New medication for gout

Q. I've had gout for many years. I used to take Zyloprim without any problems, but I just had a severe allergic reaction, so my doctor switched me to Benemid. I'm doing okay, but the drug sometimes upsets my stomach. Do you have any suggestions?

A. As you may know, gout is a common problem that results from excess amounts of uric acid, a breakdown product of a group of chemicals (purines) found in all body tissues and many foods. Normally, the body rids itself of excess uric acid by excreting it in the urine. But many men have an inherited metabolic glitch that prevents their kidneys from excreting uric acid as they should. Other men simply make too much of the pesky chemical. Either way, blood levels rise — and after a period of time, excess uric acid may be deposited in joints, causing intense pain and inflammation. Uric acid can also formkidney stones, and it sometimes builds up in large, even grotesque, tissue deposits called tophi.

The probenecid (Benemid) you're now taking promotes urinary excretion of uric acid, which lowers blood levels and protects the joints, but the extra uric acid in the urine can increase the risk of kidney stones. That's one reason allopurinol (Zyloprim) became the standard drug for preventing gout. It inhibits xanthine oxidase, the enzyme that converts purines into uric acid. As a result, blood uric acid levels fall. The drug is very effective, but allergic reactions are fairly common.

In 2009, the FDA approved febuxostat (Uloric) for the prevention of gout. Like allopurinol, febuxostat inhibits xanthine oxidase, reducing uric acid production. The drug is new, but it appears as effective as allopurinol, though it's much more expensive.

Although it's too bad you had a drug reaction, your timing was pretty good since febuxostat is the first new drug for gout in 40 years. Even though it targets the same enzyme as allopurinol, the two medications are structurally unrelated, so people who are allergic to one should be able to take the other. And for people who have missed the boat and have developed chronic tophi due to untreated gout, another new drug is on the horizon. Pegloticase (Krystexxa) breaks down uric acid, dissolving longstanding deposits, but it has not yet been approved by the FDA.

— Harvey B. Simon, M.D.
Editor, Harvard Men's Health Watch

5 Affordable and Proven Home Remedies For Gout

Because of the pain that you experience from gout, you would want to know if there is anything that could help manage or relieve the pain brought about by gout. Some of these home remedies for gout could just be lying around in your kitchen cabinet or could be in your backyard for years. Let us check and learn.

1) Water 

Water is considered to be the most affordable and a widely available remedy for gout. When excess uric acid is not flushed from the body, it will be accumulated in the joints which would form uric acid crystals and eventually would start the inflammation and pain.  Water flushes the excess uric acid and prevents it from building up in the joints or other organs in the body. An intake of at least 8-10 glasses a day would be good to keep yourself hydrated.

2) High fiber food

A high fiber diet is good to have when you have gout as it also helps broom out or flush out the uric acid out of your body.  Fruits and vegetables are fiber rich foods that are also good sources of antioxidants as well as Vitamin C which will help boost your immune system for your overall wellness.

Fruits like cherries and berries are considered to be an effective remedy for gout. It lowers the level of uric acid in the blood. They have a compound called Anthocyanin which may possess analgesic properties and anti-in?ammatory effect that could help relieve gout.

3) Potassium supplements

Potassium supplements are good for gout, but should be taken moderately and monitored medically to avoid heart problems. Potassium is a good urine alkalizer which aids in the flushing of excess uric acid in the kidney out of the body. Good sources of potassium in people with gout are bananas and potatoes, especially sweet potatoes.

4) Add baking soda on your fluids

Baking soda is a well-known alkalizing agent. Mixing ½ teaspoon of baking soda in 8oz of water will help lower uric acid level and reduce the pain caused by gout. The baking soda mixture is taken four times a day. But take note that baking soda can raise blood pressure.  You might want to refer to your doctor before starting this home remedy. 

5) Low impact exercise

 

Low impact exercises should be done by people with gout. They are easy and wouldn’t strain the joints that can add up to the sometimes-unbearable pain. Tai chi, yoga and a bit of brisk walking can be helpful. These exercises would not just reduce and maintain an ideal body weight but they also promote blood and oxygen circulation and keep a healthy immune system. 

