- Fast. During an acute flare, stop eating except for veggie juices and diluted fruit juices. There are several reasons for this. One is to cut off the supply of food which gets converted to uric acid. Another is because your body does a better job of healing itself when it’s not busy constantly digesting things. Give it a break. Especially if you have plenty of calories stored on your person, it won’t hurt you to stop eating for a day or three.
- Hydrate. Drink water and plenty of it. The goal is to dissolve the crystals and pee off the excess uric acid. Four to five liters of water per day is a good baseline for an adult.
- Tart CHERRY juice concentrate. Tart cherry juice helps you get rid of uric acid and helps reduce inflammation that’s causing pain. It’s strong so dilute it in water—2 tablespoons in a glass of water is about right. During an attack drink it all day. For longterm prevention just take one glass of water with tart cherry in it at bedtime. From here down these changes need to be longterm.
- Avoid NSAIDS. The problem is that ibuprofen, naproxen and aspirin are notoriously hard on your kidneys, and you need your kidneys working right to get rid of the uric. NSAIDS also impair your healing response. It may be OK to use them occasionally, but DON’T use them every day.
- Cut BEER. Beer is one of the strongest diuretics out there, and it contains purines which get converted to uric acid. Double whammy, beer is a gout-maker. Cut it out entirely if possible. Coffee and wine, while mild diuretics, are less harmful.
- Cut SOFT DRINKS. Anything with fructose in it, including agave syrup, impairs your body’s elimination of uric acid. And they make you die sooner anyway, so quit.
- Abolish Cigarettes. There are few things more inflammatory than smoking. Quit, already. It's not easy but you can do it.
- Easy on the Nightshades. These are tomatoes, potatoes, peppers, eggplants. You can eat a little but a lot could trigger an attack. Tobacco is a nightshade too.
- Get your Vitamin C. Longterm high vitamin C intake is preventative. Eat fruit!! And onions.
- Consume OMEGA 3 Fats. Either take Fish Oil or eat fatty fish 2-3 times/week. You need about 3 grams/day from whichever sources, or 4-6 grams during a flare.
- Easy on Animal foods. You can eat meat, cheese and eggs but keep the portions smallish longterm. Animal foods contain purines that make uric in your blood. Eat veggies!!
- SLEEP well. Your best healing is done when you get good rest.
- If you are able to do most of the things on this list and do them consistently you won’t need drug treatment to clear an attack and prevent future ones.
You get a gout diagnosis when your blood is tested and it contains too much uric acid. It happens more with age, and more to men. Uric acid forms crystals that settle in the joints, and dissolve again when the concentration dips. The problem is that the crystals poke holes in the tissues where they form and damage it, causing inflammation (pain, heat, redness) that takes longer to resolve than the crystals take to dissolve. To fix it you have to both dissolve the crystals and heal the tissue. Here is a list of ideas to help you do just that.
Swallowing isn’t easy to do when you’re thinking about it. When you eat it happens automatically. When you have a fistful of medications or supplements to get down, it can be unpleasant. There are few things worse than getting a large bitter pill stuck in your craw.
A 2015 study showed that 3/10 adults averaging age 50 would rather die than take a daily pill for the rest of their lives, and another 1/5 would gladly pay $1,000 to avoid having to take a daily medication. If taking pills is this undesirable, why don’t more people make the diet and lifestyle changes that would free them from pill taking? The answer is of course complex. During our lives, almost all of us will choose to swallow pills, if not longterm, at least long enough to give us relief from a temporary ailment.
At some time in your young life, someone asked you to swallow a pill. Children don’t know how, and are usually given chewable or liquid medicines until they learn. In old age it gets harder to swallow pills, so we end up looking for liquids and chewables again. In the meantime, between childhood and old age, we’re supposed to be able to swallow them. There are tricks. Here is a primer.
There are two main kinds of pills that you’ll be asked to swallow; capsules and tablets. Capsules are a little cylinder usually containing a powder. Usually they float, though some of them sink. Tablets, on the other hand, are made of a substance that is caked together into a mold. They can be any shape but smart designers make them round or oblong. Capsules are easier to split, and they usually sink.
It helps to know if your pills are floaters or sinkers. It’s easier to swallow the same kind together. You can test each pill in a glass or water, or in your mouth, to detect if it floats or sinks. Putting pills in a glass is a good way to see how long it takes the pill to dissolve, too. (Aside: If you put a pill in a glass of water and it doesn’t dissolve in a day’s time, you probably aren’t getting anything out of it.) Pay attention to which pills float or sink, and take the same kind together.
