What are the misunderstandings about gout?

In the near future, I will continue to update you on several major misunderstandings about gout

Myth 1: High uric acid = gout

Many patients complain when they see increased uric acid on the physical examination sheet You may think you have gout, but there is actually a difference between the two.

Hyperuricemia and gout are two different concepts. Hyperuricemia is internationally defined as: under a normal purine diet, fasting blood uric acid levels measured twice on different days are 420 μmol/L for men and 360 μmmol/L for women. According to blood uric acid levels and urinary uric acid excretion, hyperuricemia is divided into three types: poor uric acid excretion type, excessive uric acid production type and mixed type.

Gout refers to the deposition of urate crystals in patients with hyperuricemia, leading to arthritis (gouty arthritis), uric acid nephropathy and kidney stones. Some scholars only refer to gouty arthritis as gout. Therefore, when we find hyperuricemia, we must actively carry out lifestyle intervention or drug treatment to avoid the occurrence of gout.

What should we do if we find hyperuricemia?

1. Eat a healthy diet, mainly low-purine foods, and avoid high-purine foods;

Category 1: 0--25mg purine, edible

Category 2: 25-150mg purine, eat in limited quantities

Category 3: 150-1000mg purine, avoid eating

2. Drink more water, quit smoking and alcohol: drink water every day The amount is 1500ml, preferably 2000ml, and we encourage smoking cessation and prohibiting beer and liquor;

3. Keep exercising and control your weight: Try to do more than 30 minutes of physical exercise every day. Obese patients should lose weight and control their weight;

4. Properly alkalize urine, such as taking sodium bicarbonate or baking soda water.

…………Updating………

Whether it is patients or ordinary people, there are many misunderstandings about gout.

Let’s take a look at some of them, which are also your misunderstandings

1. There was a patient who ate half a catty of pork liver and suffered from headaches in his toes in the middle of the night. He came to the emergency room for a check-up. My toes were extremely red and swollen, and I thought it was gout. A blood test the next day showed that uric acid was very high.

This tells us that gout patients must not eat animal offal rich in purine. If you don’t know you have gout, eating offal once will teach you a lesson.

2. There is a patient who has suffered from gout for 10 years. He has always had a very strict diet and does not drink alcohol because the doctor said he cannot drink alcohol because alcohol contains purines. Among them, beer must not be drunk because it has the highest purine content. At this class reunion, I drank some liquor and was admitted to the emergency room that night with a gout attack.

This teaches us that although beer, white wine and red wine have high purine content, it is best not to drink alcohol. If you really want to drink, you can have two glasses of red wine.

3. Gout patients are advised not to eat seafood. But in fact, there are many kinds of seafood. Some seafood are rich in purine, such as shells, oysters, etc. Seafood containing shells is extremely high in purine. But deep-sea fish and the like are not very high in purine, so you can eat them in moderation. You cannot eat shrimps, neither crayfish nor lobsters. Remember, seafood with shells is extremely high in purine. There was once a patient who was hospitalized in the emergency after eating half a bowl of crayfish. He had no choice but to come to the hospital. His toes were so swollen and painful that he could not stand and had to be helped to go to the toilet.

Gout treatment is actually not difficult. The key is to keep your mouth shut.

Common misunderstandings about gout are as follows:

1. As long as gout does not attack, never take medicine

Most patients think that gout is just joint pain and not painful. Instead of taking medication, patients take uric acid-lowering medications as acute medications, but they don't know that this will only worsen the pain. The underlying problem with gout is high uric acid. Only by lowering uric acid can we reduce the number of gout attacks and reduce the damage caused by high uric acid.

2. With strict dietary control, uric acid can reach the standard without taking medicine.

The sources of purine are divided into exogenous and endogenous sources. Exogenous sources enter the body through food. It only accounts for less than one-third of the total purine content, and endogenous purine is mainly a product of cell metabolism and is also the main component that determines purine. Therefore, it is difficult to reduce uric acid to normal just by controlling diet.

