Medical Question : Gout

[Dazzler]

Can tomatoes trigger or aggravate gout, and are there any remedies that work for gout ?

[andy hughes]

Gout is caused by the excess production of uric acid, which crystalises and rubs against the bones - usually in the big toes. The old wives' tale says it's caused by eating rich food and drinking port, which is nonsense - I am teetotal and eat a normal diet, and suffer occasionally. Different foods start the condition in different people - with me it's sausages (!) but tomatoes could well have the same effect. Drinking plenty of water helps to flush the acid out of your system, and if it persists, your GP will be able to prescribe medication that will produce the same effect. My sympathies - it is very painful, and everyone trotting out the "port / rich food" nonsense doesn't help.

[rekstout]

I know tomatoes can aggravate arthritis - could this be mistaken for gout?

Perhaps a low-protein diet would help as well as it should reduce the amount of uric acid produced.

[number8]

Gout was the bane of my life: My first bout was at 26, and i didn't get another flare up until two years ago at 32, and since then have been getting it about four times a year. I was prescribed endomethacin for the flare ups, which is very very effective: however, I wanted treatment to avoid getting it in the first place. As a result, i was referred to a rheumatologist (correct spelling?), and after urine and blood tests, I am now on allupurinol, which suppresses the uric acid development, and therefore the theory is that I will never get it again (fingers crossed). My diet is fine, I don't drink to excess, I exercise a lot and I drink shed loads of water, so in theory, I shouldn't've got it at all: I got it becuase I inherited a defective enzyme from my father (along with a big nose - thanks dad). Whenever I've told my rugby team I couldn't play becuase of it, I was greeted with howls of laughter, but unless you've had it, people have no idea how damn painful it is. Foods to avoid are red meats, offal, shellfish (was a big problem for me as I could happily live on shellfish) and other foods that are high in purines (marmite and baked beans for instance). The remedy that I've heard helps the most is celery.

[Kit]

No, tomatoes are not responsible for gout. The most common form of gout is caused by the body's inability to deal with purines - these are metabolised into uric acid, which is insoluble, and allopurinol is the enzyme that breaks uric acid down into soluble urea, which is then washed out through the kidneys. Tomatoes are very low in purines (see http://www.jr2.ox.ac.uk/bandolier/booth/gout/purfood.html for a useful table on purines in food.) Rekstout's answer is the most likely - although it's arthritis SYMPTOMS and not arthritis itself that are made worse by certain foods, so if you react to food it will be painful but not damaging. Good news if you like tomatoes but your joints don't. As to what works - it depends very much on the type of gout, it's actually an umbrella term for a lot of different conditions which all involve uric acid deposition. Take professional advice, as the wrong drug at the wrong time can make symptoms worse - eg in some cases taking allopurinol in the middle of an acute flare-up isn't good, you have to settle it down with anti-inflammatories (eg indomethacin) first.

[apricot]

Cherries in any form, glace, dried, fresh or frozen all will help gout.