If you drink too much alcohol, you run the real risk of ruining your health. You may be able to drink within moderate limits to reduce the risk of developing health issues. Limiting yourself to one standard drink at a time, of any type of alcohol, can help you reduce the many health risks associated with excessive drinking.
One of the possible side effects of drinking too much is that uric acid can build up in the joints of your bones. Crystals begin to form and grow, leading to joint damage. This is called gout, which is a type of arthritis. Usually, uric acid passes through the kidneys and is released from the body in your urine. Gout is caused by poor kidney function, which leads to an excess of uric acid in your system. As excessive alcohol consumption lowers the functioning of various organs, including the kidneys, it can have a huge impact on your chances of developing gout.
What is Gout and What Causes it?
Gout is just one type of arthritis, and it most often presents itself in a joint of one of your big toes. When it hits, it develops fast and usually comes back repeatedly. Every time you suffer a new attack, the tissues in your big toe, or wherever you experience the inflammation, deteriorates more and more. If you have cardiovascular issues, or high blood pressure, you are at an even higher risk of developing this condition; obesity also increases this risk.
In chronic tophaceous gout, you’ll notice large lumps where a gout attack is occurring. These lumps are called “tophi”. These are clumps of urate crystals, which develop in areas where your body is cooler, such as your fingers and other extremities. If you haven’t received treatment for your symptoms (up to 10 years), this is the type of gout you may experience.
Uric acid builds up in your body when purines are being broken down. Purines are chemical compounds commonly found in seafood, red meat, poultry, and alcohol (especially beer). The levels of purines in these meats are high, making them more inflammatory than other foods. To prevent the development of gout or to control it post-diagnosis, you need to learn which foods are more inflammatory and which are less inflammatory.
Symptoms
You’ll have no doubt that something is wrong when you experience an attack of gout. The signs develop quickly and without warning. They also hit mainly during the nighttime hours.
Symptoms include:
- Range of motion becomes more limited. As time goes on and your gout progresses, it becomes difficult to move affected joints normally.
- You experience intense joint pain. The pain is most intense for the first four to 12 hours after it starts. As well as the joint of your big toe, gout can attack other joints, specifically fingers, ankles, wrists, knees, or elbows.
- There will be obvious redness and inflammation. The joint being affected will be tender, warm, swollen, and red.
- The discomfort will continue after the initial pain dies down. Even after the worst of the pain goes away, you may notice some discomfort in that joint. This may continue for a few days or up to a few weeks. As your condition progresses, attacks will likely last longer and you’ll notice that more joints are affected.
Types of Gout
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Asymptomatic Hyperuricemia
If your levels of uric acid are chronically elevated, you may not go on to develop true gout. Instead, you are diagnosed with hyperuricemia, which presents with no symptoms. You may also never develop kidney stones or nephrolithiasis. Your doctor should continue to monitor your condition and prescribe a diet lower in purines and added sugars. -
Acute Gout
You may have eaten a lot of steak or had a good time drinking with friends. This causes a spike in your uric acid levels or jostles the crystals that have already been formed in a joint. You soon experience a flare of gout, suffering intense pain and inflammation for up to 12 hours. -
Interval/Intercritical Gout
Intercritical (interval) gout is a period where your gout isn’t active. If you are continuing to drink or eat foods high in purines, your body is still depositing urate crystals, leading to joint, cartilage, and bone damage in affected joints. Your doctor should order a blood test to measure your blood uric acid level, especially if you have a past history of flares. -
Chronic Gout
Chronic gout is simply repeated flares of your gout symptoms. You may experience inflammation and pain in only one joint, or several joints may be affected. Gout of any type develops after urate crystals deposit themselves in the joints of your body, leading to accumulated damage. -
Pseudogout
This is one type of arthritis, presenting with painful swelling that develops suddenly. Each episode may run for a few days or for several weeks. In this form of arthritis, your knee joint is commonly affected. This is also called calcium pyrophosphate deposition disease or CPPD. Instead of urate crystals, your body deposits calcium crystals meaning this isn’t actually gout, but it can appear to be gout to the layman.
Risk Factors Including Alcohol
Several factors contribute to the development of gout. These include your diet. If it is high in alcohol, fruit sugar, seafood, and meat, your body may be high in uric acid and may begin depositing large amounts of urate crystals wherever it can in order to reduce the amount in the blood.
If you are overweight or obese, your body will produce more uric acid and your kidneys will have a difficult time eliminating it. If you take certain types of medications, such as low-dose aspirin or thiazide diuretic, your uric acid levels may increase. Anti-rejection medications can also lead to high uric acid levels.
