GOUT RESCUE “HOW TO GET RELIEF FROM YOUR GOUT IN HOURS, NOT

DAYS OR WEEKS, AND HOW TO PREVENT IT DESTROYING

YOUR LIFE (QUITE LITERALLY!)”

AUTHOR: JOHN CIELO

Copyright © 2016

All rights reserved worldwide.

No part of this publication may be replicated, redistributed or given away in any

form whatsoever without the prior consent in writing of the author or publisher.

Disclaimer

The content of this book is for informational purposes only. It is not intended to be a substitute for proper medical diagnosis, treatment, or advice, and you should not

assume that it is, or use it as such. Always consult with your health-care provider before taking any medications, natural remedies, supplements, or making any major changes to your diet.

Table of Contents

Gout and Me

How to Get the Most Out of This Guide

Did You Know?

Chapter 1: Gout Basics

Who is Most at Risk of Gout?

Common Gout Myths

Root Cause of Gout

How Long Does a Gout Attack Last?

Is it Gout or Pseudogout?

How Gout is Diagnosed

Gout Has 4 Stages: Which Stage Are You At?

Serious Health Risks Associated with Gout

Gout Can Also Be a Sign of an Underlying Health Problem

So Are You Taking Your Condition Seriously Enough?

Chapter 2: Treatment

How Gout is Treated Today

Your First Diagnosis

Already Got Gout?

Chapter 3: Using Diet to Help Manage Your Gout

Reduce the Purines in Your Diet

Avoid Sugar in Your Diet

Eat More Alkalizing Foods

Reduce Your Salt Intake

The DASH Diet

Chapter 4: What Does a Gout Diet Look Like?

Protein

Complex Carbohydrates

Essential Fatty Acids

Fiber

Vitamins and Minerals

Antioxidants

Chapter 5: Lifestyle Adjustments to Prevent Gout Flares

Avoid Alcohol

Keep Yourself Properly Hydrated

Lose Some Weight

Avoid High Protein Weight-Loss Diets

Exercise

Reduce Stress

Chapter 6: Liver and Kidney Health

Liver

Kidneys

Tips for a Healthy Liver and Kidneys

Chapter 7: Complementary and Alternative Medicine

Acupuncture

Acupressure

Ayurveda

Homeopathy

Mineral Tissue Salts

Hydrotherapy

Herbal Medicine

Dietary Supplements

Home Remedies

Chapter 8: My Top 3 Remedies for Fast Gout Relief

Chapter 9: Putting It All Together – Your Checklist

Chapter 10: Summary

Appendix A: Purine Tables

Completely Avoid These High Purine Foods

Limit These Moderately High Purine Foods

Enjoy These Low Purine Foods

Appendix B: Example Meals

Breakfasts

Light Meals

Mains

Desserts

Snacks

Appendix C: Resources

United States

United Kingdom

Canada

Australia

New Zealand

Forums

GOUT RESCUE

© 2016 John Cielo

1

Gout and Me I’ve had gout most of my adult life but haven’t had a

gout flare for many years now; well over 7 years at the

time of writing this guide. But I used to get multiple

attacks every year; so what changed? What brought

about this ‘miracle?’

The trigger was a conversation I had with my brother-in-

law, all those years ago. In that life-changing conversation he told me he had just

been diagnosed with gout and had started researching into it.

The stuff he had uncovered was, at the same time, both alarming and encouraging.

Alarming, because I hadn’t really appreciated just how serious and debilitating the

condition could be. Encouraging, because there was so much that could be done to

manage it successfully.

So as a long-time gout sufferer, and taking my brother-in-law’s lead, I set about

doing my own, even more in-depth, research. It became a real passion. So much so,

I have written and published several hundred articles on the subject over the years.

And here’s what I’ve discovered: a gout-free life is possible and I’m living it!

Don’t worry, if you wish to use a totally natural drug-free approach, a combination of

medication and natural treatments, or just medication, this guide has you covered.

However, whichever route you take, it isn’t enough just to get rid of the symptoms;

you must prevent recurring gout from seriously damaging your health and putting

you at a higher risk of premature death. Yes, you read that right!

Now, if you’ve had multiple flare-ups, some of what I share might seem irrelevant,

but I firmly believe that the myths, conflicting information, and misinformation I’d

been given over the years was one of the main reasons for my frequent attacks.

