This page about what gout is, is the Explanations section from the old style website. It is now maintained in the Understanding Uric Acid section where I explain all the principles of uric acid, hyperuricemia and gout.
I Need to Know What Gout Is
People affected by painful, swollen joints want to know what gout is. Sufferers and their carers are often confused by almost every aspect of gout, also called gouty arthritis.
My Explanations Of What Gout Is
When I started this website in February 2005, I was totally confused by gout.As I’ve researched different aspects of gout I’ve learned more, but I’m still learning. I will keep researching, reporting and explaining until a cure for gout is found.
Month by month, I’m growing the amount of information and looking for new ways to present it so that you can easily find and understand what you need.
What Gout Is
The hardest task, for me, was to understand what gout is. It may seem obvious, but even the medical profession have difficulty in an absolute definition. From a personal point of view, it probably doesn’t matter what gout is. If there were a standard reliable cure, it would matter even less.
But there is no magic cure, so the best approach is to understand what happens in your body to cause pain. I’ve learned that this is an extremely complex series of biochemical processes. Some are easy to understand, others less so. The complexity leads to confusion. Confusion leads to doubt. Managing gout in this situation is extremely difficult, if not impossible.
To try and cut through this cloud of confusion and doubt I have developed an explanation of what gout is. This explanation of how gout pain is caused is at the heart of making the best personal choice of treatments that suit you.
Clouds of Gout
Many advisers say that uric acid crystals resulting from excess uric acid in the blood cause gout pain. The standard solution is to:
- Treat the pain with appropriate anti-inflammatory drugs.
- Reduce uric acid levels by with a low purine diet or daily medication to remove uric acid from the blood.
This approach works for many people, but it is no use for those, like me, who want a fuller dietary choice and do not want to take lifelong daily medication. I accept that some restrictions may be necessary, but I know that these are available through small changes in lifestyle – not wholesale misery!
I also accept that I need a simple view of what gout is when I plan and implement those lifestyle changes. Now that I clearly see that U-D-R-P leads to gout pain, I can more easily manage my gout. Small lifestyle changes based on beating U-D-R-P let me reduce the intensity and frequency of gout pain, and let me deal with that pain in a more positive manner.
I have added the Clouds Of Gout graphic to some pages to show what part of gout they are about, and a link to an explanation of that part of gout. If you spot any pages that I have missed, please let me know.
For a fuller explanation of what gout is, see uric acid causes gout pain.
Why Do The Best Gout Cures Hurt?
Now that you understand what gout is, it’s easier to understand why curing gout can hurt. I’ve written this article on allopurinol medication to explain why. Please note that it actually applies to all gout treatments that lower uric acid, not just allopurinol.
Gout Food Ratings
PRAL
PRAL stands for Potential Renal Acid Load. It is a simple calculation to estimate the expected acid inducing compounds from digested foods.
Studies have shown PRAL to be a reliable indication of the acidifying or alkalizing effect of food.
Positive values have a pH lowering, acid effect. Negative values have a pH raising, alkaline effect. It is important to include both acid and alkaline foods in your diet to gain a range of nutrients, with an overall total in the alkaline range. Opinions vary, but the best ratio of alkaline:acid foods is about 67:33 up to 80:20
Antioxidant Rating
Antioxidants are good for health according to many experts. I only know of one study that shows antioxidants reduce uric acid – tell me if you find others.
There are many different antioxidants, and different ways to measure them. Until we know more about how specific antioxidants affect different aspects of health, I am highlighting those with high total antioxidant capacity as being best gout diet choices.
To avoid assigning absolute numbers to foods that can vary widely according to season, variety, growing conditions and cooking methods, I have assigned an antioxidant rating. These are High, Medium, Low, Negligible and Unknown. Even low antioxidant foods are good for you, especially where they add variety to a diet that already includes plenty of antioxidants.
I no longer maintain Gout Food Analysis pages, therefore the antioxidant rating, and the following ratings, no longer apply. See the Gout Diet section for guidance on how to plan and maintain an effective diet for gout.
Inflammation Factor
Inflammation factor is a proprietary formula for assessing the inflammatory, or anti-inflammatory effects of food. The higher the number, the more anti-inflammatory the food is.
Inflammation factor takes account of the different effects of different nutrients. High-antioxidant foods will often show a high Inflammation Factor, but the values may be reduced when foods contain high carbohydrates, particularly sugars, which have an inflammatory effect.
In the absence of scientific evidence to show the effects on gout, I am relying on commonsense to judge that anti-inflammatory foods must be good for gout.
As with acid/alkaline foods, it is important to eat a range of inflammatory and anti-inflammatory foods, but the total daily value should be positive, i.e. anti-inflammatory. A daily total of around 200 is a good target for gout sufferers.
Fullness Factor
Many weight loss plans focus on calories, but if you fill your calorie allowance from foods that do not satisfy your appetite, you will always fight a losing battle against weight. The Fullness Factor is a proprietary rating system that gives a higher rank to foods that are more filling. The rating ranges from 0 to 5, with 5 being the best.
If you are overweight, you can lose weight on the GoutPal Diet by gradually exchanging foods that do not satisfy your hunger, for those that do.
Nutrition Rating
The Nutrition Rating is a proprietary method for ranking foods according to the amount of nutrients per calorie. The rating ranges from 0 to 5, with 5 being the best.
What About Purines?
I have not included purines in the gout food ratings as I do not think they are relevant to what gout is. A few studies have shown that high purine foods can increase uric acid, but the ones I have seen are based on extreme diets or non-humans. Many extreme diets will raise uric acid, as will starvation. Your body battles against poor nutrition to neutralize oxidizing foods. Often, body tissue breaks down, producing excess uric acid, as cells die. Every fact I have read about leads me to the conclusion that you will produce more uric acid as a result of poor diet than you will ever get from a plateful of even the highest purine food.
I have retained the table of high purine foods for those people who believe that purines in food affect gout.
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