Gout is caused by the buildup of uric acid in the blood due to purines found in certain foods, including fish. Limiting high-purine foods and maintaining a healthy weight can help manage symptoms, along with medication to reduce pain and inflammation.
Gout is an arthritic condition that causes severe pain and swelling in certain joints in the body. One of the main causes of this condition is the buildup of uric acid in the blood. This buildup is the result of a compound called purines. Eating excessive amounts of foods that contain large amounts of purines is considered one of the triggers for an attack, so there is a dietary connection between fish and gout. Although diet plays a role in triggering an attack, there are other risk factors for the condition, including obesity, a family history, thyroid problems, and being a middle-aged man.
To understand the connection between fish and gout, it is necessary to understand purines and what they are. Purines are nitrogen-based organic compounds that are produced by the body and can be found in certain types of food. When the body breaks down purines, uric acid is formed, which either leaves the body during urination or is broken down by bacteria in the intestines. If it doesn’t leave the body properly, uric acid continues to build up in the bloodstream. When this occurs, it begins to form a crystalline substance, called monosodium urate (MSU), which builds up and accumulates in the joints.
Exogenous purines are the type of purines found in food. Certain types of foods contain higher amounts of purines, which is why fish and gout are often associated with each other. Eating large amounts of fish that contain excessive levels of purines can increase uric acid in the blood, triggering an attack and causing gout pain. Types of fish that are high in purines include tuna, mackerel, herring, and anchovies, as well as fish eggs or roe.
When there is a connection between fish and gout in a patient, a treatment plan that involves limiting certain types of fish is an important part of symptom management. In addition to shellfish, consumption of other high-purine foods that cause gout attacks, such as poultry, organ meat, and red meat, should not exceed 6 ounces (170 grams) per day. People with gout can also reduce attacks by losing excess weight or maintaining a healthy weight, reducing activities that are stressful on joints, and eliminating alcoholic beverages.
Although diet is an important part of managing gout and reducing attacks, medications are available to help decrease gout pain during an attack. These drugs are meant to reduce the inflammation and pain associated with the condition. Medications commonly given during this time may include prescription or over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs), corticosteroids, and colchicine.
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