gout | The PrimAGE 2/4

Does Soy Increase Your Risk of Gout?

2 min read

Do you experience joint pain, inflammation, and swelling? Do you avoid certain foods because you're afraid of triggering an attack?

If you're living with gout, you know how debilitating and restrictive it can be. And soy might be one of the foods you're avoiding. But does soy really increase your risk of gout?

What Makes Up a Soybean?

Soybeans are a type of legume that is native to East Asia. They are part of the Fabaceae family, which includes other plants such as peanuts, lentils, and beans. Soybeans are a key ingredient in many Asian cuisines, and they can be used in a variety of dishes.

Soybeans are high in protein and fibre, and they also contain a range of vitamins and minerals. Soybeans are a good source of iron, magnesium, phosphorus, potassium, copper, manganese, and zinc. They also contain vitamin B6, folate, vitamin K, and thiamin.

Does Soy Intake Increase Uric Acid Levels?

Soy is a well-known source of protein, but it's also a common ingredient in many processed foods. There is a widespread belief, that gout sufferers should avoid soy and legume products because they are high in purine.

Uric acid is a waste product produced when the body breaks down purines. Purines are found in many foods, including soy. If uric acid levels become too high, it can lead to gout, kidney stones or can even lead to cardiovascular issues.

Contrary to the popular belief, a Singapore study done of over 50,000 Chinese in the country discovered that those who ate the most soy products had a lower risk of gout than those who ate the least.

In another study conducted in Hong Kong, soy consumption did not increase urate levels among Chinese postmenopausal women with prehypertension or prediabetes.

Purine Rating for Your Favorite Soyfoods!

Soy foods are generally listed as having a moderate amount of purines, ranging from 50 to 100 mg/100 g on purine content lists. The recommended daily amount of purine in the context of gout or hyperuricemia (high uric acid level in the blood) should not exceed 400mg/day.

It is to take note that different soy products may exhibit different purine content:

Soy foods	Rating
Bean curd lees (Okara)	1
Green soybean (edamame)	1
Soymilk	1
Tofu (Kinu)	1
Tofu (Momen, chilled)	1
Deep-fried tofu	2
Fermented soybean (Natto)	3
Soybean (dried)	3
Freeze-dried tofu	4

Despite the fact that studies have shown that soy does not significantly increase uric acid levels or gout attack incidences. It is generally recommended that people suffering from gout limit their intake of purine-rich foods.

Thus, it is still recommended to consume soy-based products in moderation.

So, if you're eating a diet that consists mostly of soy-based foods, you should aim for 3-4 servings per day. This will help ensure that you're getting all the nutrients your body needs, without overburdening it.

So, How Much Soy Can I Consume?

The amount of soy you can eat depends on the serving size. A serving of tofu, for example, is about ½ cup. A serving of tempeh is about 1/3 cup. And a serving of soy milk is about 1 cup.

So, if you're eating a diet that consists mostly of soy-based foods, you should aim for 3-4 servings per day. This will help ensure that you're getting all the nutrients your body needs, without overburdening it.

Soy Is Okay for Most Gout Patients

Based on the study, soy does not seem to increase your risk of gout. However, if you are already at risk for gout, it is still advisable to have soy foods in moderation.

Could Alkalizing Salt (URAL/ Clearogout) Help Eliminate Gout Symptoms?

3 min read

Gout is a type of arthritis that is caused by a buildup of uric acid crystals in the joints. This can lead to pain, inflammation, and swelling.

There are medications that can help to reduce uric acid levels, but there may be other ways to help ease symptoms. One popular option is using uric acid neutralizing salts such as Ural effervescence or Clearogout. These over-the-counter products are designed to help relieve the painful symptoms of gout by preventing the crystallisation of uric acid crystals in joints.

Could Uric Acid Alkalizing Salt (URAL/ Clearogout) Help Eliminate Gout Symptoms?

How to Use These URAL or Clearogout Effeversence Alkalizing Salt?

Alkalizing salt works by raising the pH of urine, and by keeping urine alkaline, it prevents the formation of uric acid crystals and allows for the dissolution of uric acid stones.

When taking URAL effervescence salt, it is important to follow the dosage recommendations on the label. It is also important to drink plenty of water when taking this product in order to help the body absorb it properly.

