Common TCM Patterns Seen with Gout
Gout can fall in to several patterns according to Chinese medicine. Typically, patients have more than one indication as gout has many underlying root causes to manifest in to a disease pattern. Most gout sufferers have to utilize a combination of appropriate formulas to have lasting relief. Additionally, the herbs are not taken just at the onset of a gout attack; they are used for 6-8 months to address the underlying root imbalances to avoid future attacks.
Kidney Deficiency and Gout
It is well understood that uric acid is eliminated mainly through the kidneys. In Chinese medicine, the Kidney energetic organ system is complex and includes the kidneys, the Kidney (Bladder) acupuncture channels, and a host of other functions. Someone with gout complicated by Kidney Deficiency may have frequent urination, edema, or ED; all indications that the Kidney organ system (TCM) is not functioning optimally.
Spleen Qi Deficiency and Gout
Internal Dampness is commonly a result of Spleen Qi Deficiency according to Chinese medicine. With gout, there is often a pattern of Damp Heat presenting seen as inflammation, swelling, and redness during gout attacks. The Spleen energetic organ system in Chinese medicine is associated with digestion and how one utilizes food; this can be correlated with the body’s inability to process purine rich foods efficiently. Spleen Qi tonics are required over a number of many months to actually address Spleen Qi Deficiency if it is a clear indication.
Liver Qi Stagnation and Gout
In Chinese medicine, the Liver energetic organ system governs over the tendons; thus, any disease affecting the joints points towards a Liver imbalance. In cases of gout, the Liver energy is stagnated, heats up, combines with pathogenic Damp factors, and causes Damp Phlegm to begin to condense. Think of how a sauce begins to thicken after simmering over heat for a long while; the process of Pathogenic Fluids thickening is similar in Chinese medicine. It may take 6-8 months to sooth the Liver energy.
Accumulations of Turbid Damp Phlegm of the Joints
Herbs can help to more efficiently purge the body of uric acid build up. While these
herbs can result in some immediate relief, the relief will only be temporary until the underlying causes mentioned above are thoroughly resolved. These herbs both drain uric acid through the kidneys, and are alkaline for acid build up in the blood.
How Gout is Addressed with Chinese Medicine
Gout is addressed successfully through Chinese medicine utilizing herbal formulas. Herbs for gout work to eliminate uric acid from the body, neutralize acid in the body, alleviate inflammation in the joints, and re-enforce the underlying imbalances that lead to gout in the first place. Gout is a painful form of arthritis caused by a buildup of uric acid in the body. Typically, uric acid is excreted via the kidneys and gut, but if you have a genetic disposition to gout, or produce excessive uric acid due to the consumption of alcohol or purine rich foods, you may find yourself with swollen, red, hot, painful, or stiff joints.
In Chinese medicine, gout is seen as a joint painful Bi syndrome caused by wrong lifestyle habits including unregulated eating and drinking, or from external evil pathogens such as Wind-Damp, Damp-Heat or Damp-Cold. Alcohol, rich fatty foods, and fried foods are to be avoided. As gout progresses, Qi and Blood Stasis develop according to Chinese medicine creating sharp pain and limited mobility.
Healthy Liftestyle Choices for Gout:
Gout is considered a metabolic disease, and is often seen along with obesity, diabetes, and high blood pressure; therefore, it may be part of metabolic syndrome and is considered chronic. Uric acid is a result of the breakdown of purines that produces mono-sodium urate crystals that accumulate on the articular cartilage of joints, on tendons, and in the surrounding tissues. Purine break down also results in lactic acid, and lactic acid competes with uric acid for excretion. Uric acid chrystalines can build up under the skin creating a bumpy surface, and often cause swelling.
Purines can be generated by the body during normal breakdown of cells in cellular turnover. Purines and an over production of uric acid can also be a result of the over consumption of purine rich foods such as anchovies, sardines, liver, beef kidneys, brains, herring, mackerel, scallops, and game meats. Gout is associated with the over-consumption of protein rich foods, red meat, and alcohol.