SWALLOWING PILLS THAT SINK
Sinkers are the easiest to swallow because they behave like food does, sitting on your tongue. All you have to do is tilt your head back a little bit and let them slide to the back of your tongue, and then take a sip of water and swallow it. It is also possible to simply place the pill(s) at the back of the tongue using your hand, then drink. They will go down.
SWALLOWING PILLS THAT FLOAT
Floaters are tricker. They are easiest to swallow with a bite of pre-chewed food. If you need to swallow them with liquids, here is a trick. With the pill(s) and a modest swallow of water in your mouth, assume your best military posture, with your neck long and chin tucked. The pills will float to the roof of your mouth (your soft palate), and the good posture with chin tuck helps them move to the back. When you feel the pills on the roof of your mouth, distract yourself and swallow, or take another sip to push them along.
WHEN YOU CAN’T SEEM TO MAKE YOURSELF SWALLOW
This usually happens when you are trying to swallow too many pills at once, or a pill that is so big that it scares you. It floats around and threatens to dissolve and taste horrible. It’s OK to swallow pills one at a time until you are ready to try more.
WHEN A PILL DOESN’T GO DOWN
Usually what happens, at least in younger folks, is that the pill gets stalled out in the throat somewhere, and the natural peristaltic movements of the esophagus bring it back into your mouth. Slippery pills (like gel caps) slide back up easily. Grainy or sticky tablets can get hung up and make you gag. When a pill feels stuck, keep swallowing. Take swallows of your drink or bites of of food, and keep doing it until it goes all the way down. Some pills (like osteoporosis drugs) can hurt your esophagus if they get stuck. Your doctor will warn you if your medications have this risk.
DISTRACT YOUR MOUTH
To swallow a bunch of pills at once, put them all in your mouth with a bit of water, and then using your tongue place one pill between your teeth and gums, and swallow the rest. Something about storing the one pill distracts your mouth enough to get the rest of the swallow to happen normally.
TAKE PILLS WITH BITES OF FOOD
Liquids are harder to swallow than food. Pills that are best taken with food are also easiest to swallow with food. Basically you take a bite of food, and chew it until it is thoroughly chewed and ready to swallow. Then pop a pill or three in there and swallow it. You can chew a little more if needed to feel ready to swallow it, but try not to break up the pills.
There are more tricks, but those are the basics. If you are like me, and struggle with swallowing pills, you may need some tricks. Good luck to you. May you heal quickly and no longer need pills. May you find the medicine you need in sunshine and laughter, and the nutrition you need in food.
Walking. We figure out how to do it after crawling for a while. We do it for decades without a second thought. We skip and run, we carry loads and climb ladders and live life on two feet. Walking is effortless.
When an injury happens, suddenly walking isn't so easy. We must learn how to walk again, step by wobbly step, using crutches, rails and the strong arm of a friend. Over the years our injuries accumulate. It isn't many few decades after we stop crawling that we begin to stiffen up and slow down. Arthritis brings persistent pain into our paces.
Healing is spontaneous most of the time, and sometimes we get knees repaired or joints replaced. When walking isn't so easy, we appreciate just how important it is. Our ability to walk is part and parcel with our lives.
Walking speed correlates directly with life expectancy in our later years. Fast walkers live longer. Overall, not in every specific case. When congestive heart failure (CHF) strikes and we are confined to our beds, walking can save us or kill us. Research has shown that most people with CHF get better when they begin a program of walking. A few individuals have worse outcomes, early, the rest of have better outcomes, period.
Walking is a test and if you pass, you live.
The irony is rich. The term "snake oil" has come to mean everything that is fraudulent. The reference is to the infamous "snake oil salesman" who pitched and sold his wares out of the back of a wagon to the unsuspecting villagers of the American west.
Snake oil has real medicinal value. It was used as medicine before the North American continent was on the map. Centuries ago the Chinese used an oil made from a cold water snake called Enhydris chinensis to treat joint pain and bursitis. It was introduced to the US by Chinese laborers who worked on the Transcontinental Railroad in the mid 1800's. There's evidence that the ancient Egyptians used it too. In the early 1700's the English had a patent medicine made from snake oil. Snake oil was sold here as a panacea in the early 1900's, but the products sold were probably more filler and adulterant than they were actual snake oil.
So what's in it that's good for you? Snake oil, depending on the snakes used to derive it, can be a rich source of an fatty acid known as EPA, eicosapentanoic acid. EPA is used by the body to synthesize series 3 prostaglandins, which are anti-inflammatory and pain relieving. You can know EPA is important because it's in human breast milk. EPA is effective for treating depression, improving cognitive function, autoimmune diseases including rheumatism, high cholesterol, hypertension, and more.