The recommended dosage is in the range of 1-2 sachets, 4 times daily. [Total 4 – 8 sachets per day]

It is advised to take each dose after a meal, and just before taking, mix your prescribed dose of medication in a full glass of cold water or juice.

What Are the Ingredients inside the URAL/ Clearogout Alkalizing Salt?

Each sachet contains Sodium bicarbonate, tartaric acid, citric acid, and sodium citrate; with/ without flavourings added.

Any Side Effects for Taking URAL or Clearogout?

It is quite safe if taken for a short period of time and in accordance with the instructions provided by health care professionals. However, some people may want to remain cautious if they consume too much alkalizing salt and wish to take it for a long duration.

The preparation contains high sodium content per sachet - which may not suitable for patients with kidney and heart problems to take for a long duration.
High blood pressure patients may consider monitoring their blood pressure during the treatment course.
May potentially reduce the therapeutic effect of some medications. Do consult with medical practitioners if you are on long-term medications.
Some may have mild diarrhoea effects after taking the alkalizing salt.

It is also advisable that a low sodium diet should be considered while using alkalizing salt.

Are There Alternative Remedies for Gout Apart of URAL/ Clearogout Alkalizing Salt?

There are many remedies for gout relief. Some people find relief from over-the-counter medications, while others prefer natural solutions. For your convenience, here are some short and long-term remedies for references:

Short term relief

Drinking plenty of water - A person suffering from gout may experience significant swelling and inflammation. Drinking more water is one way to alleviate symptoms. Increased fluid consumption can stimulate the kidneys to release excess fluid, reducing swelling in gout patients.
Taking medications - Medications such as ibuprofen, and colchicine helps to reduce the inflammation and pain associated with gout attacks.
Using ice packs to reduce swelling - Applying a cloth-covered ice pack to the affected joint can help reduce gout-related inflammation.

Long term relief

Lose weight - One of the most important things you can do to help manage your gout is to lose weight if you are overweight or obese. Obesity is a well-known risk factor for gout, which is thought to be caused by insulin resistance and its effects on urate excretion by the kidney.
Follow a low purine diet - Avoid foods that are high in purine, such as red meat, poultry, seafood, and alcohol.
Supplements to regulate the uric acid level - There are several supplements that have been shown to be effective in reducing uric acid levels and relieving the symptoms of gout.

Conclusion - Could Uric Acid Alkalizing Salt Help Eliminate Gout Symptoms?

While more research is needed, uric acid alkalizing salt may be a good choice in providing short-term quick relief for gout symptoms. However, if you have certain medication conditions, such as high blood pressure or kidney problems, you should proceed cautiously.

There is no one-size-fits-all solution for gout treatment, but it may involve a variety of disciplinary actions. Gout management can include lifestyle changes, supplementation, and weight loss.

If you need help with your gout problem, do contact us.

Is Gout Common in Malaysia?

4 min read

Gout is one of the most common inflammatory arthritis in Malaysia.

Although there is no local population-based epidemiologic study in Malaysia. There have been studies from a few tertiary care hospitals that have revealed some information about gout cases in Malaysia.

Epidemiology of Gout in Malaysia

There are no in-depth population-based studies on gout available.

Hospital-based studies from a few tertiary centres reported a peak age of gout onset from 30 to 60 years. Patients were predominantly males with a ratio ranging from 8:1 to 12:1.

Distribution according to ethnicity was dependent on the region where the studies were conducted. Although the majority of the patients were Malays, the Chinese and Indians were also affected.

The epidemiology wise is very similar to the global data.

What is the best doctor to see for gout?

When it comes to gout, there are a few things you need to consider when choosing a doctor.

For starters, you'll want to see a rheumatologist. This type of specialist is specifically trained in diagnosing and treating conditions that affect the joints, muscles, and bones. They can help you get your gout under control and figure out what's causing it in the first place.

What can be mistaken for gout?

It's not always easy to be diagnosed with gout. These other diseases can mimic gout and lead to a misdiagnosis.

Infected joint (septic arthritis): Septic arthritis is a serious infection that can develop in any joint in the body. It is most commonly caused by an infection.
Pseudogout: The condition is often mistaken for gout, as both conditions share many of the same symptoms. It is caused by the deposition of calcium pyrophosphate dehydrate (CPP) crystals in and around the joints rather than uric acid in gout.
Rheumatoid arthritis: Rheumatoid arthritis (RA) is a type of autoimmune disease that causes pain, inflammation, and stiffness in the joints.
Psoriatic arthritis: Psoriatic arthritis is a type of arthritis that affects people who have psoriasis. About 1 in 5 people with psoriasis also develop psoriatic arthritis. People with psoriatic arthritis often experience pain and swelling in their joints.

