victor Konshin is the author of the #1 selling book on gout, "Beating Gout: A Sufferer's Guide to Living Pain Free". He also hosts interesting discussion about gout on his website, beatinggout.com and also has a podcast devoted to helping people that are suffering from gout.