women and gout

You wake in the middle of the night with searing pain in your big toe, which is bright red and swollen to the size of a small potato. What the—? Did you drop a safe on your foot while sleepwalking?

You may be suffering from gout, a form of arthritis that results when the body creates too much uric acid (a waste product in the body) for the kidneys to process. Sharp crystals form in the joints—usually the big toe, but also in the knees, fingers and other joints—bringing on sudden attacks of excruciating pain, swelling, heat and tenderness.

Gout is finicky. You might have one flare-up in your lifetime, or several attacks in a year. Untreated, gout can lead to kidney disease or joint damage. With appropriate treatment, gout can be controlled and future flare-ups prevented or minimized.
Gout shares certain symptoms that can look like rheumatoid arthritis, masking the condition and delaying appropriate treatment. And since gout is three times more likely to occur in men than in women, it can be easy to miss in females. (News flash: post-menopausal women develop gout at much higher rates once they’ve lost the protective effects of estrogen.)

High levels of purines—natural chemicals found in our cells and also present in many foods, especially red meat, organ meats, certain types of fish and seafood, sugary drinks and alcohol—can lead to too much uric acid in the body. While most people have little or no difficulty processing uric acid, your risk of gout increases if you are sedentary or have untreated high blood pressure, obesity, diabetes, heart or kidney disease.

Your doctor can diagnose gout from your symptoms and your health history (a predisposition to uric acid overload is hereditary). He or she may order a blood panel to check uric acid levels, imaging to detect crystals or swelling, or an analysis of fluid aspirated from the affected joint.

Typical treatment includes prescribed medicines like colchicine and or corticosteroids to reduce pain and inflammation during an acute flare-up. If flare-ups persist, prescription allopurinol can lower uric acid levels and inhibit the formation of crystals.

The Arthritis Foundation recommends avoiding alcohol, sugar and foods high in purines (see above list) if you’ve had even one episode of gout. Some people swear by the benefits of tart cherry juice, either as a beverage or concentrate in capsule form. Exercising regularly and maintaining a healthy weight can reduce the impact on your joints.

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