Q: What dietary restrictions should I follow to prevent another attack of gout?
Earl, Kansas
A:
Gout is the result of an excess of monosodium urate crystals in the body. When the crystals accumulate in the spaces between joints, they can cause excruciating pain, most commonly felt in the big toe. Indulging in meat, seafood, and alcohol can play a role. Studies have shown that individuals who are prone to developing gout should reduce their intake of meats and seafood because these foods promote uric acid formation. Low-fat diet products, on the other hand, appear to decrease the risk of gout. Protein consumption has no effect, while alcohol raises uric acid levels, which may provoke an episode of gout. It is recommended that people at risk for gout drink 10 to 12 eight-ounce glasses of nonalcoholic liquids every day to reduce the risk of developing kidney stones. Drinking plenty of fluid helps to flush the body of uric acid crystals, which characteristically accumulate in people with this disease. It is also suggested that gout sufferers maintain a stable weight, work to avoid obesity, and avoid using diuretics or water pills.
Showing posts with label oral medications. Show all posts
Showing posts with label oral medications. Show all posts
Sunday, December 19, 2010
Monday, December 13, 2010
Is Gout Prevention Possible?
Is Gout Prevention Possible?
You can't always control whether you get gout, but you can make diet and lifestyle changes to lessen your risk. Start taking gout prevention steps today. What can you do for gout prevention? "There are a number of risk factors for gout, some of them modifiable, some of them less modifiable," says Daniel Solomon, MD, MPH, associate professor of medicine at Harvard Medical School and physician in the rheumatology, immunology, and allergy department at Brigham and Women's Hospital in Boston.
Gout develops in people who have high levels of uric acid, produced when the body breaks down substances called purines, which are found in many foods, particularly meat and seafood. Excess uric acid can form sharp, needle-like crystals in the joints, leading to pain and swelling.
While some people will develop gout no matter what they do, there are some lifestyle and diet factors that can cause high uric acid levels. Researchers have identified a number of gout prevention strategies to help reduce your risk of developing gout or, if you already have gout, lower your chances of having a severe gout attack in the future.
Gout Prevention: Know Your Risk Factors
When it comes to gout prevention, scientists still don't know how much control people have over their risk of developing gout. "Gout is related to genes, environmental [influences], and gender," says Dr. Solomon. There seems to be a genetic component since gout sometimes runs in families. Also, men are at higher risk of developing gout than women. And the risk of gout increases with age.
But researchers have identified a number of gout risk factors that you can work to control:
Purine-rich diet
Excess weight
Excessive alcohol consumption
High cholesterol
Diabetes
High blood pressure
Certain medications, including some diuretics, niacin (a B vitamin), low-dose aspirin, cyclosporine, and several cancer drugs
There's more content below this advertisement. Jump to the content.
Gout Prevention Strategies
If you are looking for ways to reduce your risk of developing gout, try the following:
Limit purines in your diet. Hyon Choi, MD, DrPH, clinical associate professor of medicine in the rheumatology section at Boston University School of Medicine, says reducing the amount of purine-rich foods in your diet can lower your chances of developing gout. Eat less salmon, herring, sardines, organ meats, mushrooms, and asparagus.Reduce the red meat and seafood in your diet. In his research on gout risk factors, Dr. Choi and his colleagues found that people who had more red meat and seafood in their diet were at higher risk of developing gout.Eat more dairy. Choi also looked into how dairy products affected patients’ gout risk. "Dairy products — particularly low-fat dairy products like skim milk or yogurt — reduced the risk of gout," says Choi. For gout prevention, your daily diet should include the equivalent of two or more cups of milk.Watch what you drink. "Coffee, including decaffeinated coffee, was associated with a lower risk of gout," Choi says. On the other hand, people who drink more alcoholic beverages, especially beer, are more likely to develop gout. Choi says that drinks sweetened with high-fructose corn syrup are also associated with an increased risk of gout.Take your vitamin C. "Vitamin C tablets — 500 milligrams per day — decrease the risk of gout," Choi says. That extra vitamin C will cause you to excrete uric acid through your urine.Maintain a healthy weight. Being overweight is a risk factor for the development of gout, so aim to maintain a healthy weight.Control medical problems. Since high cholesterol, high blood pressure, and other health problems are associated with an increased risk of gout, follow your doctor's instructions to keep these conditions under control.Consider switching medications. If you are taking a medication associated with increased gout risk, ask your doctor if switching to another drug is an option for you. If you are concerned about your gout risk, talk with your doctor. The earlier you start treatment, the sooner your pain will be under control.