That’s why I’m sharing with you what I’ve researched and learned over the years.

Therefore, whether this is your first gout attack, or you’ve had multiple flare-ups,

this book might just help you to beat your gout too.

To your good health!

John Cielo

GOUT RESCUE

© 2016 John Cielo

2

How to Get the Most Out of This Guide

First things first; if you’re having a gout flare-up right now then go straight to

Chapter 8 where you’ll discover my top 3 remedies for quickly relieving a gout

attack.

Otherwise, make sure you take a look at:

Chapter 1 : Gout Basics is where you’ll discover everything about gout: what it is,

risk factors, what causes it, the symptoms, how it’s diagnosed, the 4 stages of gout,

and the very serious health conditions associated with it.

*Don’t skip this chapter because a deeper knowledge of the condition will lead to a

much better understanding of how the drug-based and alternative therapies detailed

in this book can help manage your condition and prevent future flare-ups.

Chapter 2: Treatment is where you’ll learn how gout is treated today using drug

therapy, including those for relieving the symptoms of a gout flare and those for

managing the condition long term. It also lists potential side effects.

Chapter 3: Using Diet to Help Manage Your Gout concentrates on the link

between diet and gout; in particular how many foods are high in a natural chemical

GOUT RESCUE

© 2016 John Cielo

3

that, when metabolized, can lead to gout. Here, you’ll learn how to use diet to help

manage your condition effectively.

Chapter 4: What Does a Gout Diet Look Like? goes into more detail about what

constitutes a varied, well-balanced, healthy gout diet to meet the twin objectives of

successful gout management and overall health and wellness.

It includes important information on essential vitamins and minerals you need, and

which foods are the best at providing them.

Chapter 5: Lifestyle Adjustments to Prevent Gout Flares describes several

lifestyle changes you must make in addition to your new gout diet, which, if not

undertaken, can pose a serious risk to your ability to manage your condition

successfully and stay free from gout flare-ups.

Chapter 6: Liver and Kidney Health discusses the importance of a healthy liver

and kidneys in controlling your gout and lists critical actions for preventing damage

and disease.

Chapter 7: Complementary and Alternative Medicine is where you’ll discover

how complementary medicine, alternative treatments, herbal remedies, dietary

supplementation, and natural home remedies can all help to relieve gout and

prevent future attacks.

Chapter 8: My Top 3 Remedies for Fast Gout Relief is where I’ve listed my top

3 natural remedies for getting gout relief in hours, rather than in days or weeks.

Chapter 9: Putting It All Together pulls together all the foregoing and displays it

as a “checklist” that, if followed, will help you manage your gout and reduce the risk

of further gout flares.

Chapter 10: Conclusion summarizes the key points and hammers home the

importance of not ignoring your gout, particularly with the threat of some very

serious health consequences hanging over your head if you do so.

Appendix A: Purine Tables classifies some common foods by high, moderate, and

low purine content.

Appendix B: Example Meals contains some example meals for breakfast, lunch,

dinner, desserts, and snacks.

Appendix C: Resources lists some useful resources by country.

GOUT RESCUE

© 2016 John Cielo

4

GOUT RESCUE

© 2016 John Cielo

5

Did You Know…?

The term ‘gout’ comes from the Latin word ‘gutta’ meaning ‘drop.’

It has been around for thousands of years - it’s believed that the Egyptians

were the first to identify gout and there is evidence of the condition in

mummies.

In the 5th century BC, the great Hippocrates, referred to it as the ‘un-

walkable disease.’

Gout affects nearly 6% of men and 2% of women in the U.S. according to a

2011 study published in Arthritis & Rheumatism.

It affects nearly 7% of men and 3% of women in the U.K., according to the

UK Gout Society.

That’s equivalent to over 8.3 million adults in the U.S. and 3.2 million in the

U.K.

In addition, it’s increasing year on year…the incidence of gout in the U.S.

doubled between 1961 and 2011 and by 64% in the U.K. between 1997 and

2012.

GOUT RESCUE

© 2016 John Cielo

6

Chapter 1: Gout Basics

Who is Most at Risk of Gout?

