Leto, like these historical figures, suffered from a debilitating form of crystal arthritis called gout. Although we associate gout with royal overindulgence from another age, gout is sharply on the rise once again. It affects some 8 million people in the United States (3.9 percent of adults), an estimated 225,000 men and 57,000 women in the UK, and its incidence has doubled in the last decade, making it one of the most common types of inflammatory arthritis.
This acute form of arthritis causes intense pain in certain joints, usually the metatarsal-phalangeal joint at the base of the big toe, but also, on occasion, wrist and finger joints as well.
Gout is a disease of middle age, affecting 15 times more men than women, and has long been linked to overconsumption of rich foods and alcohol, although alternative practitioners have found that food allergies and the use of diuretic drugs, often prescribed for heart conditions, can also trigger the disorder.
Pain and swelling occur when minute crystals form in the joint space, caused by excess uric acid in the body. The immune system attacks these crystals with phagocytes (scavenger cells) and the toxic by-products of this clash cause the joint inflammation. Patients receive their first warning signal when they experience an arthritic attack in one of their big toes or one of the other common sites, when the joint becomes tender and painful. Classic signs are redness, swelling and severe pain.
Leto, who developed gout after gaining 60 pounds for his role in the film Chapter 27, said the pain was so intense that he had to resort to a wheelchair to get around.
How to treat gout successfully
Although doctors usually prescribe painkillers and other arthritis drugs for gout, you can successfully treat it by following these guidelines.
1) Follow a low-acid diet
Avoid foods that are rich in purines (see box, page 52). In one study, substitution of a purine-free diet over a period of days reduced the blood uric acid levels of healthy men from an average of 5.0 mg/dL to 3.0 mg/dL.1
This diet can also prevent attacks of gout from recurring.
Drink six to eight glasses of water a day, which will dilute uric acid levels in the blood.
3) Munch a bowl of cherries
Consume about half a pound (225-250 g) of sweet cherries a day. The medical authorities remain dubious, but there is growing scientific evidence to support cherries' reputed anti-gout action.2,3
4) Sip celery juice
(. . . or celery seed), another folk remedy for gout that's apparently widely used in Australia.
5) Uncover any allergies
Follow an exclusion diet and suspect the big culprits in arthritis: the nightshade family (potatoes, tomatoes, eggplants, sweet peppers, paprika, cayenne pepper), plus gluten, dairy, soy, refined sugar, corn, eggs, chocolate, coffee, oranges, beef, pork and yeast.
6) Get needled
In one study, people who underwent one month of acupuncture treatment had a greater reduction of uric acid and other markers for gout than a control group. The researchers concluded that acupuncture may also help prevent kidney damage from gout.4
Supplements that may help with gout include fish oils, B vitamins (particularly folic acid), vitamin E and vitamin C.
Suggested daily dosages: Vitamin C: 1-3 g; vitamin E: 1,200-1,800 IU;
B vitamins (a balanced B-complex supplement that includes: B5: 25 mg; niacinamide: from 900 mg to 4 g a day in divided doses, but only under medical supervision as high levels can cause glucose intolerance and liver damage); B12 and folic acid: 800 mcg each; fish oils: 1,000-1,500 mg/day containing EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid), both omega-3 fatty acids.
8) See a homeopath
One study found that individually prescribed homeopathic remedies can help improve arthritis symptoms beyond the effect of conventional anti-inflammatories alone.5 For natural pain relief of gout, try the following remedies:
Benzoic acid is used to treat gout-like conditions and pain from deposits of uric acid.
Guaiacum, a remedy given for gout and joint abscesses when the pain is eased by cold.
Ledum pal (for joints that are mottled, purple and swollen) is often used for gout and rheumatism and symptoms that are made better by application of ice or cold packs. The usual dose of Ledum is three to five pellets of a 12X to 30C remedy, taken every one to four hours until the symptoms improve.
Aconite (for sudden burning pain and attacks that come after a shock or injury)
Belladonna (for intense, throbbing pain)
Bryonia (for pain that's made worse by motion, but gets better with pressure and heat)
Clochicum (especially good if there's nausea associated with the attacks)
9) Go to the devil
Although the scientific evidence is mixed about the African plant Devil's claw (Harpagophytum procumbens or H. radix, whose root is used in traditional remedies), one study showed that powdered devil's claw (containing 60 mg of harpagoside) was moderately effective in relieving osteoarthritis of the spine, hip and knee.6 Both varieties of devil's claw are also often recommended for natural pain relief of gout.
Suggested daily dosage: 750 mg with at least three percent harpagoside three times a day (or the equivalent of 0.3 oz of crude plant material) over at least two to three months.
WARNING: Devil's claw can interfere with diabetes medications, blood thinners and other prescription drugs.
The role of purines
Centuries ago, physicians had no difficulty linking gout—known as 'the disease of kings' or the 'rich man's disease' because most patients who developed it were wealthy and obese—to a high consumption of alcohol, meat, sweets and seafood.
These were things only the rich could afford to consume, let alone in excess. As it turns out, the old belief in a dietary cause for gout was spot on. High consumption of foods high in purines—chemicals the body converts to uric acid, which builds up in the blood—lead to the formation of crystals in a joint, which cause pain and inflammation.
The biggest offenders include:
organ meats, shellfish, anchovy, sardines, asparagus, and mushrooms.
What else causes gout?
Other risk factors for gout include:
- Excessive alcohol consumption, especially beer and hard liquors.
- Having hypertension, diabetes or kidney disease. If you have any of these conditions, you're more vulnerable to this form of arthritis.
- Regularly taking diuretics, low-dose aspirin (1-2 g/day) and drugs commonly prescribed to organ transplant recipients such as cyclosporine.1
- Lead poisoning, caused by the kidneys failing to excrete excess lead effectively.2