By Krisha McCoy, MS
Medically reviewed by Lindsey Marcellin, MD, MPH
You can't always control whether you get gout, but you can make diet and lifestyle changes to lessen your risk. Start taking gout prevention steps today. What can you do for gout prevention? "There are a number of risk factors for gout, some of them modifiable, some of them less modifiable," says Daniel Solomon, MD, MPH, associate professor of medicine at Harvard Medical School and physician in the rheumatology, immunology, and allergy department at Brigham and Women's Hospital in Boston.
Gout develops in people who have high levels of uric acid, produced when the body breaks down substances called purines, which are found in many foods, particularly meat and seafood. Excess uric acid can form sharp, needle-like crystals in the joints, leading to pain and swelling.
While some people will develop gout no matter what they do, there are some lifestyle and diet factors that can cause high uric acid levels. Researchers have identified a number of gout prevention strategies to help reduce your risk of developing gout or, if you already have gout, lower your chances of having a severe gout attack in the future.
Gout Prevention: Know Your Risk Factors
When it comes to gout prevention, scientists still don't know how much control people have over their risk of developing gout. "Gout is related to genes, environmental [influences], and gender," says Dr. Solomon. There seems to be a genetic component since gout sometimes runs in families. Also, men are at higher risk of developing gout than women. And the risk of gout increases with age.
But researchers have identified a number of gout risk factors that you can work to control:
Purine-rich diet
Excess weight
Excessive alcohol consumption
High cholesterol
Diabetes
High blood pressure
Certain medications, including some diuretics, niacin (a B vitamin), low-dose aspirin, cyclosporine, and several cancer drugs
There's more content below this advertisement. Jump to the content.
Gout Prevention Strategies
If you are looking for ways to reduce your risk of developing gout, try the following:
Limit purines in your diet. Hyon Choi, MD, DrPH, clinical associate professor of medicine in the rheumatology section at Boston University School of Medicine, says reducing the amount of purine-rich foods in your diet can lower your chances of developing gout. Eat less salmon, herring, sardines, organ meats, mushrooms, and asparagus.Reduce the red meat and seafood in your diet. In his research on gout risk factors, Dr. Choi and his colleagues found that people who had more red meat and seafood in their diet were at higher risk of developing gout.Eat more dairy. Choi also looked into how dairy products affected patients’ gout risk. "Dairy products — particularly low-fat dairy products like skim milk or yogurt — reduced the risk of gout," says Choi. For gout prevention, your daily diet should include the equivalent of two or more cups of milk.Watch what you drink. "Coffee, including decaffeinated coffee, was associated with a lower risk of gout," Choi says. On the other hand, people who drink more alcoholic beverages, especially beer, are more likely to develop gout. Choi says that drinks sweetened with high-fructose corn syrup are also associated with an increased risk of gout.Take your vitamin C. "Vitamin C tablets — 500 milligrams per day — decrease the risk of gout," Choi says. That extra vitamin C will cause you to excrete uric acid through your urine.Maintain a healthy weight. Being overweight is a risk factor for the development of gout, so aim to maintain a healthy weight.Control medical problems. Since high cholesterol, high blood pressure, and other health problems are associated with an increased risk of gout, follow your doctor's instructions to keep these conditions under control.Consider switching medications. If you are taking a medication associated with increased gout risk, ask your doctor if switching to another drug is an option for you. If you are concerned about your gout risk, talk with your doctor. The earlier you start treatment, the sooner your pain will be under control.
By Krisha McCoy, MS
Medically reviewed by Lindsey Marcellin, MD, MPH
Sunday, December 5, 2010
Foot Pain at Night
Q:
I have neuropathy in my feet. It can be extremely painful at night, and it keeps me awake most nights. Is there any way to reduce the pain, and will this ever subside?
— Debbie, Wichita, KS
A:
Neuropathy is a painful and distressing complication of diabetes. In some people, it disappears on its own over a period of about 12 months. In others, however, it persists. There are medicines your doctor can prescribe to relieve your symptoms.