There are quite a number of high risk factors for developing gout. People at a higher

risk of gout:

are male, typically between the ages of 30 and 50 for the onset of gout.

females, but more usually over 50s / after the menopause.

have a family history of gout or arthritis (genetics – see note below).

are overweight.

have a high-purine diet (lots of red meat, organ meat, poultry, seafood).

consume too much sugar (fructose).

drink too much alcohol and/or smoke.

have existing medical conditions such as, acidosis (increased acidity in the

blood and body tissue), diabetes, arteriosclerosis (hardening of the arteries),

hypertension (high blood pressure), thyroid problems, and hyperlipidemia

(increased levels of lipids in the blood).

have had surgery or prolonged bed rest including have had an organ

transplant.

GOUT RESCUE

© 2016 John Cielo

7

are on certain medicines such as, diuretics, niacin (vitamin), salicylic acid (e.g.

aspirin), levodopa, and cyclosporine.

have had a joint injury, particularly in the foot.

have had long-term exposure to lead over and above that arising from normal

community exposure.

Note: Scientists have identified several genetic mutations that contribute to a higher

risk of gout, their presence varying across race. For example, according to scientists

at John Hopkins, one particular mutation (the ABCG2 Q141K mutation) affects 10%

of Caucasians, 3% African-Americans, and 31% of Asians.

Common Gout Myths

Here are common gout myths that, if you believe them, will NEVER get you the

results you want:

Gout is all about genetics - nothing to do with lifestyle or diet.

Not so. You’re at a higher risk of gout if it’s in the family, sure, but the majority of

gout sufferers don’t have any family history of gout. Look at the John Hopkins’

figures above!

Gout is curable.

No. Gout cannot be cured...once you have gout you have it for life. However, it can

be managed, and that means keeping your blood uric acid at healthy levels, which is

what you’ll learn about in this guide.

Only men get gout.

Wrong. Women get gout too, but ten times more men than women get gout.

However, women’s risk of gout increases markedly after the menopause.

Only wealthy people have gout.

Wrong. Certainly, in older times, it was common among royal and wealthy people,

largely due to the copious amount of meat and drink they consumed.

But poorer people could also suffer with it: for example, gout was fairly common

among Roman soldiers.

GOUT RESCUE

© 2016 John Cielo

8

And today, irrespective of social status, anybody can have gout, with many people

completely unaware that gout could be the cause of their joint pain.

Gout only appears in the big toe.

Wrong. Although the metatarsophalangeal joint at the base of the big toe is the

most common place for gout (60-70% of incidences), it can, and frequently does,

flare-up in any joint including the heel, side of the foot, ankle, knee, fingers, wrist,

and elbow.

I can prevent gout just by changing my diet

No. Diet is an important element in helping to manage your gout, that’s true, but it's

not the only one. You also need to consider things like your weight, drinking habits,

any medications you are on, other medical conditions you may have, your age, sex,

and even your family history.

I can prevent gout just by relying on medication.

Not so. Medication can manage your uric acid, for sure, but it cannot help the

underlying triggers for gout such as being overweight, drinking too much alcohol

and eating an unhealthy diet. Medication is only one aspect of the solution.

Furthermore, it’s worse for first-time gout victims: many folks having their first gout

attack, unaware that it could be gout, don’t even bother seeking medical attention

and treat it at home with painkillers or anti-inflammatories.

Gout’s painful but it isn’t serious and never dangerous.

Wrong. If gout isn’t managed properly high blood uric acid and frequently recurring

gout flares can lead to some serious health problems including permanent joint

damage, kidney and liver disease, hypertension, diabetes, stroke, heart disease, and

a higher risk of premature death.

I have high uric acid, but as long as I'm not having any gout flare-ups, I'm O.K.

No. Even without having flares, the high uric acid in your blood can still be putting

you at a higher risk of those serious health issues.

Root Cause of Gout

GOUT RESCUE

© 2016 John Cielo

9

The root cause of gout is too-high levels of uric acid in the blood. This is a condition

called ‘hyperuricemia’, which, if not addressed, can lead to the formation of

microscopic needle-shaped crystals (monosodium urate) in the joints, tendons, and

surrounding tissue.

The body’s innate immune system recognizes these crystals as potentially harmful

and triggers a response that floods the joint with white blood cells and inflammatory

mediators to resist and eventually expel the ‘intruders.’

Note: It’s this inflammatory response at the site that actually causes the painful

symptoms we associate with a gout attack, NOT the actual crystals themselves.