Some medical conditions such as kidney disease, diabetes, metabolic syndrome, or untreated high blood pressure may also increase your risk of developing gout. A family history of gout predisposes you to developing the disease yourself. If you have had a recent physical trauma or surgery, you are at higher risk of experiencing an attack of gout.
Sex and age also have an impact on the development of gout. Men are more likely to develop it, though women can as well. Men tend to have higher levels of uric acid in general, though women have higher levels after menopause, meaning their risk increases as they get older. Men between 30 and 50 are also more likely to develop symptoms.
Can Alcohol Cause Gout?
It’s with good reason that gout has been called the “disease of kings”. Having too much alcohol and rich food can lead to flare ups. These days, beer seems to be the biggest cause of gout flares. Research has stated that two to four beers weekly push the risk of gout up by about 25%. Men and women who drink a minimum of two beers daily saw their chances of developing gout jump by more than 200% as compared to women who don’t drink beer.
Those who enjoy liquor are also at risk, though the percentage isn’t as high. Even one drink of liquor monthly pushes the risk up, while drinking two or more drinks of liquor daily increases the risk by 60%.
People who drink wine are much less likely to develop gout. This has led researchers to state that gout sufferers should stop drinking beer. Wine may be a good substitute if you’d still like to enjoy a glass of something at night, as opposed to beer or liquor. Researchers found that lifestyle choices, like drinking alcohol are some of the biggest contributors to the development of gout.
When to See a Doctor
If you develop symptoms that look like arthritis, a visit to the doctor is the best way to get a clear diagnosis. Your doctor will run several tests to either rule out or arrive at a diagnosis of gout. These include X-rays, which rule out other health issues; an ultrasound can view areas where uric acid is building up, and/or a joint fluid test, conducted by removing fluid with a needle from an inflamed joint. The collected fluid is studied with a microscope to see if crystals are present/visible. A blood test allows the doctor to check your uric acid level. Remember, even if your uric acid level is high, that doesn’t necessarily mean that you have gout.
See your doctor if you don’t know what is causing your joint pain. They will be able to diagnose gout or any other illnesses, such as a joint infection, which may have symptoms common to gout. A gout flare may cause a mild fever. If you have a high fever with chills, you may not be experiencing a flare and you should go to the hospital right away. Infections are serious and should be treated immediately.
Treatment
The main treatment for gout of any type is medication. Your doctor will decide what to prescribe you once they have assessed your current health. They will also discuss your preferences with you. Medications prescribed for gout are intended to prevent new attacks and treat acute (current) attacks. Prescriptions for gout can also lower the risk of complications, like the development of tophi resulting from deposits of urate crystals.
Non-steroidal anti-inflammatory medications (NSAIDs) such as Motrin or Advil can help with the inflammation and pain. Naprosxen sodium (Aleve) or prescription NSAIDs, such as Celebrex or indomethacin may also be suggested to alleviate intense pain.
Corticosteroids (prednisone) are intended to control inflammation and pain. They are available as injections or oral medications. Colchicine (Mitigare or Colcrys) is a good gout pain reliever, however, you may experience negative side effects such as diarrhea, nausea, and/or vomiting.
To prevent complications of gout, an oxidase inhibitor may be prescribed to limit how much uric acid your body produces. Probalan or Zurampic may be prescribed in order to increase your kidneys’ ability to remove excess uric acid. These drugs are relatively new and can mean that someone who has trouble changing their diet still has the chance to lower their risk of new gout flare ups. Lifestyle changes are still the most effective means of controlling this condition, but medications can help you maintain control even over the holidays or any other time you let yourself celebrate a little too hard.
Prevention
Changing your lifestyle can definitely help lower the chance of gout flares. You can begin by exercising and losing weight. Getting to and maintaining a healthy body weight lowers your chance of developing gout significantly. Another lifestyle change you can adopt is to limit your intake of alcoholic beverages and sweetened drinks. Try to drink non-alcoholic beverages and focus most on drinking water or even milk or tea. Limit your intake of foods known to be high in purines (seafood, organ meats, red meat). If medications haven’t worked or cause undesirable side effects, you will find alternative means of preventing gout can be used to great effect.
Sources:
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https://www.cdc.gov/alcohol/fact-sheets/alcohol-use.htm
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https://www.mayoclinic.org/diseases-conditions/gout/symptoms-causes/
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https://www.the-rheumatologist.org/article/treating-asymptomatic-hyperuricemia-lower-risk-developing-chronic-conditions/
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https://www.medicinenet.com/what_is_intercritical_gout/ask.htm