3. Take colchicine according to the instructions

Currently, the guidelines for gout treatment have undergone tremendous changes, but many patients and even doctors have not kept up with this situation. Most patients still take high doses to the point of diarrhea, even year-round, and patients with liver and kidney damage, or previous liver and kidney damage, still take high doses of colchicine. In fact, the current recommended dose is 0.5 mg taken 2-3 times a day, mostly for the acute phase of gout.

4. Vinegar, yogurt and other acidic foods cannot be eaten

People think that these foods cannot be eaten because most people think that uric acid is acidic. These foods are also acidic, which will affect the excretion of uric acid and affect the treatment of gout. In fact, vinegar enters the body and is metabolized to produce carbon dioxide and water. At the same time, it consumes carbonic acid in the blood and acts as an alkalizer. Therefore, vinegar can be safely consumed, but not with sodium bicarbonate. Milk and yogurt do not have high purine levels. In addition, current research also shows that low-fat dairy products can help prevent gout, and yogurt can also help reduce uric acid.

5. Soy products cannot be eaten

Although the purine content of soybeans is slightly higher than that of lean meat and fish, especially the latter has removed most of the purines during processing, so The purine content is not as high as expected, and current research suggests beans do not significantly increase uric acid levels. It may even increase the level of uric acid excretion, and the latter is the main reason, so gout patients do not need to talk about "bean" discoloration.

6. Unlimited amounts of fruits and vegetables

In fact, large intakes of fructose-rich or sweetened soft drinks, juices, and sugar-rich fruits carry a risk of weight gain, as well as It is also a newly discovered risk factor for gout. Spinach and other foods high in oxalates, which can easily interact with uric acid to form stones, should also be avoided.

I hope this answer can help you. If you have any questions, please consult our doctors, we will answer your questions for free

There are the following misunderstandings about gout:

1. There is no difference between hyperuricemia and gout: Hyperuricemia refers to a state in which uric acid in the blood exceeds the normal range. Elevated levels of urate in the blood can occur for many reasons, and gout is one of the most common causes. Hyperuricemia is a precursor to gout, but it does not necessarily cause gout. Gout occurs only when gouty arthritis attacks. Joint pain in people with hyperuricemia is not necessarily a gout attack.

2. Gout "comes and goes like wind" and can be cured without treatment: Although the pain of gout is unbearable, it will usually disappear within a few days or weeks even if it is not treated. However, this does not mean that gout can be cured without treatment. After the pain is over, the inflammation in the joint is gone, and the joint looks like a normal person. But in fact, the uric acid crystals do not disappear. After several acute attacks, crystals continue to accumulate and slowly form stone-like tophi, which will destroy the surrounding soft tissue and bone and cause permanent deformity of the joints. Even if gout patients feel the same as normal people, they cannot leave it alone. The treatment of gout is a lifelong treatment.

3. Gout is not hereditary: Modern medicine has proven that primary gout is basically a hereditary disease. If one parent suffers from gout, 40-50% of the children will suffer from gout; if both parents suffer from gout, the children will suffer from gout. 75 suffers from gout. Therefore, people whose direct relatives have hyperuricemia should pay more attention to their diet, have regular physical examinations, and monitor their blood uric acid levels.

4. Gout has nothing to do with living habits and social status: Gout is related to high social status, career achievements and knowledge. For example, excessive fatigue, excessive stress, reduced physical activity, etc. can affect blood uric acid levels.

In addition, the incidence of hyperuricemia and gout is closely related to diseases such as dyslipidemia, hypertension, cardiovascular and cerebrovascular diseases, and diabetes. These diseases are closely related to lifestyle habits.

The answers given by the previous teachers have been very professional and detailed. Weiwei just wants to add one point:

Can people with gout eat tofu?

Many people think it can’t be done~ But it’s not!

Soybeans, the raw material for making tofu, are high-purine foods and are not recommended for people with gout. However, after being beaten, coagulated, and pressed, purine will dissolve in water in large amounts and will eventually be squeezed out. Therefore, tofu, dried tofu, qianzhang, and other dense soy products with a lot of "dry goods" do not actually have high purine content and can be consumed in small amounts. Ingested! Soy products with high water content, such as soy milk and tofu curd, contain a lot of purine, so you should pay more attention!