There are two scenarios that can lead to hyperuricemia:

The kidneys, for one reason or another, are not processing and excreting

enough uric acid quickly enough: under-excretion.

The body is producing too much uric acid for the kidneys to process even

though they are working efficiently: overproduction.

But, many people with high blood uric acid may never actually experience a gout

attack in their lifetimes. It is not known exactly why someone with high uric acid

should suddenly experience a gout flare and someone else, with similar high uric

acid, can go through life without one.

However, studies have identified certain high risk ‘triggers’ for gout attacks in people

with high blood uric acid. These are:

drinking too much alcohol (particularly beer).

being overweight.

consuming too much high-purine food.

GOUT RESCUE

© 2016 John Cielo

10

certain medicines (particularly aspirin, diuretics and niacin).

some medical conditions (e.g. high blood pressure, diabetes, acidosis, high fat

and cholesterol, chemotherapy, surgery, extended bed rest).

rapid weight-loss (e.g. through illness, crash dieting).

long-term stress.

Once having had a gout attack you have gout for life. There is no known cure.

However, you can manage it, so that you can stay clear of future gout flares.

The key is to reduce your blood uric acid, maintain it at healthy levels, and correct /

manage / eliminate those attack triggers under your control, for example, diet,

weight, alcohol, blood pressure, cholesterol, acidosis, and stress.

Okay, the next section describes how uric acid is manufactured in your body. By

being better informed of the process you’ll be in a better position to understand the

way in which drugs, natural remedies, and specific lifestyle changes work to first

lower, then maintain, your uric acid at healthy levels.

Where Does Uric Acid Come From?

Purines

Uric acid is a natural byproduct of the metabolic breakdown of organic compounds

called ‘purines.’

These exist naturally in our bodies’ cells, in animals’ cells, and in the cells of the food

we eat at varying concentrations.

Generally speaking, the highest concentrations of purines are to be found in high

protein foods such as red meat, organ meat (offal), game, poultry, fish and shellfish.

Purines are extremely important; they are a part of the building blocks of our DNA

(deoxyribonucleic acid) and are needed to help synthesize RNA (ribonucleic acid) for

proteins.

DNA contains the ‘instructions’ that make each of us unique – our genetic

information - and is passed from adult to child, generation to generation.

RNA produces all the proteins in our cells: proteins being required for the proper

structure, function and regulation of our bodies’ tissues and organs.

GOUT RESCUE

© 2016 John Cielo

11

When cells breakdown and die, the purines in their genetic material also breakdown,

forming uric acid in the process. This happens with our own bodies’ cells and the

cells of food.

It’s believed that around 70% of uric acid in the body comes from purines in our

body’s cells with the other 30% coming from purines in the food we eat. Therefore,

the amount produced via food is significant enough not to be ignored.

The actual process is that the liver metabolizes (breaks down / changes) the purines

into uric acid which is released into the bloodstream, is filtered by the kidneys, and

then excreted in urine.

This process maintains blood uric acid at healthy levels. This is very important,

because we need some uric acid in our system, as it’s one of the body’s most potent

antioxidants. Antioxidants neutralize and remove free radicals that cause many

illnesses and chronic diseases, including cancers.

But, as discussed previously, when there is under-excretion or overproduction of uric

acid, excess acid will build up in the bloodstream, which can then lead to

hyperuricemia and gout.

Fructose

Another cause of increased uric acid is too much fructose consumption.

Fructose is found in table sugar and a whole array of processed foods and drinks,

often in the form of High Fructose Corn Syrup (HFCS), which is manufactured out of

corn starch.

Over the last 30 years or so, HFCS has replaced sugar as the sweetener of choice in

soft drinks, being around 1.6 times sweeter than sugar.

Fructose can also be found, naturally, in some fruits and vegetables, but in lower

concentrations.

Fructose is not a purine, but when too much fructose is ingested, it can raise uric

acid levels in several ways:

When fructose breaks down, it produces lactic acid. Studies have found a link

between increased lactic acid and a decrease in uric acid excretion.

Too much fructose can lead to insulin resistance, which is linked to decreased

uric acid excretion.

GOUT RESCUE

© 2016 John Cielo

12

It has been discovered that when the liver has to deal with too much

fructose, it results in elevated uric acid.

