Gout is caused by too much uric acid in the bloodstream and the accumulation of urate crystals in the tissues of the body.

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Gout is a type of arthritis that causes sudden inflammation of joints (shiny red or purple, swollen, hot, and stiff), Fever as high as 102.2°F (39°C), with or without chills.

It usually starts in one joint but Severe gout can sometimes affect many joints at once – known as Polyarticular gout.

The presence of the crystals triggers an acute inflammatory (pain, redness, heat, and swelling) response when neutrophils begin to ingest the crystals. Tissue damage begins when the neutrophils release their lysosomes. The lysosomes not only damage the tissue but also perpetuate the inflammation.

Uric acid is normally found in the body as a byproduct of the way the body breaks down certain proteins called purines. Causes of an elevated blood uric acid level (hyperuricemia) include genetics, obesity, certain medications such as diuretics (water pills), and chronic decreased kidney function.

A sign of chronic or severe gout is the presence of Tophi.

Gouty Tophi

When uric acid becomes supersaturated in blood and other body fluids, it crystallizes and forms a precipitate of urate salts that accumulate in connective tissue throughout the body; these deposits are called tophi.

The presence of tophi indicates that the body is substantially overloaded with uric acid and that the uric acid level in the bloodstream typically has been high for years.

The presence of tophi indicates tophaceous gout.

Longstanding untreated gout can lead to joint damage and physical deformity.

Kidney stones may be a sign of gout as uric acid crystals can deposit in the kidney and cause kidney stones.

Many allopathic drugs such as allopurinol, febuxostat, pegloticase and NSAIDS – badly effects and reduce renal function, diuretics (to control high blood pressure), that raise the level of uric acid in the bloodstream are risks for gout.

Surprisingly, allopathic drugs that lower the level of uric acid in the bloodstream, such as allopurinol, can also initially cause a flare of gout.

This is because anything that raises or lowers the uric acid level can cause a gout flare by causing uric acid crystals to deposit in a joint.

Low-dose aspirin can precipitate gout attacks. The treatment of certain types of cancer can cause gout because of high levels of uric acid released when the cancer cells are destroyed.

Allopathic drugs help control gout but do not cure it.

Degenerative arthritis also makes affected joints more likely to be the site of a guotie attack.

Stages of Gout

Gout develops in four stages:

1- Asymptomatic (In asymptomatic gout, serum urate levels rise).

2- Acute.

3- Inter-critical.

4- chronic.

The first attack of acute gout is extremely painful, peaks quickly, and generally involves only one or a few joints that become hot, tender, inflamed, and appear dusky-red or cyanotic. The metatarsophalangeal joint of the great toe usually becomes inflamed first, followed by the instep, ankle, heel, knee, or wrist joints. Sometimes, a low-grade fever is present. If the attack is mild, symptoms may subside quickly but recur at regular intervals; if severe, symptoms may persist for days or weeks.

Inter-critical periods are the symptom-free intervals between gout attacks. Most patients have a second attack within 6 months. Delayed attacks are more common in untreated patients and tend to be longer and more severe than initial attacks. Such attacks are also polyarticular, invariably affecting joints in the feet and legs and sometimes accompanied by fever.

Chronic gout is marked by persistent, painful polyarthritis, with large, subcutaneous tophi in cartilage, synovial membranes, tendons, and soft tissue. Tophi form in fingers, hands, knees, feet, ulnar sides of the forearms, a helix of the ear, Achilles tendons and, rarely, internal organs, such as the kidneys and myocardium. The skin over the tophus may ulcerate and release chalky, white exudates or pus.

The characteristic symptoms and signs of gout are:

• sudden onset of joint pain,
• joint swelling,
• heat in the affected area, and
• joint redness.

These symptoms and signs usually affect a single joint. The pain is typically severe, reflecting the severity of inflammation in the joint. The affected joint is often very sensitive to touch to the point that some people with gout attacks experience pain from something as simple as pulling the bedsheets over the inflamed joint. The affected joint becomes swollen. The medical term for excessive fluid in a joint is a “joint effusion.”

