The Center for Podiatric Care and Sports Medicine

Get Out, Gout!

Posted by on Wednesday, June 6th, 2012

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Does gout sound to you like something out of Ye Olde Time Disease Booke? Well, while it is true that gout is a condition you would hear about more in 18th century novels than in 21st century life, it is, unfortunately, something that is still with us, afflicting millions of people today.

And why are we talking about it? Well, because one of the places affected by gout is your big toe. So let’s find out about it!

What is gout? Gout is actually a form of arthritis. Your body disposes of uric acid, a waste product from when your metabolism breaks down food, through the kidneys. When your body can’t get rid of the uric acid fast enough, it builds up in your blood and crystallizes in or around your joints, causing pain and swelling.

What causes gout? Does the uric acid build up from cinching your velveteen knee breeches too tight? No, though we would never advise cinching your velveteen knee breeches too tight. Gout occurs in men more than women, especially between ages 40 and 60. There’s a hereditary tendency to gout–if someone in your family has it,  you’re more likely to develop it. You won’t definitely get it, but if you indulge in some of the behaviors that cause gout and your father and brother have gout, you’re tilting the scale in the gout direction. People with high blood pressure, high cholesterol, diabetes, psoriasis, or arteriosclerosis may also be more likely to develop gout.

Additionally, people who drink excess amounts of alcohol and some high protein foods such as meat and seafood may also be more likely to develop gout. This, by the way, is why the “disease of kings” is so often associated with chunky men in powdered wigs and velveteen knee breeches. All they did back then was drink alcohol and eat large quantities of meat; exciting salads weren’t part of the everyday diet.

Are you implying that the Founding Fathers and kings and queens everywhere were drunk? Yes. Famous gout sufferers from history, by the way, include King Henry VIII and Benjamin Franklin, a well as author Samuel Johnson, Mongolian monarch Kublai Khan, British prime minister William Pitt, scientist Sir Isaac Newton, Prussian ruler Frederick the Great, a large number of Holy Roman Emperors, and according to Blogfoot, the T-Rex skeleton nicknamed “Sue.”

Are there any present day famous people who have gout? Yes! I was hoping you would ask that. Famous modern people who have gone through a bout of gout include actor Jared Leto, pitchers David Wells and Curt Schilling (Rhode Islanders, rejoice!), NBA player/coach Maurice Cheeks, and soccer player Harry Kewell (Note: Cheeks and Kewell don’t fit the Henry VIII turkey leg chomping, wine swilling stereotype, so it looks like they have heredity to blame).

Okay, enough about them, how would I know if I had gout? Gout can occur in any joint, but is most common in the big toe. Look out for these symptoms in your big toe joint:

  • severe pain
  • swelling
  • itchiness
  • red, shiny skin
  • peeling and flaky skin
  • itchiness

If you experience any of these symptoms, then you very likely have gout. The best way to get an accurate diagnosis, though, is to see a podiatrist at The Center for Podiatric Care and Sports Medicine (212.996.1900).

If I have gout, what can I do about it? Gout typically flares up for about a week at a time. Over the counter remedies such as nonsteroidal anti-inflammatory drugs (ibuprofen, acetaminophen) can help you deal with the pain temporarily. There are also prescription drugs to help deal with gout. If you have trouble walking, a podiatrist at The Center for Podiatric Care and Sports Medicine (212.996.1900) may recommend orthotics to take pressure off your big toe. Also make sure that your shoes fit with plenty of room for the big toe in the toe box.

Lifestyle changes are a very important part of eliminating gout. Cutting back on certain foods can lessen the pain during gout flare ups, and make them less common. Here are some foods to avoid:

  • some seafood, such as herring, tuna, anchovies, scallops, mussels, mackerel, sardines
  • meat, especially liver, kidney, turkey, goose, veal, and venison
  • beer
  • foods containing yeast extract such as marmite (you’re all clear on this one, Americans)
  • spinach, asparagus, and lentils (though you don’t have to avoid these completely, just cut down on them)
  • sugary drinks with lots of high fructose corn syrup
  • alcohol, especially port and sherry (sorry, velvet and powdered wig crowd!)

Feeling deprived? Here are some things you can eat if you have gout: low-fat dairy foods, complex carbohydrates, coffee,  fruits (especially citrus fruits). Drink lots of fluids, too–but not beer, port, or sherry (thanks to Health.com for the list).

And for super good news, I don’t see chocolate anywhere on the forbidden list!

Gout isn’t pleasant, but you can defeat it with a little care about what you eat and drink. If you have pain in your big toe or anywhere else in your foot, contact The Center for Podiatric Care and Sports Medicine. Dr. Josef J. GeldwertDr. Katherine Lai, and Dr. Ryan Minara have helped thousands of people get back on their feet.

 

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If you have any foot problems or pain, contact The Center for Podiatric Care and Sports MedicineDr. Josef J. GeldwertDr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.