By David Blyweiss, M.D., Advanced Natural Wellness
Even though gout is quite common, it’s one of the most misunderstood forms of inflammatory arthritis.
Gout is caused by a build-up of uric acid in the body, a condition called hyperuricemia (pronounced hyper-yur-i-see-me-ya). This causes solid uric acid crystals to form in joints that results in excruciating pain.
The thing about gout is that the flare-ups occur on an irregular basis. They can happen suddenly once or twice a year. Maybe even less. In chronic cases, flare-ups will occur more frequently. And in either case the symptoms can last anywhere from a few days to a couple of weeks.
So it’s easy to think of gout as something of a painful mobility disorder during flare-ups… and forget all about it during periods of remission.
But unfortunately, hyperuricemia isn’t only about gout. It’s about your cardiovascular health, too.
Excess uric acid also causes silent systemic inflammation which damages the inner lining of your blood vessels (the endothelium.) It also increases levels of oxidized LDL.
When LDL particles become oxidized it makes them even more inflammatory. This injures you by blocking arteries and restricting blood flow to your heart, brain and other organs.
At the same time, it robs your body of vital nitric oxide (NO). This naturally occurring gas helps relax and expand your blood vessels so blood can flow freely through your body. When you don’t have enough NO it can damage your arteries, contribute to plaque build-up and cause a dangerous increase in blood pressure.
What’s more, uric acid increases mitochondrial damage – a key feature in heart failure.
All things taken into consideration, it’s no surprise that gout patients are at higher risk of heart attack and stroke than those without it. But the connection between uric acid, gout and cardiovascular health may be even more serious than we previously thought.
Gout Flare-Ups May Predict Heart Attack or Stroke
In a recent study out of the U.K., researchers performed a retrospective analysis on the connection between heart attacks or strokes and recent attacks of gout.
They went through medical histories and found patients who had gout flare-ups. Then, they identified those who experienced a cardiovascular event, and those who didn’t. What they learned was startling.
They discovered that a gout flare-up doubles the risk of a heart attack or stroke within the next two months. The risk continues to be about 1.5 times higher through the third and fourth month after a flare-up before returning to normal.
As if that’s not bad enough, they went on to find out if there was a link between gout and death from heart attack and stroke.
It turned out that gout patients who died from a heart attack or stroke had over four times the odds of experiencing a gout flare-up in the preceding 60 days. And over twice the odds of a gout flare-up in the preceding three to four months.
So as far as I’m concerned, a gout flare-up is like the red light on your car. It’s blinking, a warning. “Hey, your engine is going to seize up unless you do something about it”. And it’s a good idea to heed that warning.
Get Your Uric Acid Under Control
If you’ve never had your uric acid levels tested, it would be a good idea to ask your doctor for the simple blood test on your next visit.
But don’t despair if your levels are high. There are several things you can do to bring your uric acid levels down and enjoy a long, healthy and active life.
First and foremost is to eat a healthy, plant-based diet. Both a Mediterranean style diet and the DASH diet have been shown to reduce uric acid levels, reduce gouty attacks, and are associated with better cardiovascular health.
In the meantime, here are some specific foods and beverages that you want to watch out for.
- Organ meats, red meat and fatty fish are all high in purines, compounds that are broken down into uric acid. So the first thing I recommend to patients with high uric acid is to reduce their overall meat intake – red and otherwise – to about 15% of their diet or less.
- Foods and beverages high in sugar and high fructose corn syrup don’t contain purines. But they do increase production of uric acid. This explains why people who drink more than one soda a day have about an 85% increased chance of gout. So I definitely recommend passing up on sweets and sodas.
- Alcohol works on uric acid levels in much the same way sugars do. Beer is the worst. Vodka and whiskey aren’t quite as bad, but they’ll still raise your levels. However, red wine is okay as long as you don’t drink more than one glass a day.
At the same time, include more of the items below to help clear excess uric acid from your body.
- Drinking plenty of water is one of the best ways to rid excess uric acid from your body. Aim for at least 10 to 12 glasses a day. (Adding a squirt of fresh lime juice can enhance the effects.)
- Cherries and cherry juice extract also have great effects on uric acid. They can lower it in just a few hours. Eating a half pound of bing cherries daily, or taking two teaspoons of black cherry concentrate added to a cup of water twice a day, will both do the trick.
- Replenish your nitric oxide levels with high nitrate foods. Beetroot (or beetroot juice) is by far the top NO booster. Celery, lettuce, Chinese cabbage, radish and turnips are also good choices. Or you can supplement with a plant-based NO booster that has beetroot as its main ingredient.
I also recommend supplementing with 1,500 mg of vitamin C daily. This not only has a significant effect on your uric acid levels, it can also cut your chances of gout by almost half. Adding 500 mg. of quercetin each day can further slash your levels of uric acid.
Kimura Y, Tsukui D, Kono H. Uric Acid in Inflammation and the Pathogenesis of Atherosclerosis. Int J Mol Sci. 2021 Nov 17;22(22):12394.
Knowlton AA, Chen L, Malik ZA. Heart failure and mitochondrial dysfunction: the role of mitochondrial fission/fusion abnormalities and new therapeutic strategies. J Cardiovasc Pharmacol. 2014 Mar;63(3):196-206.
Colantonio LD, Saag KG, Singh JA, Chen L, Reynolds RJ, Gaffo A, Plante TB, Curtis JR, Bridges SL Jr, Levitan EB, Chaudhary NS, Howard G, Safford MM, Muntner P, Irvin MR. Gout is associated with an increased risk for incident heart failure among older adults: the REasons for Geographic And Racial Differences in Stroke (REGARDS) cohort study. Arthritis Res Ther. 2020 Apr 16;22(1):86.
Seminog OO, Goldacre MJ. Gout as a risk factor for myocardial infarction and stroke in England: evidence from record linkage studies. Rheumatology (Oxford). 2013 Dec;52(12):2251-9.
Flare-ups of gout are linked to heart attack and stroke, says new study. University of Nottingham. News Release. Aug 2022.
Cipolletta E, Tata LJ, Nakafero G, Avery AJ, Mamas MA, Abhishek A. Association Between Gout Flare and Subsequent Cardiovascular Events Among Patients With Gout. JAMA. 2022 Aug 2;328(5):440-450.
Choi HK, Curhan G. Soft drinks, fructose consumption, and the risk of gout in men: prospective cohort study. BMJ. 2008 Feb 9;336(7639):309-12. MacFarlane LA, Kim SC. Gout: a review of nonmodifiable and modifiable risk factors. Rheum Dis Clin North Am. 2014 Nov;40(4):581-604.