Understanding Gout and How to Prevent It (with transcript)
Spiro Koulouris is a leading gout diet expert, author, and blogger. He’s dedicated his life to inspiring people to obtain a healthy lifestyle and living a gout-free life.
Spiro has battled with the disease for years and has dedicated himself to become educated and informed on the subject. He has become an expert in the different home remedies, medicines, health practices and experiments from around the world. As the founder of GoutandYou.com Spiro is intent on educating the gout sufferer in hopes of beating this terrible disease for good.
Frank: Welcome to Boomers Today. I'm your host, Frank Samson. Of course, each week we bring you important, useful information on issues facing baby boomers, their parents and loved ones. And we just want to really thank everybody for all their support.
We have another wonderful guest today. We have with us Spiro Koulouris, who is a leading gout diet expert, author, and blogger. He's dedicated his life to inspiring people to obtain a healthy lifestyle and living a gout-free life. Spiro has battled with the disease for years and has dedicated himself to become educated and informed on the subject. He has become an expert in the different home remedies, medicines, health practices, and experiments from around the world. As the founder of goutandyou.com, Spiro is intent on educating the gout sufferer in hopes of beating this terrible disease for good. Spiro, thank you so much for joining us on boomers today. I really appreciate it.
Spiro: Glad to be here, Frank.
Frank: I think that this is very important stuff, and something that doesn’t get talked about enough. It affects a lot of people in their 50s and 60s. And I know it had a horrible effect, I remember, on my father. I just think there's just not enough education on it, so I really appreciate you coming on. But let's talk about what gout is. Maybe explain that first, what gout is and who it does affect.
Spiro: Gout is an arthritic condition that affects about 2% of the general population, but I would say it affects about 10% of those folks that are 50, 60 years old and older. As you age, your chances of getting gout increases. It's basically an excess of uric acid in the blood that accumulates you have when you eat foods. There's a chemical compounds called purines. Every seed has purine. It's just meet, process foods. Seafood has more purines than, let's say, vegetables. And as your body and your kidneys and liver breakdown those purines, it produces uric acid.
Now uric acid is usually flushed by the urine, but if your kidneys are not working properly then they won’t be flushing efficiently, then your excess uric acid remains in the body. Then it crystallizes in the joints, usually in the big toe. It could be in the knee, elbow, hands for some, and then you get a gout attack. That's what basically it is. It falls under the arthritic family. It is the most common form of arthritis today.
Frank: It's interesting, a form of arthritis. Is there a way, obviously through blood work, I would think, is there a way to know it's coming, and we see it happening?
Spiro: Yes. If you're doing regular blood work, I would recommend once a year. Your doctor can notice if there's an unusual trend in your uric acid levels going higher and higher over time, and you can prevent it and take preventions. But for most people, it just comes out of the blue. Usually, you'll get a gout attack out of nowhere in the middle of the night. Then you'll go to the doctor, they'll ask you to do blood work, and then they'll see that the uric acid level is too high and diagnose you with gout. That's how it happened with me when I visited my doctor. I was in there, thinking I busted my ankle or something, or I stubbed my big toe. And then he told me, "No, it's probably gout for sure."
I was 26 at the time. I didn't want to believe it, but then the blood work came back and then he pointed out that my uric acid levels were too high. And I was diagnosed with gout, which was a shocker for me because a young person is not supposed to get gout. But in my personal health situation, I have a small, tiny condition. Thalassemia minor, I was born with it, which is a minor blood disorder. It's not serious in my case, but that could be the root cause of me getting gout at a young, early age.
Gout usually affects people who are obese, or who drink a lot and eat a lot of meat. So usually, bad dieting and alcohol are the culprits. Offensive seafoods that could trigger gout are usually seafood, red meat, pork, processed meats like sausages, cold cuts and alcohol. A lot of people that drink a lot of alcohol will eventually get gout later in life. That's pretty much it when it comes to the foods. Those are the most offensive foods I would say.
Frank: You were 26 years old when this happened. So obviously you felt strong enough about it to really dedicate yourself to helping to educate people on gout. You must have felt pretty strong about that.
Spiro: Yeah, I was searching online for information and I couldn't find good patient stories or a good community where gout sufferers could share information. Most of the sites are mostly Mayo clinic or Cleveland Clinic or medical websites, so I decided to blog about it and do my own research. And as I looked at studies, medical studies and research, I basically published my opinions on it, so goutandyou.com.
Basically, goutandyou.com is a site where you could find plenty of tips, what foods. I break it down to what foods to eat, what foods to avoid and other lifestyle topics surrounding gout to live a healthier life and control uric acid. Because at the end of the day, diet is very important for gout sufferers. You will be treated with medication for most. Mostly, you'll be treated with medication. But at the end of the day, you still want to control your diets because if you do not, if you continue your bad eating habits, the doctor will only increase the dosage of allopurinol or colchicine over time, which are the two main drugs to control uric acid levels in the blood.