Knowledge extension:

Purine is a water-soluble substance, not only in soy products, but also in fish, chicken, etc.; when using fish or chicken to stew soup, the stewing time The longer it is, the more delicious the soup will be~ Why? Because the umami substances in fish and chicken are dissolved into the water, yes ~ these umami substances are water-soluble substances, and purine is also an umami substance! Therefore, a large amount of purine is dissolved in delicious soups such as broth and fish soup, which should be avoided by people with gout!

I hope my answer will be helpful to you! Best wishes!

Life needs nutrition, and so does life! Welcome to follow Nutrition Weiweidaolai

This starts with the purine content of food. According to the purine content of different foods, they can be divided into high There are four categories: purine foods (purine content 150mg/100g), medium-high purine foods (purine content 70~150mg/100g), low purine foods (purine content 30~75mg/100g), and very low purine foods (purine content 30mg/100g) .

The purine content of dried soybeans is as high as 160mg/100g, which is a high-purine food, so many gout patients dare not eat it at all. In fact, this statement is biased. Although dried beans have high purine content, after soaking, grinding, stewing and squeezing out water, the purine content in southern tofu is only 13mg/100g, which is a low-purine food; dried tofu is more squeezing out more water, and the purine content in it is only 13mg/100g. The content is even lower; because soy milk is soaked in water and made with about 20 times more water, the purine content has been greatly diluted. The purine content of 200ML of soy milk is 16 mg, which is also a low purine food. Therefore, gout patients can eat soy products.

I am happy to answer this question for you!

Misunderstandings about gout. A gout patient I met really played a word game with me! For every gout patient I treat, I will emphasize to them the need to drink more water, because drinking more water can indeed reduce the formation of uric acid stones. Water can dilute our blood, but the most important thing is to dilute our blood. Once the concentration of uric acid in the urine is high, the risk of forming stones will greatly increase. By drinking more water, you can completely dilute the concentration of uric acid in the urine to prevent or reduce the occurrence of uric acid stones. !

Therefore, what I emphasize most to my gout patients is to drink more water and keep your daily urine excretion to 1.5L or 2L. Then a fat gout patient will also listen to it every day. My doctor ordered me to drink more water, but eventually I inevitably developed uric acid stones!

Later I discovered that he never considered the weather changes, especially since he was so fat, and the amount of water consumed by sweating in the summer, but blindly kept drinking 2L a day, which actually removed the water from the human body surface. Water loss and sweating in summer are far from diluting urine!

In fact, what our doctors call drinking 2L of water a day, which is eight glasses of water, is a normal temperature and body type. When it comes to gout patients who are prone to sweating in summer or who are obese, For example, to achieve the effect of diluting urine, you actually need to achieve the actual "urine volume" of about 2L every day. Then you may have to drink 3L of water under special circumstances to achieve this!

At the same time, gout patients can also add a little baking soda to the water. It is not that baking soda can reduce uric acid very well, but it can alkalize the urine and inhibit uric acid stones!

Gout is a common and complex type of arthritis. People of all ages may suffer from this disease, and the incidence rate is higher in men than in women. Gout patients often experience sudden joint pain at night. The onset is acute and severe pain, edema, redness, swelling and inflammation occur in the joint area. The pain gradually decreases until it disappears, lasting for several days or weeks. When pain attacks, patients will wake up in the middle of the night from the pain. Some patients describe the pain as being like a big toe being burned. The most commonly affected joint is the big toe, which is the first metatarsal, but the affected joints are not limited to this. It is also common in the joints of the hands, knees, elbows, etc. The affected joints will eventually become red, swollen, and inflamed. After the edema, the tissues will become soft, and the activities will be limited, which will eventually affect daily life. These symptoms will reoccur, so once severe and sudden pain occurs in the joints, it is necessary to see a doctor promptly for symptom management and prevention. If not treated in time, the consequences of delay will be that the pain will become increasingly intense and unbearable. Not only that, the joints themselves can also be damaged, and in severe cases, kidney stones or even kidney failure can occur, which is life-threatening. Many people have heard of gout and know about gout, but they do not understand the specific situation, and many people will fall into the misunderstanding of gout when treating and preventing gout.