Gout frequently involves joints in the lower extremities. The classic location for gout to occur is the big toe (first metatarsophalangeal joint). Podagra is the medical term for inflammation at the base of the big toe. Gout can also affect the foot, knee, ankle, elbow, wrist, hands, or nearly any joint in the body. When gout is more severe or longstanding, multiple joints may be affected at the same time. This causes pain and joint stiffness in multiple joints.

Another sign of gout is the presence of tophi. (As defined above) A tophus is a hard nodule of uric acid that deposits under the skin. Tophi can be found in various locations in the body, commonly on the elbows, upper ear cartilage, and on the surface of other joints. When a tophus is present, it indicates that the body is substantially overloaded with uric acid. When tophi are present, the uric acid level in the bloodstream typically has been high for years. The presence of tophi indicates tophaceous gout and treatment with medications is necessary. Kidney stones may be a sign of gout as uric acid crystals can deposit in the kidney and cause kidney stones.

Longstanding untreated gout can lead to joint damage and physical deformity.

Complications:

• Cardiovascular lesions
• Chronic renal dysfunction
• Coronary thrombosis
• Hypertension
• Atherosclerotic disease
• Stroke
• Infection (when tophi rupture)
• Nephrolithiasis
• Joint degeneration and deformity

Diagnosis of Gout:

• Aspiration of synovial fluid (arthrocentesis) or of tophaceous material reveals needle-like intracellular crystals of sodium urate.
• Monosodium urate monohydrate crystals in synovial fluid taken from an inflamed joint or tophus establish the diagnosis.
• Serum uric acid is above normal, although hyperuricemia isn’t specifically diagnostic of gout.
• X-rays are normal initially; however, in chronic gout, X-rays show “punched out” erosions, sometimes with periosteal overgrowth. Outward displacement of the overhanging margin from the bone contour characterizes gout.
• Urinary uric acid is usually higher in secondary gout than in primary gout.
• Erythrocyte sedimentation rate and white blood cell (WBC) count may be elevated, and the WBC count differential shows increased immature neutrophils (bands) in acute attacks.

Allopathic treatment for Gout

There is no proper treatment for gout in allopathic medicines accept painkillers and steroid treatment to reliefs the symptoms and ease life.

Limiting foods/dieting regime associated with gout, should be initiated in anyone who has had gouty attacks, even in Homeopathic treatment.

Treatment of gout with medications is necessary when frequent disabling gouty attacks occur, when kidney stones caused by uric acid are present and when there is evidence of joint damage from gout on X-rays, or when tophi are present.

When attacks are frequent, uric acid kidney stones have occurred, tophi are present, or there is evidence of joint damage from gout attacks, medications are typically used to lower the uric acid blood level.

Medications for the treatment of gout generally fall into one of three categories: uric-acid-lowering medications, prophylactic medications (medications used in conjunction with uric-acid-lowering medications to prevent a gout flare), and rescue medications to provide immediate relief from gout pain.

Urate-lowering medications are the primary treatment for gout. These medications decrease the total amount of uric acid in the body and lower the serum uric acid level. For most patients, the goal of uric-acid-lowering medication is to achieve a serum uric acid level of less than 6 mg/dl. These medications also are effective treatments to decrease the size of tophi, with the ultimate goal of eradicating them. Uric-acid-lowering medications include allopurinol, febuxostat, probenecid, and pegloticase.

But these drugs have very severe side effects on gastrointestinal tract especially on duodenum.

Prophylactic medications are used during approximately the first six months of therapy with a medication to lower high levels of uric acid to either prevent gout flares or decrease the number and severity of flares. This is because any medication or intervention that either increases or decreases the uric acid level in the bloodstream can trigger a gout attack. colchicine and any of the NSAIDs (nonsteroidal anti-inflammatory drugs) such as indomethacin, diclofenac, ibuprofen, or naproxen sodium are frequently used as prophylactic medications to prevent gout flares during uric-acid lowering.