Frank: Got it. We're going to talk about the proper diet for this in just a moment, but I know that there's a lot of perceptions of gout, and you hear the term rich man's disease. How did gout get that term? I know you talked about drinking alcohol and rich foods. I assume it's related to that, but you could expound upon that. And is it really a fallacy that it only happens to people that just do that? Let's talk about that a little bit.
Spiro: Well, rich man's disease, the story with that is it goes back to the Kings and Queens of England and France in the 16 and 1700s. Back then, the only folks that had access to rich foods, like lots of great red wine, lots of meat and rich desserts were the kings and queens or the aristocrats. That's how King Henry and other kings developed gout, if you check that out. Whereas the peasants, they will live in the farms and they wouldn't be able to afford the meets and the red wines, and all the alcohols and desserts. They would eat off the land.
And what is off the land? It's basically vegetables, fruits, whole grains. So they would eat a diet in high complex carbohydrates, whereas the kings and queens would eat a diet high in meets and protein and alcohol. That's where that comes from. That's where that story comes from, and they coined the term, the rich man's disease.
Frank: It’s really not a fallacy though? It makes sense what you just explained.
Spiro: No, it's not a fallacy. And that's why I advocate in my website for gout sufferers to switch their diet to one that's high in complex carbohydrates. I recommend at least 80% of your daily calories be complex carbohydrates like fresh vegetables, legumes, 100% whole grain breads, 100% whole grain pasta, 100% whole grain rice. Avoid the refined carbs. Eat beans for protein.
10% can be fat, as animal fat like eggs, low fat milk, Greek yogurt, butter, and so on. And the final 10% can be protein. I do allow, if you want to have meat, you enjoy meet, go ahead. I would say avoid the meats, definitely 100% avoid pork, avoid sausages, the processed meats. Stick to healthy chicken breasts, lean beef. If you want to have a steak once in a while, make it lean, not high in fat. Make sure you trim the fat. Turkey and fresh fish. I would stick with those meats for protein basically, and avoid the rest when it comes to protein.
That's a big offender when it comes to gout because it takes about 90 hours for your body to break down and process meat, whereas vegetables that's processed very clean in your body and comes out rather easily. So basically, that's what I advocate on goutandyou.com is 80% complex carbohydrates diet, but only 10% fats and 10% protein.
Frank: Would you recommend this diet to people who are in their 50s and 60s, even if they don’t have gout?
Spiro: I would recommend this diet as well because I've had folks write back to me, tell me they went to the doctor's office. They did their blood work and their cholesterol levels went down. Their sugar levels went down. Thank you very much for this diet. I know it works and it follows very closely actually to the classic Mediterranean diet.
Frank: What is it? What happens? How does it affect your day to day life, et cetera?
Spiro: Well, a gout attack usually comes in the night because that's when your extremities in your body are the coldest. It usually strikes then, so while you're sleeping. So even a bed sheet over your foot, that pressure, you won't be able to tolerate it. That's how painful it is. Your big toe usually becomes very warm, reddish and basically throbbing. And you can't walk. You have to limp around basically. And usually, it lasts for, I would say anywhere between a few days. If you get treated quickly enough with colchicine, up to a couple of weeks for most, but sometimes it can go even longer for others if it's really a big attack.
It's very painful, you can't get around. You're basically stuck at home. If your job is basically manual labor and you need to walk around, you won't be able to go in that day.
Frank: It sounds painful. I understand why you wouldn’t want to get it. Okay, moving on. I mentioned your website, but why don't you share with anybody any other contact information you wanted to share if you want, or just the website, and what people could learn on your website or any services that you provide.
Spiro: Well, basically my website is goutandyou.com. If you suffer from gout or you know anybody who suffers from gout, it's a great resource to learn how to work with the condition and see what foods you could eat, which foods to avoid. We dive into mostly dietary information, but there's also lifestyle information and medical information as well.
I answer all the emails, so if anybody wants to email me with questions, I will respond within 24 hours. So firstname.lastname@example.org. We're live on all social media channels, so Facebook, Twitter, YouTube, Pinterest, Instagram, you name it. It's all at Gout and You, which is our handle for all the social media channels.
Frank: Got it, got it. Let's say somebody does end up with gout. What are some of the treatments, medications? What options do people have?
Spiro: This is what is going to happen. If you visit your doctor during a gout attack, just look up and you are feeling that pain in some joint, you will visit your doctor. They will probably treat the inflammation with colchicine. It is a drug you take on a daily basis until the pain and inflammation subsides. Or they will treat it with NSAIDs, which are corticosteroids. Basically, it could be through a needle injection on the effected joint to lessen the pain and get rid of the pain and inflammation.
After that, after the pain and inflammation subsides, even a bit before that, they will decide if they're going to put you on allopurinol, which is the main drug to lower uric acid levels over the long term. And usually for most gout sufferers, it is a drug you have to take for life. They will determine a dosage. The most popular dosage is about 300 milligrams daily for most gout suffers, and you take that for the rest of your life. It's a rather safe drug. There's very little consequences or any symptoms.
Frank: You say that they make have to take the medication for life. Is it common for gout to come back to those that had suffered from it?
