Gout (Hyperuricaemia)

Description: Exquisitely tender, red and painful joint.


Cause:
Excess blood levels of uric acid, which is produced as a normal breakdown product of protein in the diet. Normally uric acid is removed by the kidneys, but if excess is produced or the kidneys fail to work efficiently, high levels build up in the body and precipitate as crystals in the lubricating fluid of a joint. Under a microscope the crystals look like double ended needles. An alcoholic binge or eating a lot of meat can start an attack in someone who is susceptible.

Symptoms:
A very red, swollen and excruciatingly painful joint. The most common joint to be involved is the ball of the foot, but almost any joint in the body may be involved. In severe attacks, a fever may develop, along with a rapid heart rate,loss of appetite and flaking of skin over the affected joint. Attacks start very suddenly, often at night, and may occur every week or so, or only once in a lifetime.

Investigations:
high levels of uric acid found on blood tests. A needle may be used to take a sample of fluid from within the joint for analysis in difficult cases.

Western Treatment:
nonsteroidal anti-inflammatory drugs(eg.Indomethacin) and colchicine.        

Prevention:
  taking tablets(eg. Allopurinol, probenecid) daily for the rest of the patient's life.

Complications:
uric acid crystals can form lumps (tophi) under the skin around joints and in the ear lobes. More seriously, the crystals may damage the kidneys and form kidney stones. If the prevention tablets are missed an attack of gout can follow very quickly.

How TCM can help:
Traditional Chinese medicines see gout as a stagnation syndrome of Qi and blood. It is mainly due to the dysfunction of spleen and kidney.

1.Kidney Qi Deficiency: Kidney Qi is vital for the body. Deficiency of kidney Qi will weaken immune system and body resistance. It makes the body vulnerable to invasion of pathogen such as Wind, Damp, Cold and Hot,inducing imbalance, poor blood circulation and causing irregular function of organs such as "Dysfunction of spleen" and "Kidney Essence Deficiency" in case of Gout.
2. Dysfunction of spleen: Spleen is an organ of the body situated at the left of the stomach, which regulates the quality of the blood and controls the transformation of nutrients in the body. Dysfunction of spleen will weaken protein metabolism with excess uric acid been produced. Due to the "Kidney Qi Deficiency", renal excretion of uric acid is weakened;  it results in excess blood level of uric acid in the body, then starts causing problems.
3. Kidney Essence Deficiency: Kidney Essence is important for bone health, it refines bone marrow and provides adequate nutrition to strengthen bones. Deficiency of Kidney Essence will cause weak bones and fail to resist pathogen.. High level of uric acid build up in the body will precipitate as crystals in the lubricating fluid of a joint then causes sharp pain thereafter.

TCM treats gout by reinforcing kidney function and strengthening spleen function. Reinforcing kidney function can enhance the ability to resist pathogen and the renal excretion of uric acid. Strengthening spleen function help the metabolism of protein and reduce the production of uric acid.

TCM treatment on Gout is safe and effective. TCM can control the pain for patients who suffer acute attack. In the case of chronic recurrence gout, further attack can be prevented by enhance the function of spleen and kidney.Unlike conventional medicine, Chinese herbal and acupuncture has no side effect, aiming to improve the condition of the body rather than harming. In addition, the treatment has a long effect with no need to take further medication.

Diet: No alcohol, keep weight under control, drink plenty of fluid to prevent dehydration, avoid overexposure to cold, not exercise too extreme.  It is important to avoid foods that contain high level of purine, which would metabolize into uric acid (eg. prawn, shellfish, liver, sardines, game birds etc. ).