Nutrition. Vitamins. You.
Subscribe Today! Please see below for a complete transcript of this episode. HOW TO FIGHT SPRINGTIME ALLERGIES, INVITEⓇ HEALTH PODCAST, EPISODE 636 Hosted by Amanda Williams, MD, MPH *Intro Music* InViteⓇ Health Podcast Intro: [00:00:04] Welcome to the InViteⓇ Health Podcast where our degreed health …
Subscribe Today! Please see below for a complete transcript of this episode. MOOD MATTERS TO YOUR HEALTH, NUTRIENTS CAN HELP, INVITEⓇ HEALTH PODCAST, EPISODE 635 Hosted by Amanda Williams, MD, MPH InViteⓇ Health Podcast Intro: [00:00:04] Welcome to the InViteⓇ Health Podcast, where our degreed …
Written by Dr.Claire Arcidiacono, ND
For further questions or concerns email me at carcidiacono@invitehealth.com
Last week we finished our conversation about lupus. Today we will be discussing gout. Gout will be the last condition specific blog in this series on joints. What exactly is gout? Basically, gout is a form of inflammatory arthritis in the joints. This arthritis is interesting because it is associated with uric acid build up in the joints. This uric acid causes the joints to become inflamed and this inflammation is what leads to the joint damage and pain. (1) Please see picture for exactly what this looks like. † (2)
Symptoms of gout may sound familiar, interestingly gout usually starts in the joint of the big toe. As the condition progresses more and more joints become involved. Like other inflammatory disorders in gout the joints will be red, tender, swollen and even warm to the touch. In addition to joint pain the buildup of uric acid can also cause the buildup of crystals in the kidneys leading to what is known as urate nephropathy. In addition to these symptoms’ gout can also lead to systemic symptoms such as fatigue and even a high fever. † (3)
The symptoms of gout are caused by the buildup of uric acid crystals. Therefore, anything that increases the uric acid levels in the body will increase the risk of developing gout. Diet is a very well-known risk factor for gout. A diet high in alcohol, meat, seafood and sugar can increase the uric acid in the body and thus can increase gout risk. (4) Another well-known diet-based risk factor for gout is a diet that is high in purines which can increase uric acid. Purines are a part of every cell and break down into uric acid. Because they are found everywhere it is impossible to eliminate them entirely. It is possible to try and limit the foods that have a very high purine content. (5) These foods include but are not limited to anchovies, shrimp, mushrooms, seaweed and organ meats. (6) Some research has indicated that potatoes as well as chicken can increase the risk of developing gout. (7) As a result of the fact that gout occurs when uric acid builds up anyone that has kidneys that do not excrete the uric acid properly is at a higher risk of developing gout. † (8)
Certain genes have been found to increase the risk of developing gout. Therefore, anyone with a family history of gout may want to reduce their other risk factors for the disease. † (9)
Gout is associated with certain medications as well as certain chronic conditions. For example, diuretics, niacin, aspirin, ACE inhibitors as well as Beta blockers and even some chemotherapy may increase the risk of gout. (10) Interestingly with excessive vitamin D (blood work showing vitamin D over 80) there is an increased risk of gout. (11) A few examples of chronic conditions that are associated with gout include but are not limited to the following: metabolic syndrome, kidney failure, organ transplant recipients, those exposed to lead and those who are obese/overweight. † (12)
Other triggers that can lead to a gout flare up can include rapid changes in the weather. Additionally, trauma, surgery and having sleep apnea increase the risk of gout. † (13)
While having high uric acid on blood work or hyperuricemia is considered to be a classic sign of gout not everyone with gout has this classic sign. In fact, up to 50% of people with gout never develop high uric acid on blood work. (14) In order to diagnose gout uric acid crystals are found in the synovial fluid of the joints. (15) Other conditions that should be ruled out can include but are not limited to pseudo-gout, RA, psoriatic arthritis and rheumatism. † (16)
ICYMI:PSORIATIC ARTHRITIS>>READ NOW!
