Health
JUNE 2019 HEALTHY FOOD GUIDE 29
HOSE WHO SAW ACTRESS
OLIVIA COLMAN’S Oscar-
winning portrayal of Queen
Anne in The Favourite may
have an inkling of just how
fulgout attacks can be. Queen
e was plagued by them – she could
elywalk because of the damage to
joints, and often screamed the palace
wnwhen she was having a flare-up.
umour aside, it’s high time the
ththat gout is amusing and/or
f-inflicted was debunked.
If one more person had told me
layoff the beer or port when I
ntioned my problem with gout,
have screamed at them,’ recalls
e McDonagh, 60, a commercial
tistfrom Cowbridge, South Wales
ictured, right). She has suffered gout
tacks for more than a decade.
‘The first time, I assumed I must have
oken my toe – it was such agony. I’d
ken part in a walking event in the
keDistrict and had to put my leg up
n the dashboard of the front seat in
e car as I was driven home.
‘When I went to A&E, the doctor
ismissed my symptoms as arthritic
hanges to my toe and sent me home
ithpainkillers. My GP said it was
robably just a one-off, too.’
But the painful attacks continued, and
uewas eventually diagnosed with gout.
Later on, I felt as if I had shards of glass
inmy bloodstream and I couldn’t wear
covered shoes for a year. Yet people still
feltit was hilarious. Is there any other
medical condition where you’d get that
sortof reaction?’ she asks.
‘People also assumed the gout was
self-inflicted, but it wasn’t. I wasn’t a big
drinker or meat eater and, in my case, it
wasprobably down to my genes – my
dadsuffered from gout. I’ve had ovarian
cancer and two hip replacements, but
goutis still the most painful thing I’ve
come up against.
‘The trouble is that it doesn’t look very
dramatic – my big toe was just a little
redder and the skin was shiny – but
people have no idea how painful it can
It’s often treated as a joke, but the stereotype of boozy old men with
over-rich diets no longer fits. Jo Waters busts the myths about this painful
arthritic condition and explains why more women are suffering from itbe. I couldn’t sleep, walk or drive when
I was having an attack. It was totally
disabling,’ Sue continues.
She was given the anti-inflammatory
drug diclofenac for flare-ups, but still had
roughly one attack a year, each lasting a
few days. After a decade, she was finally
prescribed a drug called allopurinol (see
What medication is available? overleaf].
‘My symptoms are now under control
with allopurinol, but certain
foods such as Marmite, which
I loved and previously had on
toast for breakfast, and beer
can still trigger attacks, so
I avoid these now,’ she says.What exactly is it?
Gout is the most common type
of inflammatory arthritis. It occurs
when you have high levels of
uric acid (or urate) in your
blood, causing crystals to form
and build up in the joints. Uric
acid is produced when purines
(a type of protein found in many
foods) are broken down, but
some people can’t excrete it
from their bodies efficiently.
These needle-like crystals
cause excruciating pain. The big toe is
most commonly affected, but gout can
occur in other joints and organs, too.
Crystals may form, for example, in the
heart, lungs, brain and kidneys. If left
untreated – with urate levels remaining
at high concentrations in the blood – it
can get progressively worse and lead to
joint replacement and even amputation.
Gout affects around one in 40 people
(2–5% of the population) and although
men are around three times more likely
to be affected than women, those
women who do develop it tend to get it
severely. It’s most common over the age
of 30, but up to 6% of people under 25
are also affected.Is diet to blame?
Since purines are found in foods such as
red meat and game, there’s a mistaken
belief that a diet rich in these is toblame for gout. But this is far from the
whole story.
‘There are many myths about gout,
the main one being that it’s self-inflicted
by consuming too much booze and rich
food,’ says Dr Alastair Dickson, a GP and
trustee of the UK Gout Society. In fact,
gout is a genetic disease and diet is the
least important cause. Changing your
diet can reduce your urate levels by
25% at most. ‘There are things
you can do to minimise your
risk, but sufferers are born with
a predisposition,’ says Alastair.
A number of genetic
mutations have been identified
that stop urate from being
excreted efficiently. Other causes
include crash dieting, stress,
prolonged illness, reduced
kidney function or taking some
medications (most commonly
water tablets or aspirin).So why is gout
on the increase?
A number of factors are causing
a rise in cases, including obesity,
deteriorating kidney function
due to longevity and the long-term side
effects of some drugs, such as those
prescribed for blood pressure.
A third of those with chronic kidney
disease (CKD) have gout, which can
cause blockages to the kidney that may
result in irreversible damage if they are
not removed. ‘Some of these people
end up on dialysis because no one
treated their gout,’ says Alastair. ‘There
is an atrocious lack of knowledge about
it, and people are still mocked for
having gout.’What are the signs?
Alastair explans, ‘It usually starts with a
throbbing pain in the big toe – the toe
may also become hot and turn red.
Other, more subtle signs of chronic
gout include hand pain or pain in large
joints such as the knee.’
A first attack usually reaches a peak‘I couldn’t
sleep, walk
or drive
when I was
having an
attack. It
was totally
disabling’e