Alphabetical Reference of Nutritional Support

Formula Catch Phrase

Key Benefits

Gelatin Complete Joint Restore Powder

This formula contains glucosamine, MSM, gelatin and additional nutritional co-factors, and has been clinically trialled and shown to reduce pain and inflammation and promote the healing of joint tissues.

Highly Bioavailable PEA and Magnesium for Neuromuscular Support and Pain

Palmitoylethanolamide (PEA) is a natural fatty amide with anti-inflammatory and analgesic properties that shows potential for managing gout. Magnesium intake is associated with lower uric acid levels and reduced gout risk and may prevent gout flare ups – although is not an acute treatment for an acute attack.

High Purity, Low Reflux, Concentrated Fish Oil Liquid or Capsules

Fish oils are consistently shown to benefit chronic illnesses as they reduce inflammation. They specifically protect bone and joint health, and are protective in metabolic disorders, commonly associated with gout.

pH Adjusted Vitamin C Metabolites and Hesperidin Tablets or Powder

Higher vitamin C intake is demonstrated to lower risk of developing gout. Men with a vitamin C intake of 1,500 mg/day had a 45% lower risk of gout compared with those who had a vitamin C intake of less than 250 mg/day.

Specialised Pro-Resolving Mediators

SPMs are a next-generation omega-3 marine-lipid concentrate, derived from fish oils to complement the body’s own natural production. These pre-formed molecules actively support the resolution of inflammation and promote healthy tissue homeostasis. Clinically demonstrated to reduce and manage chronic mild joint pain.

Supportive Lifestyle Programs

Shake It Practitioner Weight Management Program

Lowering carbohydrates in the diet reduces the production of uric acid whilst increasing protein supports the excretion of uric acid. Although purines tend to be found in protein foods, these may be avoided to reduce uric acid production. Reducing dietary glycaemic load will reduce insulin release, helping patients to lose excess body fat, particularly visceral adipose tissue, whilst also minimising the metabolic risks of elevated uric acid, including hypertension.

Metagenics Clinical Detoxification Program

Gout is commonly, although not always, associated with diet and lifestyle excesses and poor digestive function. The Metagenics Clinical Detoxification Programs are designed to address the primary source of toxicity in patients, and encourage elimination of and protection against these toxins. A questionnaire is available for patients to complete which assist the Practitioner in determining the most appropriate program. There are three programs available:

• Health Reset
• Gut Pathogen Elimination
• Liver Chemical Clearance

Wellness and Healthy Ageing Program

This program recommends a low glycaemic load diet with healthy lifestyle recommendations for exercise, relaxation, intellectual stimulation and effective stress management – all factors associated with chronic disease prevention, including metabolic syndrome and gout.

Aetiology and Risk factors

A number of risk factors are related to the development of gout. These include:

• Obesity
• High alcohol intake
• A genetic predisposition
• High intake of foods rich in purines (e.g.: certain seafood and meat)
• Certain medicines e.g.: diuretics (fluid tablets)
• Injury to a joint
• Long-standing kidney disease.
• Occasionally there is no obvious cause for an attack of gout.

Signs and Symptoms

Common signs and symptoms of gout include

• Pain in a single joint, often at the base of the great toe, but can be in other joints of the feet, fingers, wrists, elbows, knees, and ankles
• "Exquisite" pain and tenderness
• Swelling, heat, and stiffness of joint
• Shiny red or purple coloration of joint
• Fever of up to 39°C (102.2°F), with or without chills. This begins within hours of a flare up and may subside over a few days or last up to three weeks.
• Untreated, attacks will be more frequent and more severe.

Diet and Lifestyle

Dietary and lifestyle guidelines may assist in the management of gout:

• Avoid obesity. However, it is important to avoid crash dieting and rapid weight loss.
• Avoid alcohol, especially beer, which has a higher purine content than wine or spirits.
• Hydration—Drink plenty of water: dehydration may exacerbate gout.
• Restrict purines in diet which increase lactate production which competes with uric acid for excretion. Avoid foods high in purines:
  • Shellfish (pipis, paua, oysters, mussels) and fish roe
  • Offal foods (brains, liver, kidney, tripe)
  • Red meat (beef, pork/bacon, lamb)
  • Yeast extracts (Marmite, Vegemite)
  • Foods containing yeast (bread, beer)
  • Oily fish (sardines, herrings and anchovies).
• Foods with moderate purines:
  • Meats, poultry, fish, and shellfish not listed above.
  • Spinach, asparagus, beans, lentils, mushrooms, and dried peas.
• Recommend Cherries—One half pound of cherries/day (fresh or frozen) for two weeks lowers uric acid and prevents attacks. Cherries and other dark red berries (hawthorn berries and blueberries) contain anthocyanidins that increase collagen integrity and decrease inflammation. 250 to 300 mLs of cherry juice per day is also helpful. A lower maintenance dose may be continued for prevention.
• Reduce glycaemic load of diet. Elevated insulin inhibits uric acid breakdown and increases gout episodes. Avoid sugars and refined grains. Limit total carbohydrate intake.

Clinical Assessment

TEST

INTERPRETATION GUIDELINES

Primarily medical history and physical exam

• History of gout in your immediate family.
• History of sudden attacks of arthritis affecting one joint, especially the big toe, foot, ankle, knee, wrist, or finger.
• History of wrist or ankle sprains or tendinitis without having an injury or your symptoms go away on their own in about a week.
• Recent injury or surgery.
• Recent infections of the skin, kidney, bladder, or lung.
• Alcohol use.
• Exposure to lead.
• Recent diets.
• Medical conditions, including high blood pressure, high triglyceride levels, heart disease, kidney disease, and diabetes.
• Use of certain medicines, especially diuretics and aspirin.