The goals of working with gout include stopping the acute attack or flare up that is occurring right now and then from there we work on lowering the uric acid. By lowering the uric acid, we can reduce the risk of a flare up in the future. Now I know some people might think that they only need to work on gout during a flare up but it’s important to work to reduce the uric acid levels regardless of flare up status. Each gout “attack” or flare up increases the risk of damaging the joint. This can lead to destruction of the joint surface and even cause the joint to become deformed. Lastly in 30% of those with untreated gout something called tophi can occur. This is basically a buildup of uric acid that most commonly occurs on the ear, olecranon process and the Achilles. † (17) Please see the attached picture (18) †
To help reduce uric acid and thus reduce the risk of gout the following have been found to be helpful:
Next week we will be discussing how to heal from surgical based interventions. †
REFERENCES
Subscribe Today! Please see below for a complete transcript of this episode. DEPRESSION & AGING, WHAT CAN BE DONE, INVITEⓇ HEALTH PODCAST, EPISODE 634 Hosted by Amanda Williams, MD, MPH *Intro Music* InViteⓇ Health Podcast Intro: [00:00:04] Welcome to the InViteⓇ Health Podcast where our degreed …
Subscribe Today! Please see below for a complete transcript of this episode. DANGERS OF OVER-THE-COUNTER DRUGS & THE NUTRIENTS THAT MAY GET DEPLETED, INVITEⓇ HEALTH PODCAST, EPISODE 633 Hosted by Amanda Williams, MD, MPH *Intro Music* InViteⓇ Health Podcast Intro: [00:00:04] Welcome to the InViteⓇ …
Written by Dr.Claire Arcidiacono, ND
For further questions or concerns email me at carcidiacono@invitehealth.com
In our last blog we completed our lupus discussion. This week we will be discussing another autoimmune disease called psoriatic arthritis. Psoriatic arthritis is a type of arthritis that occurs in individuals affected by psoriasis. In fact, psoriatic arthritis occurs in up to 30% of people with psoriasis. While in most people the skin changes of psoriasis precede the arthritis in up to 15% of individuals the psoriatic arthritis occurs before the rash. † (1)
Since psoriatic arthritis is an inflammatory disorder, its symptoms, include joints that are red, warm to the touch and joints that are swollen, stiff and there is often pain. In 70% of cases there is what is referred to as “asymmetrical oligoarthritis” which just means that the inflammation affects 2-4 joints during the first 6 months of the disease. Interestingly in 15% of cases the arthritis is symmetrical throughout the joints. In addition to causing joint pain a classic symptom of psoriatic arthritis is a swelling of the entire finger and or toes. This phenomenon is known as dactylitis. (2) Over time psoriatic arthritis may lead to arthritis mutilans which is a deformity of the joints that looks like a pencil in a cup on an X-ray.† See Picture (3)
In addition to affecting the fingers and toes there can also be pain in the sacrum caused by sacroiliacs or spondylitis. Pain can also occur in the ankles. † (2)
Psoriatic arthritis is arthritis that occurs in an individual who has the condition psoriasis and thus symptoms of psoriasis are seen in addition to the joint symptoms. Psoriasis is an autoimmune condition that results in scaly skin, lesions that are normally present over the scalp, natal cleft, elbow and umbilicus. (4) Please see the added picture. † (5)
Psoriasis can also affect both the nails and even the nail beds. It can cause visible changes in these structures such as pitting, ridging of the nails, onycholysis and hyperkeratosis. It can also cause the nails to separate from the nail bed. (6) As a consequence of psoriatic arthritis being an autoimmune condition just like we saw in RA and lupus we can see some systemic symptoms. An example of one such symptom is fatigue. The fatigue is not corrected by sleep and may persist for days or weeks. (7) As with any autoimmune disorder there may be periods of remission and periods of “flare up” where the symptoms become less/more severe in intensity. †
One risk factor for developing psoriatic arthritis is having a peptide known as human leukocyte antigen (HLA) B27. (8) Both psoriasis and psoriatic arthritis are usually considered to be genetic disorders that have been triggered by something in the environment. (9) Flare ups can be triggered by stress as well as certain medications. Just like with other autoimmune conditions “bad guys” such as bacteria or yeast can increase the risk of both developing the condition or increase the risk of a flare up. For example, studies have found an association between staphylococcus aureus, Malassezia and even Candida. † (10).
Nutritionally a vitamin D deficiency has been found to be associated with severe psoriasis and psoriatic arthritis. (11) Additionally, being overweight or obese is an important risk factor for psoriasis and psoriatic arthritis. (12) As I spoke about in my blogs regarding lupus the standard American diet also called a western diet is also a risk factor for autoimmune disorders such as psoriatic arthritis. (13) Lastly once again as we spoke about during our lupus discussion is the interesting topic of leaky gut. As I stated previously leaky gut is associated with autoimmune disorders such as psoriasis and psoriatic arthritis. (14). While there may be less common risk factors that can cause a flare up of psoriatic arthritis in this blog, I have just reviewed the most common. †
Several conditions can mimic psoriatic arthritis and must be ruled out before a diagnosis can be made. They include but are not exclusive to the following: Rheumatoid arthritis, osteoarthritis, gout, lupus and irritable bowel disease associated arthritis. † (15)
When working with psoriatic arthritis just like with any other autoimmune disorder we want to work on the underlying autoimmune aspect. By now in our series some of these suggestions will sound familiar to you. That is because as you can see, I only make suggestions that work either by showing studies, and by both looking at the research and my own clinical experience. †
WAYS TO MANAGE PSORIATIC ARTHRITIS:
While other supplements can be helpful, I have covered the ones I consider most important. To determine which supplements and dietary changes are best for you it is important to talk to an Invite nutritionist. Next week we will be discussing Gout. †
REFERENCES