Spiro: Yeah, if you do not treat it. That is another issue in the gout community. Most gout sufferers, from all the conditions like diabetics, heart disease and so on, this community does not like to take their drugs because they will not feel symptomatic after they clear it for the first time. Then after a few months, they might say, "You know what, I'm stopping this allopurinol. I do not believe I'll get another gout attack again. I'll just go back to my old ways." And boom, after a year later they get another gout attack. Sometimes even more severe, and then they're back in the saddle again.
For those that don't take their drug, I recommend at least you do regular blood work with your doctor and make sure your uric acid levels are below six milligram DL. If not, you're going to get another gout. It's just a matter of time.
Frank: Did you experience another one?
Spiro: Yeah. At the beginning I was stubborn and I did not want to take the drug. Then I got a few gout attacks. And after that I realized yeah, this is for life. This is a tough pill to swallow. And ever since, I haven't had any other gout attacks.
Frank: Well, why is there such, I don't know, you say the word or the name gout and there's just this negative perception out there?
Frank: People, they don't want to talk about it. Why do you think that is?
Spiro: It's an embarrassment. Some people are embarrassed by it because when you hear gout, most people associate it with you being careless and lazy about your health. But at the end of the day, anybody can get it. The Western diet is mostly high protein, high sugar intake. That's another culprit, sugar. It raises uric acid levels, especially high fructose corn syrup, which is found in Coca-Cola, processed foods and so on nowadays. Unfortunately it's unfair, but that's the stigma attached to it.
Frank: You could have been an expert on dementia and I said, "What's the best diet for people to have to decrease their chances of that?" I bet they would have probably discussed a very similar diet as you just went over. I think that it's a good way to live.
Spiro: Yeah, exactly.
Frank: How has your life changed as it relates to your lifestyle, exercises, et cetera? What are you doing differently? And what do you recommend to people doing differently than maybe they were before? Just general lifestyle exercise and such.
Spiro: In the beginning, it's baby steps. You're not going to change overnight. Changing your eating habits has to be a gradual process because your body won't adapt if you change immediately, and then you're going to get the cravings, and then you're just going to go back to your old ways.
And then you'll realize as you change your eating habits slowly, slowly you're replacing your meat, maybe with beans. You'll have a bean burrito instead of a beef burrito. You'll notice your taste buds will change. You'll enjoy your food more. I know it tastes better. Eating healthier you'll feel better. You'll lose the weight. Your uric acid will come into control more. That's what I suggest is baby steps. Take it one step at a time.
And then if you really like your burger and beer, have it once in a blue moon. On a Saturday night if you want to go to a restaurant, celebrate somebody's birthday, order that burger, have that beer and you'll be flying over all. As long as the majority of the time you're eating well, you could have your so-called chief meal once in a blue moon if you're a gout sufferer.
Frank: What about on the exercise front? How does that help?
Spiro: Exercise, it's very important. The more you exercise, you strengthen the joints. I recommend going to the gym, doing some weight training if you're young. But if you're older, like 65 and older, you don't have access to gym, at least walk as much as you can. Try and get anywhere between 6,000 and 10,000 steps a day. That's going to help strengthen the joints, the heart rate. Uric acid levels would be controlled with exercise as well. It's very important.
Other than that, you can do yoga, which is great for strengthening the joints as well. And if you don't have time, I also recommend a seven minute workout, which is on my website on goutandyou.com. There's a few exercises you can do in the house with your body basically, and build some strength in your legs, arms and back, and so on. But exercise has to be part of your gout lifestyle for sure.
Frank: Got it, got it. Tell us, we've got just another minute or two left, maybe give us an overview of the types of information that people could find on your website that are available to them.
Spiro: There's plenty on goutandyou.com. There's plenty of articles on what foods to eat. If you follow us on Twitter and Facebook, I publish all the latest studies that come out about gout. And then you'll get a wealth of information there from the doctors and the researchers that study the disease. That's pretty much it.
We also sell dietary supplements for those that want to supplement their gout diet. We have NutriGout, which is very popular. It consists of six key ingredients: milk thistles, celery seed, chanca piedra, bromelain, dandelion extract and tumeric root. These ingredients work synergistically to flush out excess uric acid, keep your kidney levels healthy. It's not a medication. You do take it to supplement your gout diet and it cleanses your organs, basically, where uric acid is produced, to keep them healthier and more stable.
We also have a popular cream for pain relief if you get a gout attack that you apply on the effected joint. That has great reviews. We sell all that on amazon.com where we're the primary brand for gout patients on Amazon, and on our website, at goutandyou.com as well. And some other products like tart cherry extract, AlkaHydra, which is alkaline water, oral calcium, apple cider vinegar, which helps with digestion, and so on.
Frank: Great. Spiro, thank you so much for joining us on Boomers Today. A wealth of information. Thank you so much.
Spiro: Thank you, Frank, and I hope I offered some value to your listeners.
Frank: Oh, you absolutely did. I learned a lot. Thank you.
Spiro: Thank you.
Frank: And I want to thank everybody out there for joining us as well on Boomers Today. Please be safe out there and we'll talk to you all soon.