Fructose increases the breakdown of ATP (adenosine triphosphate), a

molecule in the body, which is the primary source of energy for the cells. It is

also a purine so, as it breaks down, even more uric acid is produced.

Don’t forget that too much sugar causes weight gain and we know that being

overweight is one of the highest risk factors for gout.

And, it’s interesting to note, that an increasing number of medical professionals now

identify sugar as a potentially higher risk factor for gout than purines in

food.

What Are Safe levels of Uric Acid?

Not everyone with high uric acid will get gout. On the other hand, not everyone with

low levels of uric acid will escape gout either.

The reasons for this anomaly are not yet known, but it is generally agreed that a

person with high uric acid is at a significantly higher risk of gout than someone with

low levels of uric acid.

The key is to get blood uric acid levels down below the saturation point at which

urate crystals form, and maintain those levels.

According to the American College of Rheumatology, the target is to have a serum

uric acid level less than 6 milligrams per deciliter (6 mg/dL).

The University of Rochester Medical Center has a slightly different measure: they

allow a maximum of 7 mg/dL for males and 6 mg/dL for females.

But, it's generally assumed that 'high uric acid' is anything over 6 mg/dL.

However, some people can have levels over 9.0 mg/dL and still not suffer from gout

attacks. Equally, gout is found in patients with levels under 6 mg/dL.

Much depends on the individual. But, as a general rule of thumb, maintaining your

levels below 6 mg/dL is a good target.

The fact is that different laboratories and health authorities around the world use

different reference points and units of measurement. Your doctor will advise you on

GOUT RESCUE

© 2016 John Cielo

13

what your results mean to you, whilst taking into account your health position at the

time.

Gout Attacks Are More Common at Night

A recent study has proved what gout sufferers have known all along: gout attacks

are more common at night.

The study, published in the American College of Rheumatology journal Arthritis &

Rheumatology concluded that the risk of gout attacks during the night and early

morning is 2.4 times higher than in the daytime.

One reason given is that body temperature naturally falls during sleep, particularly in

the feet. These lower temperatures reduce the solubility of uric acid in the blood,

making it easier for urate crystals to form out of the uric acid.

However, there is now another possibility, and that is the presence of ‘sleep apnea.’

Recent studies have established a possible link between sleep apnea and gout.

Sleep Apnea

Sleep apnea (spelled “apnoea” in some countries) is a condition in which the

sleeper's airway is blocked for short periods so that no air gets to their lungs. This

can last for seconds to a minute or more, and can happen hundreds of times during

the night.

Oxygen starvation builds-up with each apnea, which increases cell degradation

leading to even more uric acid production. And, as the blood becomes more acidic

due to reduced oxygen with each apnea, it's easier for uric acid crystals to form,

resulting in a gout flare.

Sleep apnea is a serious condition with numerous other complications such as

fatigue, memory loss, hypertension, obesity, diabetes, stroke, heart failure, and

several others.

Many people are completely unaware that they have sleep apnea so the presence of

gout (high uric acid) could be a sign that they have it. Someone with recurring gout

might well consider speaking to his or her doctor about being tested for sleep apnea.

How Long Does a Gout Attack Last?

GOUT RESCUE

© 2016 John Cielo

14

An attack of gout can last anywhere from 3 to 21 days, sometimes even longer. 7 to

10 days could be the average for most people.

But a lot depends on its location in the body, how quickly it is diagnosed, how

quickly treatment is started, and the type of treatment used.

However, there are other determinants for how long a gout attack can last. For

example, gout may last longer in patients who:

are overweight.

consume high-purine diets.

drink alcohol to excess.

are stressed.

have certain underlying medical conditions.

are taking certain medications.

Do these seem familiar? They should be. They are the high-risk triggers for gout

attacks, discussed previously. Therefore, not only do they raise the risk of an actual

attack in someone with high uric acid, they also raise the risk of prolonging it.

You will know yourself if you fall into any of these categories. The first four are

completely under your control; the other two you need to speak to your doctor

about.

Is it Gout or Pseudogout?

Pseudogout -- calcium pyrophosphate dehydrate crystal deposition disease (CPDD) --

is a disease that can cause arthritic attacks whose symptoms are very similar to

gout: sudden intense joint pain, redness, tenderness, stiffness, warmth, and

swelling.