EPA can be derived in the body from other fatty acids, but it's much easier to eat in your food. The richest sources are fish: herring, mackerel, salmon, trout, pilchards, menhaden and sardines. Fish do not make their own EPA. They get it from eating algae like spirulina, which we also can eat. Plant foods don't contain any EPA at all.
Part of the reason it's easier to eat EPA than to make it in your body has to do with human genetics. Some people have the gene to make the enzyme which lets them convert ALA (alpha linolenic acid) into EPA. Other people have mutations in their genes that limit their ability to do the conversion. Diabetes and some allergies also limit a person's ability to convert ALA to EPA. ALA is an essential fatty acid, meaning that no humans can make it; we have to get it from the diet.
If we don't make it very well, and we don't eat much fish, we need to get our EPA some other way to keep our cell membranes happy. Many healthcare professionals recommend that we take fish oil. Fish oil contains 12-18% EPA. Salmon oil tops the list at ~18%. Chinese water snake oil contains ~ 20% EPA, whereas rattlesnake oil is said to contain 8.5%. Cod liver oil has more DHA than EPA and is best reserved for specific uses, like building baby brains or healing brain injuries.
The reason why some snakes have more EPA than others has to do with the temperatures that they live in. Snakes and fish are both cold blooded, so they have to function with their bodies at the same temperature as their environments. Omega 3 fats like EPA don't harden in cold temperatures like omega 6s do. They help keep cell membranes flexible. Flexible membranes don't get injured as easily, and are able to function better. Cold water fish, or cold water snakes, will have more EPA than those that live in warm sunshine, like rattlesnakes.
The next time someone tells you that a treatment is "snake oil", remember this. Public attitudes and language reflect our history, not our future. Science continues to give us reason to revise belief systems, erase myths, and sometimes to welcome old treatments back into the fold.
Recent post by Dr Gryder at the Madness Medicine Blog.
Macular degeneration is the #1 cause of visual loss in folks over 55, and it is #2 after cataracts in folks over 65. Until your 40's, you might never even hear about it. But if your own vision begins to change and worsen, you might wish you'd started to pay attention sooner. To that end, here are a few things you can do to keep your eyes healthy.
One of the best things anyone can do for themselves is to eat foods that support health. Any doctor who is worth her salt will tell you how to optimize your diet for your particular health needs. The eyes in particular are sensitive to metabolic disease and systemic inflammation, which can be caused by eating bad (trans) fats, having high blood sugar, and not consuming enough antioxidants.
All antioxidants, including the ones you get from eating berries and bright colored vegetables, are fair game. The more the merrier, in fact, because they seem to have synergistic effects. The specific antioxidants that are protective pigments in the eye are lutein and zeaxanthin. You can buy supplements that have these things in them, but you don't have to. The best way to get these may be by eating good food. Dark leafy greens are an excellent source of these and of vitamin A. Spinach salads, kale, turnip greens and collards are best, but anything green probably has some of it in there. If you're not wild about greens, maybe you can find some other way to get a daily dose of them, such as putting them in casseroles and blending them up in a yummy fruit smoothie. Other vegetable sources of are broccoli, pumpkin, brussel sprouts, and sweet yellow corn. Anything that is brightly orange or yellow-colored has a chance of containing some.
One of my favorite sources is egg yolks. Each egg yolk contains approximately 210 micrograms. You'll notice, if you're an egg-eater, that egg yolks are not all the same color. The ones you want are the brightest, orangiest ones you can find. Usually organic eggs have better color, but they are so expensive that many people balk. You can scope out the best source of eggs from your grocery store by noting the yolk color each time you break some open. If you have two different brands, break open one from each dozen and compare. When you go shopping again, bias your buying toward the brighter yolks. They're good for your eyes. Eggs also happen to contain B vitamins and choline which are good for your brain and liver and most everything else. And in case you hadn't heard yet, eggs do not drive up your cholesterol, so if you stopped eating them for that reason, you can start up again now.
Another dietary addition that is great for the eyes is Brazil nuts. They contain just enough selenium that eating 2/day will keep you replete for the nutrient. If these nuts aren't your favorite, try chopping them up and mix them into your breakfast oatmeal. You won't even notice them, but they will help your eyes and support many other body systems as well.
Aging gentlemen need to be aware that taking a lot of zinc, without also consuming plenty of antioxidants, could actually cause macular degeneration. Zinc is great for the guys because it helps prevent BPH, so lots of men take it later in life. Make sure you're also eating colorful fruits and berries to prevent this possible negative effect!
One last suggestion that might help you keep your vision longer is to always protect your eyes from the sun. This means buying quality sunglasses and using them when you're in bright sun. Never stare directly at the sun (just like your momma said), and use hats to help protect your eyes when you're out for a long time.
Author: Teresa Gryder
Integrative Physician and Student of Life, Medicine, and the River.