There might be other home remedies for gout that are not mentioned here, but these are so far the most common, effective and proven. Moreover, they are readily available, doable and affordable. All you have to do is learn and practice living that much needed lifestyle. And if it’s not too much of a burden, try to change some of your old habits. Some of them may actually be causing your unwanted chronic pain.

3 Groups Of Foods To Avoid With Gout

There are foods to avoid with gout and there are foods that are good for those who suffer gout. If you’re one of those who are in constant search on what food to avoid gout attacks, then pay particular attention to these 3 key food elements that are commonly seen in one’s dining table.

1. Meats that are rich in purine

          

Purines are substances found naturally in almost every cell of a body. Foods high in protein such as kidney, yeast, sardines are also high in purines. But why should you limit foods that are high in purine?  

When cells get recycled, it breaks down the purine along with it. And when purines are entirely broken down, uric acid is formed. Though uric acids are good for our body as they are good antioxidants, high levels of such could be detrimental. When your kidney could hardly keep up in getting rid of them, it could eventually result to gathering of uric acid in different parts of the body. That’s when the problems occur. Too much cell breakdown can also lead to building up of uric acid. When uric acid starts to build up, uric acid crystals would start to form which can directly hit the joints, kidneys, and other organs. The build-up is simply referred to as “gout”. In some cases, inflammation of joints such as the big toe, fingers, elbows and the like can be experienced. That’s primarily the reason why you should limit the intake of foods high in purine.

Meats rich in purine that need to be avoided are:  Lobster, Shellfish, Crab, Oysters, Tuna, Codfish, Carp, Ham, Bacon, Beef, Chicken, Duck, Goose, Lamb, Turkey and animal internal organs (brain, intestines, kidney, liver, and the lungs). 

2. Alcoholic beverages

There are a couple of reasons why alcohol consumption can lead to gout.

1) Alcohol is rich in purine. Beer approximately contains 100mg uric acid/100g and less.

2) Alcohol slows down the removal of excess uric acid from the body which could build up and form uric acid crystals in the joints or in the kidney.

3. Foods with high fructose

Fructose or fruit sugar found in many plants is a simple form of sugar that cannot be further broken down to simpler sugar through hydrolysis. It goes through the bloodstream directly during digestion.

In a research made from observing more than 50,000 health specialists, there was an increase of chances of having gout from an increase consumption of fructose in their diet. It was observed that two cans of sodas a day have almost doubled the risk of gout, just like two glasses or cups of fruit juice. Fructose most probably gives people a greater risk of having gout than that of alcohol.

There may be a degree of difficulty in avoiding or minimizing the consumption of the diet you are used to having, but following what is advised especially on your diet will be of great help in combating the condition called gout. Complications brought about by gout are something you wouldn’t want to have. Since the beverages and foods to avoid are accessible by men (and women) with gout online or offline, the best thing one with gout can do to reduce the chances of its recurrence and gout’s further complications is to avoid or take them very moderately.

Which fruit is a must in any gout sufferer’s diet

How cherries have proven to lower uric acid for gout sufferers

I love cherries, it is one of my favorite fruits, I can have an entire bowl of them and I usually have to control my portions cause sometimes I can’t seem to stop and not because I have gout; but for my passionate desire and deep love of cherries! Thank God they are actually good for us gout sufferers! So what is so special about this fruit? Cherry nutritional facts and health benefits point to the fact that the cherry is very high in vitamins both C and A. All cherries contain Vitamin C and fiber. Studies show that consistent intake of Vitamin C can help reduce uric acid levels by up to 50 percent, and control inflammation of gout-ravaged joints, which is a primary cause of severe gout pain. The cherry is also a very low calorie fruit, only 63 calories for 100g, pigment rich food that have powerful anti-oxidant properties and anti-inflammatory agents helping reduce heart disease risk. In addition, cherries help the human body to fight against cancers, aging, jet lag and neurological diseases and can even calm down the nervous system which helps relieve neurosis, insomnia, headache conditions even depression. Furthermore, they don’t only help us gout sufferers but can help people with fibromyalgia, a painful muscle condition and sports injuries.