Misunderstandings in the treatment of gout

One of the misunderstandings: High-dose antibiotics such as penicillin are used to treat acute gout attacks. During an acute attack of gout, significant redness, swelling, heat, pain, and dysfunction often occur locally in the affected joints (mostly in the big toe and instep). In addition, in severe cases, fever, white blood cells, including neutrophils, may also occur. Elevated granulocytes and other phenomena. Without detailed medical history, physical examination and blood uric acid examination, it is easy to be misdiagnosed as local infection or inflammation, and then treated with large doses of penicillin and other antibiotics. This is the most common and common misdiagnosis and mistreatment in the treatment of gout. Since acute attacks of gout are self-limiting to a certain extent, in general cases, even without any treatment, they can gradually and naturally resolve within 3-10 days of the onset of the disease. This self-relief is often mistaken by doctors or patients for the efficacy of penicillin. Be credited in the anti-infection credit book. In fact, antibiotics such as penicillin are not only ineffective against acute attacks of gout, but can also aggravate the condition, delay remission, and increase the course of the disease.

This is because most of the antibiotics such as penicillin injected into the body are excreted by the kidneys. This is the same as the renal excretion of uric acid, the main culprit of gout. Everyone squeezes out from one outlet. When more penicillin escapes, less uric acid naturally escapes. , as a result, the uric acid in the blood increases due to reduced kidney excretion, thus aggravating the condition.

Misunderstanding 2: During an acute attack of gout, benzbromarone or allopurinol and other uric acid-lowering drugs are used alone to treat it. Gout is a chronic disease, and most patients often take uric acid-lowering drugs such as benzbromarone and/or allopurinol for a long time as prescribed by their doctors. Because these drugs are widely used in clinical practice, some people think that they should be taken as long as they have gout. Some gout patients blindly increase the dose of uric acid-lowering drugs during an acute attack, and even prescribe such drugs separately to patients diagnosed with an acute attack in order to terminate the attack and avoid pain, but the results are counterproductive. Benzbromarone and allopurinol are anti-gout drugs in the pharmacopoeia. The former can increase the renal excretion of uric acid, while the latter can inhibit the formation of uric acid. Their simultaneous effect is to reduce the concentration of uric acid in the blood and correct high uric acid. blood, prevent the occurrence of chronic gouty lesions such as tophi, kidney stones, gouty kidney, etc., so it is mainly suitable for chronic gout. It is the most commonly used and effective drug for the treatment of chronic gout. However, uric acid-lowering drugs have no anti-inflammatory and analgesic effects. Not only can it not relieve the patient's unforgettable severe pain, but it is also ineffective in terminating acute attacks. Moreover, when used alone at this time, due to the mobilization of uric acid pools in the body, blood uric acid can rise for a time, causing so-called metastatic gout attacks, aggravating the condition and prolonging the attack process.

Misunderstanding No. 3: Long-term use of non-steroidal anti-inflammatory drugs such as indomethacin after an acute attack of gout. In order to eliminate the acute inflammatory reaction, relieve pain, and terminate the attack, doctors often prescribe some non-steroidal anti-inflammatory drugs such as indomethacin to patients with acute gout attacks. The dosage is larger and the number of doses is greater every day. The purpose is to Save the patient from pain as soon as possible. However, anti-inflammatory and analgesic drugs neither affect uric acid metabolism nor increase uric acid excretion. They are symptomatic treatments rather than causative treatments. Moreover, these drugs have many side effects. In addition to severe gastrointestinal reactions, they can also cause varying degrees of renal failure. Functional impairment. Therefore, once the acute attack has passed, the medication should be reduced quickly and discontinued within a short period of time.

