Gout is a common and painful form of arthritis that affects more men than women. It occurs more commonly during festive seasons like New Year due to the type of foods eaten.

Gout is characterised by:

• Sudden, intense joint pain (pain is most severe within the first 4-12 hours)
• Can affect any joint but commonly affects the large joint of the first big toe
• Redness, burning sensation, swelling and tenderness in the affected joints
• Limited range of motion
• Typically happens at night and can last 3-10 days

Causes

Gout is caused by a build-up of urate crystals in your joints. Urate crystals can form when you have high levels of uric acid in the blood.  

Uric acid is like sugar – when you add sugar to tea, it dissolves. However, if you add too much sugar, it stops dissolving, remaining as crystals no matter how much you stir. 

Uric acid crystals normally accumulate in the joints and tendons, triggering intense inflammation and resulting in swelling, redness, burning sensation, and intense pain. 

What is uric acid?

Uric acid is a chemical made naturally in your body. It is also produced when your body digests food that are rich in purines. Uric acids are produced as a waste product when purines are digested. 

Normally, uric acid exists in a soluble state in the blood and excreted out of the body in urine via the kidneys.

Uric acid can build up in your blood if:

1. The kidneys do not remove the excess uric acid efficiently 
2. You consume too much food that are rich in purines
3. The body produces too much uric acid

Risk factors for gout

• Age 
• Male gender
• Eating food rich in purine
• Drinking too much alcohol and artificially sweetened drinks 
• Obesity
• High levels of uric acid
• Chronic kidney disease / poor kidney function
• Family history 

Gout attacks are intense and painful. However, there are ways to manage the symptoms and prevent flares. 

How can TCM help with gout?

A willingness to change his/her diet and lifestyle is the most crucial factor in preventing future attacks. TCM herbs and acupuncture can be administered to reduce dampness heat, condition the body and prevent recurrence of attacks. 

What can I do to avoid gout?

1. Change your diet to reduce or limit / avoid food rich in purines.

Examples of food rich in purines

• Internal organs (liver, kidney, heart, brain, etc.)
• Some types of seafood (sardines, shellfish, anchovies, tuna, etc.)
• Red meat (beef, mutton, pork, etc.)
• Vegetables high in purine (spinach, broccoli, cauliflower, mushroom, asparagus, etc.)
• Soybean products

2. Drink more water. 

Recommended dosage for a normal adult is at least 2 litres per day (unless instructed by a doctor not to do so). Drinking water can help to eliminate uric acid from the kidney.

3. Restrict consumption of alcohol and beer. 
4. Restrict consumption of artificially sweetened drinks.
5. Exercise regularly. 

However, do not exercise too vigorously as it can cause a build-up of lactic acid and increase the internal acidity environment of the body. 

6. Maintain a healthy lifestyle. 

7. Wear comfortable shoes.

TCM drinks that can help reduce the risk of gout flares

Ingredients:
*Use Chinese Barley/Job’s Tears and not Pearl Barley!

• 1 Cup of Chinese Barley/Job’s Tears
• 2 litres of water (depending on individual)
• Honey (optional)
• Candied winter melon (optional) 

Steps:

1. Rinse and soak the Chinese barley for a few hours.
2. Bring the barley and water (and candied winter melon, if using) to boil in a saucepan. Reduce the heat and let it simmer for 30 minutes until the grains are softened and cooked. Add more water if necessary.
3. Strain the barley water.
4. Add honey to taste.

Drink 2-3 times a week to reduce heat dampness of the body. 

As Chinese Barley tea is cool-natured, it is not advisable for people who feel cold easily to drink it often. 

Ingredients:

• 10 grams of mulberry twig (4-5 pieces)
• Honey (optional)

Steps:

1. Add boiling water and let it steep for 10 minutes 
2. Add honey to taste

Drink 2-3 times a week to promote blood circulation and clear the collateral channels.  

*Not suitable for consumption during pregnancy

Article by Physician Tan Kang Ting

Note: Information provided is not a substitute for a physician or any form of medical care. Individual symptoms differ due to different body constitutions and diagnosis. One should consult a licensed TCM practitioner for accurate diagnosis and treatment.