Like gout, crystals in the joints cause it, but unlike gout, the crystals are made from

an insoluble calcium salt called “calcium pyrophosphate dehydrate.” Because of the

similarity of symptoms, CPDD is often misdiagnosed as gout.

Therefore, it’s important to get a professional diagnosis to determine which disease

is present because, apart from the use of non-steroidal anti-inflammatory drugs

GOUT RESCUE

© 2016 John Cielo

15

(NSAIDs) and perhaps steroids to reduce inflammation, the treatment for each

condition is different.

With pseudogout, treatment is essentially about ongoing inflammation and pain

management. Pseudogout crystals cannot be dissolved. But, if they continue to be a

problem, they may be removed physically along with synovial fluid through needle

aspiration.

With gout, however, treatment can help to dissolve uric acid crystals and reduce

blood uric acid levels to prevent further crystal formation and flares.

How Gout is Diagnosed

Your doctor will usually ask about your symptoms, when they first appeared, and

inspect the physical signs. Even although the symptoms could indicate gout, they

will want to first rule out any other possible causes by asking pertinent questions

and may even arrange for an x-ray.

They may also want to quiz you on any sudden change of diet - which can elevate

uric acid levels - and any medications you may be taking.

They should also ask about any family history of arthritis and / or gout, if they don’t

already have that information on record.

Some may seek confirmation through a blood test to measure uric acid serum

concentration. However, uric acid levels can go down during a gout attack (nobody

really knows why) so a blood test can be unreliable at this time.

A much safer test is for synovial fluid to be drawn-off and examined under the

microscope in polarized light for evidence of yellow, needle-shaped, gout crystals.

Pseudogout will show up as blue, rhomboid-shaped, crystals under polarized light.

This test can also help to rule out bacterial infection as a potential cause of the

symptoms.

A 2014 study by the Mayo Clinic has shown that the most accurate test for some

patients is a CT scan. However, the study author, Dr. Tim Bongartz, said it should

only be used where the patient has had several attacks (of what looks like gout), but

needle aspirations had shown up negative.

Interestingly, while the CT scan was more accurate in multiple attacks, the study

showed that the synovial fluid test is effective in most cases and was actually more

accurate in identifying first-time (new onset) gout flares.

GOUT RESCUE

© 2016 John Cielo

16

Gout Has 4 Stages: Which Stage Are You At?

Gout progresses through four stages, each with its own symptoms, or indeed, lack

of any signs or symptoms. As the disease progresses, each stage is more painful and

more debilitating, until in the last stage things get very serious.

1. Asymptomatic Hyperuricemia

In this first stage, a sufferer will have high blood uric acid levels. However, there will

be no signs or symptoms, so that the person is usually unaware that they have the

condition.

They will continue with their normal lifestyle unaware that that lifestyle could be

raising uric acid levels even further. It’s usually near the end of this stage that urate

crystals start to form.

2. Acute Gout

The start of this stage is the sudden onset of the first gout attack and its associated

painful symptoms caused by the build-up of crystals of urate in the joints and

surrounding tissue. Further attacks will occur during this stage. And, as the disease

progresses, these flares will usually occur more frequently and last longer.

3. Interval or Intercritical Gout

This can be misleading for many gout sufferers. This stage defines the intervals

between each gout flare where there are no symptoms and the joints are back to

normal or, at least, appear to be.

This can lead to sufferers forgetting that they have the condition and perhaps

believing that they are ‘cured.’ The problem is that they then stop taking their

medication and lapse back into their previous lifestyle, which raises the risk of

another gout attack.

4. Chronic Tophaceous Gout

This is the final and most debilitating stage. It’s during this stage that serious

complications can arise such as permanent joint damage, kidney disease, kidney

stones, heart disease, stroke, and even a higher risk of premature death.

GOUT RESCUE

© 2016 John Cielo

17

In this stage, uric acid crystals come together to form a small lump (tophus) in soft

tissue, cartilage and bone around the body. Under the skin, they look white or

yellowish-white.

Although most commonly found in the fingers, toes, heels, ankles, elbows and ears,

tophi (plural) may be found in any area of the body. They have even been known to

appear, albeit very rarely, in the vocal cords and spinal column.