By taking one of these prophylactic or preventative medications during the first six months of treatment with allopurinol, febuxostat, or probenecid, the risk of having a gout attack during this time is decreased. Prophylactic medications are not used in combination with Krystexxa.

The third category of medications is those used during attacks of acute gout to decrease pain and inflammation. Both colchicine (Colcrys) and NSAIDs can be used during an acute gout attack to decrease inflammation and pain. Corticosteroids such as prednisone, methylprednisolone, and prednisolone, also can be used during an acute gouty flare. However, the total dose of steroids is generally limited due to potential side effects such as cataract formation and bone loss. Steroid medications are extremely helpful in treating gout flares in patients who are unable to take colchicine or NSAIDs.

Homeopathic treatment for Gout

Combination therapy is very effective in reducing the length and frequency of attacks and treatment duration. (Dr. Qaisar Ahmed MD)

Studies have shown that even the most rigorous diet does not lower the serum uric acid enough to control severe gout, and therefore medications are generally necessary.

Homeopathic treatment for gout is no longer than 30 days in acute, and 60-90 days in chronic (even with deformed joints, tophi) cases.

If carefully diagnosed, the Homeopathic treatment and prognosis is more than 96% success in all types and stages of gout.

1. Bryonia Alba

Bryonia Alba is medicine for gout in cases where there is excessive pain, swelling, redness, and heat in the affected joint. The nature of the pain is sharp or tearing. The pain may get worse from the slightest movement while warming the joint provides relief. Gout.

2. Colchicum Autumnale

Colchicum Autumnale best choice for gout– intense swelling and pain in the knee(s) – worse on movement and from the slightest touch. Evening aggravation, tearing in the back- worse during motion, Tearing pains in arms… in the legs, Hot (edematous) swelling.

3. Lycopodium Clavatum

Lycopodium Clavatum – heel pain and high levels of uric acid. Gout. Pains worse while walking – a sensation of stone under the heel. Profuse sweat on the feet and coldness of feet. Chronic gout where chalky deposits/pus have formed in the joints.

4. Benzoicum Acidum

Benzoicum Acidum is for gout that affects the knee joint. Gout. Joint is swelling and pain, cracking in the joint with movement. In some cases, tophi are from the deposits of urate crystals on the knees.

5. Ledum Pal

Ledum Pal – gout leading to ankle pain. Gout. Pain and swelling in the ankle that radiates upwards in the leg are present, pain gets worse with movement, knee-joint; hip-joints; toe-joints; gouty pain, cracking of the joints, Arthritic nodosities in joints of hands and fingers.

6. Abrotanum

Abrotanum is medicine for gout that causes wrist pain, along with high uric acid levels. Gout. The wrist gets inflamed and sore to the touch. Stiffness and a pricking sensation may be present. Abrotanum is also indicated for gout in the ankles.

7. Causticum

Causticum is medicine for gout in the elbow joint when there is a pressing or gripping sensation felt in the elbow, along with pain. Warmth in the elbow area can help relieve the pain. Causticum also helps in lowering uric acid levels. Gout.

8. Berberis Vulgaris

Berberis Vulgaris is an anti-uric acid medicine that even helps dissolve kidney stones. It is indicated in cases where there is pain in the kidney area. Gout, the pain may radiate down to the urinary bladder from the kidney area, along with a stinging, burning sensation in the kidneys. The urine may also contain sandy or slimy sediments.

9. Urtica Urens

Symptoms return at the same time every year. Gout and uric acid diathesis. Favors elimination. Pain in acute gout deltoid; pain in ankles, wrists. Urine suppression. Renal calculus. Raised, red, itching blisters on skin of hands and fingers. Tophi.