The U.S. Food and Drug Administration has approved two drugs, duloxetine and pregabalin, to treat the foot pain from diabetic neuropathy. Duloxetin is an antidepressant, and pregabalin is used to treat seizure disorders. Both have some side effects. Duloxetin can cause nausea, sleepiness, dizziness, decreased appetite, hot flashes, and constipation. Pregabalin can cause sleepiness and confusion and can also lead to dependence.
You might consider other kinds of treatment too, both traditional and not. In one Australian study, the antioxidant alpha-lipoic acid was shown to reduce pain. And other medications — including some antiseizure medications, antidepressants, and opiates — have been used with some success. Some people have used acupuncture, topical creams containing capsaicin (a substance found naturally in hot peppers), and other alternative therapies. Of course, many of these treatments have not been well studied enough to determine their effectiveness.
I would advise you to consult with your doctor to decide which treatment works best for you. It's important to remember, of course, that none of these medicines cure the underlying cause of neuropathy. That's why it's important to focus on tight glucose management. The basic problem that leads to neuropathy is nerve and blood vessel damage caused by high blood glucose levels.
Learn more in the Everyday Health Type 2 Diabetes Center.
I have neuropathy in my feet. It can be extremely painful at night, and it keeps me awake most nights. Is there any way to reduce the pain, and will this ever subside?
— Debbie, Wichita, KS
A:
Neuropathy is a painful and distressing complication of diabetes. In some people, it disappears on its own over a period of about 12 months. In others, however, it persists. There are medicines your doctor can prescribe to relieve your symptoms.
The U.S. Food and Drug Administration has approved two drugs, duloxetine and pregabalin, to treat the foot pain from diabetic neuropathy. Duloxetin is an antidepressant, and pregabalin is used to treat seizure disorders. Both have some side effects. Duloxetin can cause nausea, sleepiness, dizziness, decreased appetite, hot flashes, and constipation. Pregabalin can cause sleepiness and confusion and can also lead to dependence.
You might consider other kinds of treatment too, both traditional and not. In one Australian study, the antioxidant alpha-lipoic acid was shown to reduce pain. And other medications — including some antiseizure medications, antidepressants, and opiates — have been used with some success. Some people have used acupuncture, topical creams containing capsaicin (a substance found naturally in hot peppers), and other alternative therapies. Of course, many of these treatments have not been well studied enough to determine their effectiveness.
I would advise you to consult with your doctor to decide which treatment works best for you. It's important to remember, of course, that none of these medicines cure the underlying cause of neuropathy. That's why it's important to focus on tight glucose management. The basic problem that leads to neuropathy is nerve and blood vessel damage caused by high blood glucose levels.
Learn more in the Everyday Health Type 2 Diabetes Center.
Thursday, December 2, 2010
Comprehensive Care for Diabetic Neuropathy
Diabetic neuropathy is a common complication of diabetes that can be difficult to treat using oral medications alone. By addressing both the neuropathy and the underlying diabetes, patients experience better overall outcomes.
“The standard treatment for diabetic neuropathy involves medication management using either Neurontin [gabapentin], Lyrica [pregabalin] or Cymbalta [duloxetine],” says Kelly Miller, D.C., FASA, N.M.D., Clinical Director of Waldo Rehabilitation, Health and Wellness in Kansas City, MO. “However, statistically, those medications are only helpful for about 30% of patients suffering from diabetic neuropathy — and they are expensive drugs with many side effects.”
At Waldo Rehabilitation, Health and Wellness, treatment for diabetic neuropathy in patients with type 2 diabetes involves management of the patient’s disease through specialized nutritional services meant to help patients lose weight. This diet helps correct the metabolic syndrome.
“If patients’ blood sugar levels are unstable, their risk for developing other complications, such as retinopathy, kidney failure and nerve damage, is much higher,” says Dr. Miller. “We provide patients with type 2 diabetes education about their diabetes and the options available to help better manage their insulin resistance through lifestyle modifications. We have medical doctors, podiatrists, chiropractors and physical therapists on staff — all under one roof. This cooperative integration of the different disciplines allows us to treat chronic conditions, such as diabetes, in a comprehensive manner that can be challenging for a single provider.”