What is the correlation between cherries and gout?

Now to the evidence that it helps us gout sufferers, the first study on cherries for gout appeared in medical literature in 1950 (Texas Reports on Biology and Medicine). A study published in 2003 in the Journal of Nutrition found that among 10 healthy women eating two servings of Bing cherries, uric acid fell by 15%.  A Journal of Nutrition study from 2006 found that 18 healthy adults who ate 280 grams of Bing cherries each day for a month had a significant reduction in blood levels of substances associated with inflammation and immune cell activity. A Journal Arthritis & Rheumatism study of 633 patients with confirmed gout and followed for 1 year, found that patients with gout who consumed cherries (1/2 cup serving or the equivalent of 10-12 cherries) or cherry based extract for 2 days were less likely of a subsequent gout attack by 35%. Those patients who ate more cherries, up to three servings in two days, had an even lower, 50 percent reduction in risk. Even more, the risk for gout attacks was decreased by nearly 75% when cherry intake was combined with allopurinol use.

How does a gout sufferer consume cherries?

Eating cherries in their many forms and varieties, like canned, frozen, raw, cooked, tart, pill, sweet and black are thought of been beneficial to treat gout. Consuming dried cherries, fresh or juiced are all good. Eating about 25 cherries are ten times stronger than aspirin and other ordinary pain-relievers. But if you get a gout attack or flare up, how many cherries should you eat? Some suggest that 30 to 40 every 4 hours is advisable during a gout attack and the same amount daily for prevention reasons; or simply eat minimum a cup of fresh or dried cherries after each meal, which is very effective for the pain treatment. About 20 cherries equal 25 milligrams of anthocyanins, the daily dose that should be taken, either in juice or eating the fruit for preventative measures. You can even drink a cup of cherry juice, black cherry juice or tart cherry juice twice a day or 2 tablespoons of concentrated cherry powder with one cup of water. You can easily find cherry juice in your local health food store or online. It might seem strange that cherries would lower your risk of gout, as this condition is often associated with sugar, fructose and fruit juice consumption. But you only need to eat a small amount of cherries to get the benefit, meaning the sugar contribution is small. 10 sweet cherries or 1 cup of sour cherries contain about 4 grams of fructose, 25 cherries would put you at 10 grams of fructose. Berries, apples, pineapple, oranges, bananas and grapes have way more sugar per 100g than cherries. You would need to eat more than 60 cherries to put you over the limit where the fructose of the cherry might start affecting you negatively and produce higher uric acid levels. I think eating 12 to 25 cherries daily is ideal. Limiting fructose/sugar in your diet is one of the most important parts of managing and preventing gout attacks. If you have gout, it’s imperative to restrict your fructose/sugar intake to below 25 grams a day, including from fruit, as fructose/sugar drives up uric acid levels in your body. Remember treatments vary according to different people; you should adjust the dose accordingly. For example, regular cherry concentrate is very sweet and thick. One tablespoon equals to about 45 to 60 cherries. On a side note, whenever looking for cherry-based products it would be better if made of tart cherries, because they are the ones more effective among all other cherries to fight arthritis, working better in the prevention and treatment of this painful condition, by reducing the levels of uric acid and breaking up the crystals that are responsible for the joint pain. Generally, tart cherries have been found to have higher concentrations of phenolics and anthocyanins than sweet cherries. Tart cherries are also slightly lower in sugar.

There you have it folks, make sure to add the cherry in your daily diet in whatever form and/or method you prefer, it is a must for the gout sufferer. Until next time!

