Gout

All information on gout

At a glance

The term gout (also uricopathy or arthritis Urica) stands for a metabolic disease, the cause of which is an increased serum uric acid level(hyperuricemia). Gout is therefore a result of too much uric acid in the blood, which is deposited in crystal form in the joint skin. Women and men are affected about the equaly frequent, but women only contract gout after the menopause, as they are protected by estrogens until then.

For more information

If the concentration of uric acid in the blood rises permanently above a value of 6.4 mg/dl or body temperature and / or pH decrease, then uric acid crystals may precipitate in the form of sodium amate. The uric acid salt triggers a series of inflammatory processes. The immune system reacts to the crystals in the tissue like to penetrated foreign bodies. The big toe is particularly frequently affected by gout. This is due to the fact that the big toe base joint is the coldest part of the body. The temperature there can vary by up to 10 degrees Celsius.

A distinction is made between primary and secondary hyperuricemia.

The primary form can be attributed to a genetic disorder in most patients (99%).

Only in 1% an increased endogenous uric acid formation is the cause. Secondary hyperuricemia develops as a result of a disease in which the renal excretion of uric acid is impeded. These include renal insufficiency and diabetes.

Typical symptoms are aching, sometimes also swollen, reddened joints. The pain is not directly triggered, as many believe, by the uric acid crystals. Instead, the crystals are absorbed by white blood cells and waste organelles are formed. When they are self-dissolved, enzymes enter the surrounding tissue and cause inflammation there. Due to the associated pH-value-reduction,further uric acid is precipitated.

However, uric acid levels can be controlled by a consistent dietary change and other lifestyle factors. It is primarily necessary to normalize body weight, to limit purine intake with food, to refrain from alcohol consumption and fructose-rich drinks as far as possible, and to ensure a sufficient supply of fluids.

Base therapeutics can also be used as a supplement to gout therapy.

Certain micronutrients can also specifically support the organism.

For example, coenzyme Q10, magnesium or vitamin C.

From the point of view of urine diagnostics, monitoring the urine pH is most useful in at-risk patients. Permanent acidification of the body (latent acidosis) significantly increases the risk of suffering a gout attack. In this case, an acidosis correction is a valid measure.

Sources

  • Schroeder, U. et al. (02/2017):Übersäuerung – basische Ernährung– Entschlackung, Tritime Magazine
  • Neogi T et al. (2015): Gout Classification Criteria. An American College of Rheumatology/European League Against Rheumatism Collaborative Initiative. Arthritis Rheumatol, 2557-2568
  • Roche Diagnostics Deutschland GmbH (2009): Nierendiagnostik Grundlagen der Labormedizin, 1-60
  • Stetka, B. (2016): Ernährung bei Gicht: „Ein Mangel an Verständnis und eine Menge Fehlinformationen“, URL: https://deutsch.medscape.com/artikelansicht/4904531, Retrieved 18.06.2019
  • Mutschler, E. et al. (2013): Arzneimittelwirkungen. Lehrbuch der Pharmakologie und Toxikologie. 10. Aufl., Wissenschaftliche Verlagsgesellschaft, Stuttgart
  • Herdegen, T. (2014): Kurzlehrbuch Pharmakologie und Toxikologie. 3. Aufl., Georg Thieme Verlag, Stuttgart
  • Bruhn, C.: Gichtanfälle verhindern, URL: https://www.deutsche-apotheker-zeitung.de/daz-az/2016/daz-7-2016/gichtanfaelle-verhindern , Abgerufen am 18.06.2019
  • Goraya, N., Wesson, D. E. (2012): Acid-base status and progression of chronic kidney disease, Curr Opin Nephrol Hypertens, 21(5):552-6
  • Akute Gicht in der hausärztlichen Versorgung. S1-Leitlinie der Deutschen Gesellschaft für Allgemeinmedizin und Familienmedizin (DEGAM), AWMF-Registernr. 053/032b, Retrieved on 18.06.2019
  • Matzik, S. & Fux, C. (2018): Gout, URL: https://www.netdoktor.de/krankheiten/gicht/, Retrieved on 18.06.2019
  • Säure-Basen-Ratgeber: Gicht-Patienten, URL: https://www.saeure-basen-ratgeber.de/ziel-risikogruppen/uebersaeuerung-gichtpatienten/ , Retrieved 18.06.2019
  • Flückiger, A, Brühlmann, P. (2009): Die Therapie der Gicht, Rheuma 44
Status of information: Autumn 2019