A healthy, balanced diet rich in whole foods is critical to curing gout; foods that are rich in potassium such as bananas, spinach, and carrots are especially helpful in reversing gout, as potassium aids in the breakdown of uric acid.
About 75% of the time, gout first attacks the big toe; interestingly, the Liver and Spleen acupuncture channels converge at the big toe, and the Kidney channel runs beneath. Early attacks are typically short lived; however, as the uric acid builds up, the painful attacks last longer and become more frequent as the uric acid crystals begins to irritate the ankles, heels, knees, wrists, fingers and elbows. Gout can appear suddenly and cause extreme burning pain. It is important to address gout quickly, as it can cause permanent damage to the joints, kidney damage, and kidney stones. Gout is one of the most painful forms of arthritis. While herbal remedies can effectively support and improve the Kidney Function of elimination of uric acid, patients typically have to make lifestyle changes for natural medicine to effectively treat gout.
The kidneys are responsible for approximately one-third of uric acid excretion and it is important to avoid becoming dehydrated with gout; the rest of uric acid is normally broken down in the blood or the gut. When uric acid levels in the blood are high, it is called hyperuricemia. Not everyone who develops hyperuricemia will develop gout, but it becomes more likely.
Gout appears to be more prevalent in males ages 40-50, and in African Americans. There is a strong familial relationship with gout, and genetic dispositions to gout can include kidney abnormalities and the inability to produce enzymes that allow for the proper break down of uric acid.
Other possible causes of gout:
- Certain pharmaceuticals
- High levels of lead
- Crash diets
- Sudden, severe illness
- Joint injury
- Excessive exercise
For many people, the first attack of gout occurring often in the big toe and will wake a person from sleep. The toe is very sore, red, warm, and swollen. An attack of gout can be brought on by a stressful event, consumption of alcohol or drugs, or another illness. Early attacks usually get better within 3 to 10 days, even without treatment. The next attack may not occur for months or even years. Gout can cause:
- Stiffness in joints
In addition to the big toe, uric acid build up can create:
- Gout in instep
- Gout in ankles
- Gout in heels
- Gout in knees
- Gout in wrists
- Gout in fingers
- Gout in elbows
There are also in many foods, such as liver, dried beans and peas, and anchovies. Normally, uric acid dissolves in the blood. It passes through the kidneys and out of the body in urine. But uric acid can build up in the blood when:
- The body increases the amount of uric acid it makes.
- The kidneys do not get rid of enough uric acid.
- A person eats too many foods high in purines.
You are more likely to have gout if you:
- Have family members with the disease
- Are male
- Are overweight
- Drink too much alcohol; especially beer
- Eat too many foods rich in purines
- Have an enzyme defect that makes it hard for the body to break down purines
- Are exposed to lead in the environment
- Have had an organ transplant
- Use some medicines such as diuretics, aspirin, cyclosporine, or levodopa
- Take the vitamin niacin
Western Medicine and Gout-How Is Gout Diagnosed?
Your doctor will ask about your symptoms, medical history, and family history of gout. Signs and symptoms of gout your doctor will look for include:
- Hyperuricemia (high level of uric acid in the blood)
- Uric acid crystals in joint fluid
- More than one attack of acute arthritis
- Arthritis that develops in 1 day, producing a swollen, red, and warm joint
- Attack of arthritis in only one joint, usually the toe, ankle, or knee
To confirm a diagnosis of gout, your doctor may draw a sample of fluid from an inflamed joint to look for crystals associated with gout. Western medicine use medicines to treat an acute attack of gout, including:
- Nonsteroidal anti-inflammatory drugs (NSAIDs), such as Motrin
- Corticosteroids, such as prednisone
- Colchicine, which works best when taken within the first 12 hours of an acute attack
Many of these medications have severe side effects which inspire patients to seek natural health care methods such as acupuncture and Chinese herbs that have low to no side effects and low risk.
Note: Pseudogout has similar symptoms and is sometimes confused with gout. However, it is caused by calcium phosphate, not uric acid.