Find out gout’s favorite vitamin

Fight gout with this popular vitamin

The connection between gout and Vitamin C has been the subject of a few studies over the past 30 years. You may have read in the news about a recent New Zealand study about Vitamin C and gout. The study claims that taking vitamin C supplements daily doesn’t lower uric acid levels as much as drugs do. This is a study that only evaluated 40 people for about 8 weeks! Is this study supposed to debunk the other 20 year study of nearly 47,000 men (done between 1986 and 2006) taking vitamin C supplements which showed to decrease uric acid levels and ease inflammation of gout sufferers? Hmm…I wonder if Big Pharma had anything to do with this study getting so much publicity? Gotta push that Colchicine and Allopurinol, we got the quarterly report coming up and we must boost sales and profit!

In the same study from the Boston University School of Medicine, 1317 men, developed gout during this 20 year period. The study found that those who took 1,000mg to 1,499mg per day had a 34% lower risk of gout and those who took 1,500mg per day had a 45% lower risk. Note that this was irrespective of other gout risk factors such as diet and alcohol use.

The lowdown on the latest vitamin C study and gout.

Going back to our original study that came out a couple months ago, the researchers split 2 groups of 20 people with gout, the first group was already taking allopurinol and the second group were not. The first group was told to either increase their dose of the medicine or also take 500 milligrams of vitamin C supplements every day. The second group who were not already taking medication were either started on allopurinol or told to take a 500mg vitamin C supplement every day. At the beginning of the 8 week study, the of uric acid levels in the patients’ blood was 9 mg per decilitre on average. The researchers said a healthy uric acid level falls below 6.5 mg per decilitre. In both cases, patients who started taking vitamin C, with or without allopurinol, did not see a significant decrease in uric acid levels. There was, however, a significant decrease in the uric acid levels of the patients who started on allopurinol, about 3 mg per decilitre and in those who were on the drug but increased their doses, about 1.6 milligrams per decilitre decrease, the study claimed. At the end the researchers concluded that vitamin C had no effect but this was quickly dismissed by Dr. Tim Bongartz, a rheumatologist from the Mayo Clinic in Rochester, Minnesota, who basically said that it’s difficult to make any firm conclusions from the new study, because it would take about 200 participants in each group to see a difference. He also added that even if the study could reproduce the results of past studies of people without gout, it probably wouldn’t bring people’s uric acid levels below the threshold of 6.5 milligrams per decilitre and it doesn’t mean medication is the only answer. Dr. Bongartz went on to say that there are other measures that can help gout sufferers drop their uric acid levels and the most important one being for obese individuals to lose weight. At the end fellow gout sufferer, it is you that must discern, properly breaking down the evidence and make your own decision on what to believe is fact or fiction from the information provided here. Don’t take my word for any of the information and recommendations provided by myself on this website, do your own homework and make your own conclusions from the information you process.

What are the benefits of vitamin C?

Now let’s take a closer look at vitamin C, it has many health benefits which include boosting your immune system, helps us detoxify, protects against cardiovascular disease, helps with good bacteria in the gut, eye disease, removes heavy metals from our bodies and many other benefits. Try to include it in your diet from fresh raw foods like oranges, cantaloupe, broccoli, red peppers, chili peppers, rose hips, parsley, kiwi fruit but make sure all of that stuff is organic! I personally take a supplement of vitamin C daily of 500mg and have been for years now, I buy the big bottle from Costco’s brand Kirkland, lasts me for 500 days! Remember vitamin C is an essential nutrient for humans and certain other animal species. Remember, that vitamins and drugs operate in 2 different ways in order to reduce uric acid levels. Drugs like allopurinol restricts its’ supply by inhibiting purine breakdown into uric acid and vitamins like vitamin C improve uric acid’s excretion in the urine. Improving excretion may be more important for you than lowering production.

I’m not saying Vitamin C is a cure-all for gout but when combined with other vitamins for gout, a low purine diet and the other natural remedies for gout described elsewhere on this website, it could be very useful, my fellow gout sufferer. If you do take vitamin C, make sure to drink plenty of water and check your urine pH regularly to avoid excess acidity or you can take an Ester-C version of Vitamin C, because it is non-acidic.

