How to Prevent Gout Flares

January 27, 2021

Gout is a type of arthritis, or joint inflammation. It is caused by uric acid crystals in the joints. Uric acid reaches the bloodstream when purine, a molecule found in certain foods and body cells, is broken down by the liver. The kidneys normally eliminate uric acid through the urine. When the kidneys are unable to eliminate enough uric acid, blood levels become too high, and uric acid accumulates in the joints, where it forms crystals and causes pain.

Signs and Symptoms of Gout

  • Pain most commonly occurs in the big toe, but any joint can be affected. Other joints frequently affected are the ankles, knees, elbows, wrists, and fingers, usually reaching its peak in 4 to 12 hours.
  • Further, more moderate pain can last a few days to a few weeks after the acute attack.
  • Swelling, redness, tenderness of the affected joint
  • Limited movement as gout progresses


Prevention: Lifestyle Changes

  • Normalize weight–losing weight helps put less strain onto joints
  • Eliminate high purine foods
    • Shellfish
    • Anchovies, sardines, tuna
    • Organ meats
    • Asparagus, spinach
    • Beer, distilled liquors
  • Cut down on
    • High fat poultry
    • Red meat
    • High fat dairy products
  • Eliminate high sugar foods that help raise purine levels
    • Honey
    • Brown sugar
    • Palm sugar
    • Refined sugar
    • High fructose corn syrup
    • Fruit juices
  • Eat a healthy diet
    • Whole fruits, including cherries
    • Vegetables
    • Whole grains
    • Low fat dairy and lentils
    • Drink plenty of water to stay hydrated


Medications for Prevention

  • Xanthine oxidase inhibitors work by lowering uric acid production. These are taken as prophylaxis between flares, but are not used to treat an acute flare.
    • Aloprim, Lopurin, Zyloprim (allopurinol)– This drug is taken orally at a dosage of 200 to 300 mg per day, to bring the blood level to 6 mg/dL.
    • Uloric (febuxostat)– Dosage is 40 or 80 mg taken orally each day.
  • Probalan (probenecid)–works by increasing the amount of uric acid released into the urine by the kidneys. It is taken orally at a dose of two, three, or four 500 mg tablets per day.


Treatment of an Acute Gout Flare

  • Anti-inflammatory pain medications (NSAIDs) work by treating the inflammation in the joint caused by the crystals. It is important not to combine these three medications but rather choose one:
    • Indomethacin is the most commonly prescribed NSAID for gout flares.
    • Naproxen Dosage is 250-500 mg taken twice a day.
    • Ibuprofen Dosage is 400-600 mg taken every 6 hours.
  • Colchicine is used if there is a health reason not to take NSAIDs
  • Tylenol (Acetaminophen) is over-the-counter non-narcotic pain medication that can be used in gout flares and can be combined with NSAIDs.


Did you know? QuickMD can prevent gout episodes from the convenience of your home, and provide you with a prescription for allopurinol  online (or either of the other anti gout drugs).

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