Diabetic Neuropathy Management
When patients present at Waldo Rehabilitation, Health and Wellness with diabetic neuropathy, a specific regimen of injections is utilized. Immediately following these injections, which are administered by a podiatrist, patients receive electrotherapy and infrared light therapy surrounding the injection site, which helps to not only anesthetize the fibers causing pain, but also increases circulation in the patient’s foot by 3,000%, according to Dr. Miller.
“By administering electrotherapy immediately after the injections have been completed, the medication is able to provide pain relief while also alleviating the numbness patients experience,” says Dr. Miller. “Improved sensory perception of the feet puts patients at decreased risk for wounds, infections and falls, which not only improves their overall well-being, but also reduces the amount of health care dollars spent on wound care. By taking a proactive approach to diabetes and diabetic neuropathy, we are able to reduce the number of patients who suffer from diabetic foot wounds, falls and other related health problems.”
For diabetic patients experiencing other health concerns, such as pain in their hips, knees and shoulders, physical therapy and chiropractic services are provided. Transdermal nutritional formulas are also used for diabetic neuropathy patients to help reverse any nerve damage that has been sustained and help them sleep.
“By utilizing a comprehensive approach that entails stabilizing blood sugar levels, correcting type 2 diabetes and applying specific nutrients — including B vitamins, melatonin, vitamin D and magnesium — patients have better outcomes for diabetic neuropathy,” says Dr. Miller. “In many cases, we can reverse nerve damage that has been sustained, which provides a much higher quality of life for patients.”
“The standard treatment for diabetic neuropathy involves medication management using either Neurontin [gabapentin], Lyrica [pregabalin] or Cymbalta [duloxetine],” says Kelly Miller, D.C., FASA, N.M.D., Clinical Director of Waldo Rehabilitation, Health and Wellness in Kansas City, MO. “However, statistically, those medications are only helpful for about 30% of patients suffering from diabetic neuropathy — and they are expensive drugs with many side effects.”
At Waldo Rehabilitation, Health and Wellness, treatment for diabetic neuropathy in patients with type 2 diabetes involves management of the patient’s disease through specialized nutritional services meant to help patients lose weight. This diet helps correct the metabolic syndrome.
“If patients’ blood sugar levels are unstable, their risk for developing other complications, such as retinopathy, kidney failure and nerve damage, is much higher,” says Dr. Miller. “We provide patients with type 2 diabetes education about their diabetes and the options available to help better manage their insulin resistance through lifestyle modifications. We have medical doctors, podiatrists, chiropractors and physical therapists on staff — all under one roof. This cooperative integration of the different disciplines allows us to treat chronic conditions, such as diabetes, in a comprehensive manner that can be challenging for a single provider.”
Diabetic Neuropathy Management
When patients present at Waldo Rehabilitation, Health and Wellness with diabetic neuropathy, a specific regimen of injections is utilized. Immediately following these injections, which are administered by a podiatrist, patients receive electrotherapy and infrared light therapy surrounding the injection site, which helps to not only anesthetize the fibers causing pain, but also increases circulation in the patient’s foot by 3,000%, according to Dr. Miller.
“By administering electrotherapy immediately after the injections have been completed, the medication is able to provide pain relief while also alleviating the numbness patients experience,” says Dr. Miller. “Improved sensory perception of the feet puts patients at decreased risk for wounds, infections and falls, which not only improves their overall well-being, but also reduces the amount of health care dollars spent on wound care. By taking a proactive approach to diabetes and diabetic neuropathy, we are able to reduce the number of patients who suffer from diabetic foot wounds, falls and other related health problems.”
For diabetic patients experiencing other health concerns, such as pain in their hips, knees and shoulders, physical therapy and chiropractic services are provided. Transdermal nutritional formulas are also used for diabetic neuropathy patients to help reverse any nerve damage that has been sustained and help them sleep.
“By utilizing a comprehensive approach that entails stabilizing blood sugar levels, correcting type 2 diabetes and applying specific nutrients — including B vitamins, melatonin, vitamin D and magnesium — patients have better outcomes for diabetic neuropathy,” says Dr. Miller. “In many cases, we can reverse nerve damage that has been sustained, which provides a much higher quality of life for patients.”
Subscribe to:
Posts (Atom)
