Gout (Hyperuricemia): Therapy

General measures

Gout attack: cooling, immobilization, and elevation of the extremity; administration of an analgesic/pain reliever (e.g., indomethacin).
Nicotine restriction (refrain from tobacco use).
Limited alcohol consumption (men: max. 25 g alcohol per day; women: max. 12 g alcohol per day) or, if necessary, abstain from alcohol. A daily alcohol consumption of 100 g leads to a significant increase in uric acid in the blood. Beer has a high content of easily absorbed purines. Non-alcoholic beer contains as many purines, whereas wine contains no purines.
Aim for normal weight!Determination of BMI (body mass index, body mass index) or body composition by means of electrical impedance analysis and participation in a medically supervised weight loss program.Weight reduction lowers the risk of developing gout. Weight reduction should be done slowly (no crash diets!).
Review of permanent medication due topossible effect on the existing disease:
- Avoidance of medications that lead to uric acid elevation (e.g., acetylsalicylic acid, ciclosporin (cyclosporin A), diuretics (loop diuretics, thiazide diuretics); for others, see below Hyperuricemia/Causes/Medications).
Avoidance of environmental stress:
- Beryllium
- Lead

The following vaccinations are advised, as infection can often lead to worsening of the present disease:

Nutritional counseling based on nutritional analysis
Adapted diet and lifestyle improvement can reduce uric acid levels by up to 18%!
Observance of the following specific nutritional medical recommendations:
- Low purine diet – prefer vegetarian sources of protein; avoid meat, offal, shellfish.
- The daily amount of drinking should be at least 2 liters, so that the kidney has an adequate supply of fluid for uric acid excretion. It should not be forgotten that the urine is alkalized, which leads to an increase in uric acid excretion. The morning urine pH should be at least 7.
- Diet rich in fruits (but not with too much fructose) and vegetables – this contributes to the alkalinization of urine, in addition to the general health value.
- Avoidance of:
  - Sugar substitutes sorbitol, xylitol and fructose in high doses.
  - Drinks containing fructose lead to an increase in uric acid serum levels in circa 5% of patients
  - High fat diet
  - Fasting
Urinary alkalinization (transferring the pH of urine from the acidic to a more alkaline range)! (Dietary supplements with, for example, magnesium, potassium and / or calcium citrate).
See also under “Therapy with micronutrients (vital substances)” – if necessary, taking a suitable dietary supplement.
Detailed information on nutritional medicine you will receive from us.

Endurance training (cardio training) and strength training (muscle training).
Preparation of a fitness or training plan with appropriate sports disciplines based on a medical check (health check or athlete check).
Detailed information on sports medicine you will receive from us.

Because of poor adherence to therapy in gout patients, comprehensive patient information is as important as drug therapy!The patient should be informed about the causes and course of hyperuricemia/gout, lifestyle modification measures (see above), and need for regular medication.