What are the common gout medications used in Malaysia?

There are a few different medications that are commonly prescribed to treat gout in Malaysia.

Non-steroidal anti-inflammatory drugs (NSAIDs)

NSAIDs help control inflammation and pain in the affected joint. A higher dose may be prescribed by the doctor to stop an acute attack, followed by a lower daily dose to prevent future attacks. NSAIDs are recommended to use for a short period only. Eg : ibuprofen, naproxen and indomethacin.

You may want to take some precautions when taking NSAIDs if you have the below conditions:

Heartburn and stomach pain
Ulcers in the stomach
A tendency to bleed more, particularly on aspirin medication.
History of allergy to medications. Rashes, wheezing, and throat swelling is examples of allergic reactions.
Problems with the liver or kidneys. If you have kidney problems, you should not take NSAIDs without first consulting your doctor.

Colchicine

Colchicine is one of the most common medications used to treat gout. It helps to reduce inflammation and pain.

Colchicine is not meant for long-term consumption. You may need to stop taking this medication as soon as the pain is relieved or at the first sign of nausea, vomiting, stomach pain, or diarrhoea.

Corticosteroids

Corticosteroids are a common medication for gout. Corticosteroids can be taken orally or injected into the joint. Corticosteroids are typically reserved for patients who are unable to take NSAIDs or colchicine.

Because corticosteroids suppress the immune system, it increases the risk of infection. It is not recommended for long-term use as it may be associated with more serious complications.

Uric-acid-lowering medications

This medication has the potential to reduce the amount of uric acid in the blood. Allopurinol is a medication in this category that is commonly used to prevent gout attacks.

Inform your doctor if you noticed sensitive reactions such as skin rash or other allergic reactions (eg, trouble breathing or swallowing, swelling of your hands, face, or mouth).

Medications that enhance uric acid removal

Normally, this medication is used when allopurinol is not well tolerated. It enhances the kidney's ability to remove uric acid from the body. e.g. probenecid.

One may need to monitor kidney functions since it boosts the secretion of uric acid through the urine. Check with your doctor if you find it painful or difficult to urinate; or notice blood in the urine.

Alkaline Salt

This is another OTC medication (e.g. Ural effervescent salt) that is believed to neutralise blood acidity, thus reducing the risk of uric acid crystal formation.

[Can alkalizing salt like Ural/ Clarogout help to eliminate gout?]

Should I be worried if keep on having gout attack?

Why would someone keep getting gout? Should I be worried?

When you have gout, your blood contains an abnormally high level of uric acid, a substance produced by your body when it digests food. The uric acid crystallises over time and collects around joints.

Long-term consequences of gout can include joint damage, skin nodules of uric acid, kidneys and other organ injury/ damage.

Signs of Gout getting serious

Patients who have had two or more gout attacks in the last year.
Have one or more tophi (small lumps forming under the skin).
Have any gout-related joint or kidney damage?
Uric acid causes the formation of one or more kidney stones.

Uric acid normal range for Malaysian

Gender	Male	Female
Uric acid range	4.0-8.5 mg/dL or 0.24-0.51 mmol/L	2.7-7.3 mg/dL or 0.16-0.43 mmol/L

Can I stop gout permanently?

Patients can never be cured of gout. Here are some suggestions you can do to avoid recurrent gout:

Get to a healthy weight (without resorting to crash diets).
Consume a healthy, balanced diet.
- Avoid eating animal organ meat, such as kidneys or liver, as well as seafood.
- Limit your intake of sugary drinks and snacks.
- Limit your intake of fatty foods.
Stop alcohol or reduce alcohol consumption at least.
Drink plenty of fluids to avoid dehydration.
Exercise on a regular basis, but avoid strenuous exercise or putting excessive strain on joints.
Quit smoking.
Consider taking a uric acid lowering supplement.

Conclusion

Gout is a common disease in Malaysia that can be controlled through medication, supplements and lifestyle changes. If you are experiencing any symptoms of gout, it is important to see a doctor for diagnosis and treatment.