10. Lycopodium Clavatum

Tearing in joints. Chronic gout, with chalky deposits in joints. Abscesses beneath skin. Hives. Tophi. Urine retention. Polyuria during the night. Heavy red sediment.

11. Guaicum

It is also a well indicated remedy in treating high uric acid levels. It is more suited in chronic cases where the deformities and contractures set in. Guaiacum is very well indicated when there is intolerance to heat in any form. Rheumatic pain in hands, arms and shoulders. Gouty pains tearing and lancinating, worse from motion, heat, cold wet weather, touch and pressure, from 6pm to 4 am. Better by external pressure. The affected joints may be extremely hot to touch. Guaiacum may be given when there is a bad smell from the body. In some cases, it could be given in very acute cases as well. The affected limb is painful, stiff and immobile.

12. Lithium Carbonicum

Lithium  carb is a good remedy in treating raised uric acid levels. The high levels of uric acid give rise to an unusual stiffness all over the body. Another peculiar feature is itching all over the skin of the joints. The pains are relieved by pouring hot water. Uric acid may get deposited in the joint spaces to give rise to nodosities which can be felt externally also. The nodes may also be felt in the finger joints and in some severe cases, they may be felt in the ear pinna.

13. Benzoic Aecidium

It is an excellent medicine for high uric acid levels. The uric acid crystals may be deposited in the kidneys or the urinary tract giving rise to stones. Urine repulsive odor; changeable color; brown, acid. Enuresis; dribbling, offensive Joints crack on motion. Tearing with stitches. Pain in tendo Achillis. Rheumatic gout; nodes very painful. Gouty deposits. Ganglion; swelling of the wrist. Pain and swelling in knees. Bunion of great toe. Tearing pain in great toe. Crackling in the joints. Knee swelling, difficulty in walking or even moving the limb.

Medorrhinum

Coldness of legs, hands, and forearms. Pain in back, with burning heat. Legs heavy; ache all night; cannot keep them still. Ankles easily turn when walking. Burning of hands feet. Finger-joints enlarged, puffy. Gouty concretions. Heels and balls of feet tender. Soreness of soles. Restless; better, clutching hands. Nocturnal enuresis. Renal colic. Urine flows very slowly.

Ocimum Canum

Diseases of the kidneys, bladder and urethra. Uric acid diathesis. Red sand in the urine is its chief characteristic, and frequently verified. Swelling of glands, inguinal and mammary. Renal colic (symptoms of renal calculus are pronounced). High acidity, formation of spike crystals of uric acid. Turbid, thick, purulent, bloody; brick-dust red or yellow sediment in urine. Odor of musk. Pain in ureters. Cramps in kidneys. Heat and swelling of left testicle.

Berberis Vulgaris

Old gouty constitutions. Pain in region of kidneys. Inflammation of kidneys with haematuria. Kidney stones. Rheumatic paralytic pain in shoulders, arms, hands and fingers, legs and feet. Neuralgia under fingernails, with swelling of finger-joints. Sensation of cold on outside of thighs. Heels pain, as if ulcerated. Stitching between metatarsal bones. Pain in knee joints. Intense weariness and lameness of legs after walking a short distance.

Question(s) about potencies, combination info, required medicine etc. feel free to leave a message or voice message for Dr Qaisar Ahmed at Wapp# +923119884588.

P. S: This article is only for doctors having good knowledge about Homeopathy and allopathy, for learning purpose(s).

For proper consultation and treatment, please visit our clinic.

None of above-mentioned medicine(s) is/are the full/complete treatment, but just hints for treatment; every patient has his/her own constitutional medicine.

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Dr. Sayyad Qaisar Ahmed (MD {Ukraine}, DHMS), Abdominal Surgeries, Oncological surgeries, Gastroenterologist, Specialist Homeopathic Medicines.

  Senior research officer at Dnepropetrovsk state medical academy Ukraine.

Location:  Al-Haytham clinic, Umer Farooq Chowk Risalpur Sadder (0923631023, 03119884588), K.P.K, Pakistan.

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