There usually isn’t pain with small tophi. However, as they grow bigger - as more

and more crystals cluster together - the patient will feel pain and discomfort,

especially with tophi in, and around, joints.

The only solution is to reduce uric acid levels below the saturation point for crystal

formation. This prevents new crystals forming and so stops any more tophi growth.

The existing crystals are then able to slowly dissolve and shrink the tophi ‘lumps’ in

the process. In many cases, if caught early enough, they should disappear

altogether.

However, if not properly treated, tophi lumps can grow to an enormous size, occur

in multiple locations, and be extremely unsightly and debilitating. At this point,

surgery may be required to remove the tophi and even to repair or replace any

permanently damaged tophi joints.

So, as a gout sufferer, it’s vital to keep your uric acid levels below saturation point in

order to inhibit urate crystal formation. And, at the very first sign of tophi, however

small, address the problem right away, as tophi are a sure sign of too high uric acid.

Serious Health Risks Associated with Gout

It has been known for some time that frequently recurring gout can cause

permanent joint damage and kidney stones. However, more recently, a stream of

GOUT RESCUE

© 2016 John Cielo

18

studies have associated high blood uric acid with other serious health problems,

including a higher risk of premature death:

A recent University of Maryland study linked high uric acid to kidney disease,

kidney failure, diabetes, stroke, heart disease and an increased risk of death.

In 1997, researchers at the University of Kuopio, Finland, linked high levels of

uric acid to an increased risk of non-fatal and fatal stroke.

In the same year, researchers at John Hopkins linked high uric acid to mini

strokes that, although hardly noticeable, could lead to mental decline in aging

adults.

A 2013 study by University of Limerick researchers found that, compared to

individuals without gout, people with gout died earlier and had a 42% higher

risk of death. In addition, people with gout had a 58% higher risk of dying

from cardiovascular disease.

The Limerick study also showed that raised uric acid levels were even

detrimental to people who had otherwise healthy lifestyles, i.e. were

physically active, did not smoke, and didn’t drink.

A 2015 Chinese study by Weijie Wang and colleagues linked gout to a higher

risk of cancer, particularly that of urological cancers, digestive system

cancers, and lung cancer.

Another 2015 Chinese study by Dandan Yan, Yinfang Tu, and colleagues

identified an association between elevated blood uric acid and an increased

risk of diabetic kidney disease.

In 2016, Dr. Yasuhiko Kubota (School of Public Health, University of

Minnesota) and colleagues established a link between high blood uric acid and

an increased risk of Venous Thromboembolism (VTE).

A 2010 study by Dr. Anita Afzali (Senior Fellow, Dept. of Medicine,

Gastroenterology, at the School of Medicine, University of Washington) and

colleagues linked elevated blood uric acid to an increased risk of chronic liver

disease.

And, data from a 2013 study in China by Yuanliang Xie and colleagues

suggested that elevated blood uric acid was associated with non-alcoholic

fatty liver disease (NAFLD).

GOUT RESCUE

© 2016 John Cielo

19

A 2016 study by Taiwanese researchers associated gout with a higher risk of

hip fractures compared with not having gout, especially in women.

In summary, then, studies have associated gout with a higher risk of:

kidney disease

kidney failure

liver disease

hip fractures

new-onset diabetes

diabetic kidney disease

fatal and non-fatal stroke

cardiovascular disease

cardiovascular death

venous thromboembolism – blood clots in the vein

cancers – especially urological, digestive system, and lung cancers

early death

So, it’s vital to do everything in your power to keep your uric acid at healthy levels,

to prevent recurring gout flare-ups and to reduce the risk of some extremely serious,

and potentially fatal, conditions.

Gout Can Also Be a Sign of an Underlying Health Problem

Gout is also commonly associated with a number of other diseases and conditions:

Metabolic Syndrome

Nearly 75% of gout patients exhibit metabolic syndrome; the medical term for a

group of conditions associated with the development of cardiovascular disease (i.e.

GOUT RESCUE

© 2016 John Cielo

20

coronary heart disease, heart attack, congenital heart disease, angina, and stroke)

and type 2 diabetes.

This metabolic ‘group’ includes abdominal obesity, hypertension, insulin resistance,

and abnormal lipid levels. And, although you can have any one of these on its own,

patients will very often have them together, which greatly increases the risk of

cardiovascular disease and type 2 diabetes.