Misunderstanding No. 4: Once you find that your blood uric acid is elevated, you should take uric acid-lowering drugs for a long time. Hyperuricemia is a biochemical marker of gout, but it is not a synonym for gout. The vast majority of hyperuricemic patients do not suffer from gout throughout their lives, and only those aged 5 to 12 years old develop gout. Asymptomatic hyperuricemia does not necessarily require long-term uric acid-lowering drug treatment, because uric acid-lowering drugs such as allopurinol have various side effects, and some side effects are more serious. Exfoliative dermatitis caused by allopurinol It can even cause death. Of course, hyperuricemia does not mean ignoring it. Regular follow-up and reexamination are required. If there is an obvious family history of gout, if the uric acid levels in blood and urine are significantly increased, or if clinical symptoms have already appeared, drug treatment may be considered. Even patients who have had 1 or 2 acute attacks of gout do not necessarily need drug control immediately. This is because there are large individual differences in the frequency of gout recurrence. Some people only have one attack in their life and will never have another attack. Medication for these patients seems to be too aggressive, and may even lead to more harm than gain. What needs special emphasis here is the indications for drug use. It is generally believed that only those who have more than two attacks per year, or have symptoms of tophi, kidney damage, or whose blood uric acid is still significantly elevated after diet control, need drugs to control it.

Misunderstandings in the life of gout patients

Myth 1: Vegetables are low-purine foods, and gout patients do not need to limit them. Many people believe that vegetables have low purine content and will not induce gout, so there is no need to limit them. Compared with animal foods such as organ meats, seafood, and broth, the purine content of vegetables is generally lower than that of animal foods such as offal, seafood, and broth. However, the purine content of some vegetables is not low, such as lentils, asparagus, seaweed, bean sprouts, etc., which are not suitable for gout. It is one-sided for patients to insist that vegetarian food should be avoided. During the acute attack of gout, they should also try to avoid eating the above-mentioned vegetables with high purine content. During the remission period, they should reduce the frequency and amount of food eaten.

Myth 2: Soybeans contain high purine content, so gout patients cannot eat soy products.

The purine content of dry beans (soybeans, black beans, mung beans, red beans, etc.) is indeed relatively high, but because water-soluble purines are lost during processing, when soybeans are processed into tofu and tofu skin, their purine content drops significantly. During the remission period of gout, it is okay to consume soy products in moderation. The recommended order of choosing beans and soy products is tofu, dried tofu, soy milk, and whole beans. The intake should also be gradually reduced in that order.

Myth 3: Gout patients cannot eat meat. Once many gout patients discover that they have a gout attack, they insist on eating low-purine foods and do not dare to eat meat. They mainly eat vegetables, cereals and potatoes. After eating for a period of time, they find that their bodies are particularly weak. This is due to the long-term lack of protein intake, which leads to the destruction of the nutritional structure of the human body. So even if gout comes, meat must be supplemented, but we can eat a small amount of meat as long as it can maintain the body's protein needs.

Conclusion: There are actually many misunderstandings about gout, but in any case, it is best not to wait until gout symptoms appear before dealing with them. When we find that uric acid is high, we should actively control the further development of uric acid, or we should actively prevent hyperuricemia when uric acid reaches dangerous levels. If control and prevention are done well, many people will not develop gout in their lifetime. Condition.

Hello, WeDoctor is here to answer your questions.

When it comes to high uric acid, people usually think of gout first, and most people think that “high uric acid = gout”, but this is not the case.

1. Gout

Gout is a crystal-related arthropathy caused by the deposition of monosodium urate, and the measurement of blood uric acid is a biochemical marker for the diagnosis of gout. The main characteristic of gout is high blood uric acid, which can cause gouty acute arthritis, tophi formation, tophi chronic arthritis and joint deformities, uric acid kidney stones, urate nephropathy and other kidney diseases, and is often accompanied by metabolic syndrome. Other manifestations of the syndrome, such as abdominal obesity, dyslipidemia, type 2 diabetes and cardiovascular disease, are extremely harmful to health.

2. High uric acid and gout

High uric acid is not gout, but high uric acid is closely related to gout and is the basis of gout.

Gout does not necessarily occur when uric acid is high. Gout only occurs when urate is deposited in body tissues and causes damage. According to statistics, only 5% to 12% of people with high blood uric acid develop gout. However, although some patients with hyperuricemia have precipitated urate crystals, due to their reduced immune function and weakened phagocytic function of white blood cells, the symptoms of gout attacks are mild or even undetectable.

Generally, the higher the blood uric acid level and the longer it lasts, the greater the chance of gout. When acute gouty arthritis attacks, affected by individual differences, blood uric acid levels may not always be high.