The main causes of metabolic syndrome are being overweight, physically inactive,

and having inherited a genetic tendency to develop insulin resistance.

Other Conditions

Other conditions associated with gout include:

lead poisoning

polycythemia (high red blood cell count)

hemolytic anemia (high red blood cell destruction rates)

peripheral vascular disease (poor circulation in the limbs)

psoriasis (a chronic skin condition)

kidney disease

erectile dysfunction (ED)

So a formal diagnosis of gout may be the first sign of an otherwise unknown medical

problem. In other words, the presence of gout could be a symptom of an underlying

medical issue.

Which is why, if you suspect you have gout, seek expert medical help at the earliest

opportunity. In fact, some experts suggest that, when diagnosed with gout, patients

should be tested for known associated diseases and conditions.

You should note that the link between metabolic syndrome and cardiovascular

disease and diabetes is independent of the link between high uric acid

(hyperuricemia) and the risk of those same conditions.

This fact is important because many gout patients rely on their medications alone to

manage their uric acid levels, ignoring the underlying triggers for gout: being

GOUT RESCUE

© 2016 John Cielo

21

overweight, an inactive lifestyle, an unhealthy diet, stress, and drinking too much

alcohol.

So, although they may be free from actual gout flare-ups, by ignoring those

underlying issues they are putting themselves at a higher risk of cardiovascular

disease, type 2 diabetes, and other conditions and diseases associated with gout.

So Are You Taking Your Condition Seriously Enough?

Too many gout sufferers just concentrate on eliminating the excruciating pain of a

gout flare then, once the attack has abated, completely forget about it assuming, or

rather, hoping against hope, that it won’t come back. But, it’s highly likely that it

will; once you have gout, you have it for life.

In the words of Dr. Larry Edwards, a Specialist in Internal Medicine and

Rheumatology at the University of Florida School of Medicine: “It’s important to

remember that once you have gout you have it for life, not just when you’re having

symptoms of an acute attack. That’s why you should educate yourself about it. This

will help you take steps to prevent it from progressing and minimize the chances of

an attack.”

So, even between gout flares, you’ve still got gout. The fact that you’re going about

your daily life, symptom-free, doesn’t mean that you’re cured of gout. You are not.

However, the good news is you can definitely manage your condition so that you

stay free from further attacks. And, by not relying on medicines alone, you can

reduce the risk of those serious diseases and conditions associated with gout.

The following chapters set out how you can do this...

GOUT RESCUE

© 2016 John Cielo

22

Chapter 2: Treatment

How Gout is Treated Today

Gout is treated using medication: one type to help relieve the pain and

inflammation, and another to help lower and maintain uric acid levels. Your doctor

should also advise on dietary and lifestyle changes you should make.

Pain and Inflammation

For pain and inflammation, non-steroidal anti-inflammatory drugs (NSAIDs) such as

ibuprofen, naproxen, indomethacin, and diclofenac can be effective.

Where a patient cannot take NSAIDs, or where they have been found to be

ineffective, then colchicine may be prescribed instead. Colchicine is not a painkiller

as such, but rather, helps to relieve pain by reducing the white blood cell count in

the inflamed area.

And, in the situation where a patient cannot take NSAIDs or colchicines, then

corticosteroids, such as prednisone, can be prescribed. These are administered orally

or by injection into the affected area.

Note: Low-Dose Aspirin

Aspirin is a NSAID and, as such, would seem to be a perfect, low cost solution for a

gout flare. However, aspirin has certain characteristics that make it unsuitable for

treating the inflammation and pain of a gout attack.

GOUT RESCUE

© 2016 John Cielo

23

It’s known that aspirin can increase uric acid levels by reducing the kidneys’ ability to

excrete uric acid. Therefore, taking aspirin at the onset of, or during, a gout attack

will only exacerbate the symptoms. So, doctors don’t recommended aspirin for gout.

But, there are many people who take low-dose aspirin to help reduce the risk of

heart disease and stroke. What happens if they also suffer from gout?

According to a study published in PubMed.gov in February 2014, those on such low-

dose aspirin, and who have gout, are at a higher risk of recurring attacks.

END OF SAMPLE

To unlock ALL the invaluable knowledge and information in GOUT RESCUE including the ‘fast-track’ gout relief system,

please click here