Which foods to avoid if you have gout

When I was diagnosed with gout, I remember researching on the net about it and coming across this keyword that kept popping up article after article, this word was “purines”. When reading or hearing this word, my brain has this strange association with Purina Cat Chow even to this day! So what is this “purines”, what does it consist of and why must gout sufferers cut down on it, if they want to lower their uric acid levels.

A great article explains this natural substance very well:

“Purines are natural substances found in all of the body’s cells, and in virtually all foods. The reason for their widespread occurrence is simple: purines provide part of the chemical structure of our genes and the genes of plants and animals. A relatively small number of foods, however, contain concentrated amounts of purines. For the most part, these high-purine foods are also high-protein foods, and they include organ meats like kidney, fish like mackerel, herring, sardines and mussels, and also yeast.”

It then goes on to explain how purines are metabolized into uric acid:

“When cells die and get recycled, the purines in their genetic material also get broken down. Uric acid is the chemical formed when purines have been broken down completely. It’s normal and healthy for uric acid to be formed in the body from breakdown of purines. In our blood, for example, uric acid serves as an antioxidant and helps prevent damage to our blood vessel linings, so a continual supply of uric acid is important for protecting our blood vessels.

Uric acid levels in the blood and other parts of the body can become too high, however, under a variety of circumstances. Since our kidneys are responsible for helping keep blood levels of uric acid balanced, kidney problems can lead to excessive accumulation of uric acid in various parts of the body. Excessive breakdown of cells can also cause uric acid build-up. When uric acid accumulates, uric acid crystals (called monosodium urate crystals) can become deposited in our tendons, joints, kidneys, and other organs.”

A low purine diet is beneficial for us gout sufferers:

“Because uric acid is formed from the breakdown of purines, low-purine diets are often used to help treat conditions like gout in which excessive uric acid is deposited in the tissues of the body. The average daily diet for an adult in the U.S. contains approximately 600-1,000 milligrams of purines.

Recent research by Choi and others has shown that the impact of plant purines on gout risk is very different from the impact of animal purines, and that within the animal food family, purines from meat and fish act very differently than purines from dairy. Choi’s work has demonstrated that purines from meat and fish clearly increase our risk of gout, while purines from vegetables fail to change our risk. Dairy foods (which can contain purines) actually appear to lower our risk of gout. In summary, this epidemiological research (on tens of thousands of men and women) makes it clear that all purine-containing foods are not the same, and that plant purines are far safer than meat and fish purines in terms of gout risk.”

These are the foods to avoid that contain the highest purine levels (up to 1000mg per 3.5 ounce serving):

• Mincemeat (cut down on those burgers!)
• Anchovies
• Brains, Kidneys, Liver, Animal hearts (my advice is not too even touch organ meats)
• Gravies
• Sardines
• Sweetbreads
• Yeasty foods
• Mackerel
• Mussels
• Herring
• Beer and other alcoholic beverages

These foods are to be limited since they contain moderately high purine levels (5-100mg per 3.5 ounce serving):

• Asparagus
• Beef
• Chicken
• Chicken soup
• Lobster
• Lima Beans, Navy beans, Kidney beans, lentils & peas
• Mushrooms
• Pork
• Oatmeal
• Tuna
• Turkey
• Shellfish
• Bacon
• Rabbit
• Veal
• Oysters
• Cauliflower
• Duck
• Goose
• Ham
• Lamb
• Snapper, Trout & Halibut fish
• Perch
• Spinach

So what do you notice from these foods that are high in purines? What they all have in common is that most of the foods are very high in protein, mainly meat and fish. So limit your meat intake mostly cause fish is healthier for you since it is considered the best source of protein and has very little fat, consisting of 3-5% of its calories as fat, whereas meat has 70-75% of its calories as fat. When we eat too much protein, its metabolism produces ammonia, urea and other waste products, that take seven to eight times more water to flush out through the kidneys than carbohydrates. The more meat you eat, the more stress you cause to your kidneys in trying to filter out the waste. As a gout sufferer, I strongly recommend a high carbohydrate diet rich in fruits and vegetables composing 80% carbs, 10% protein  and 10% fat.

As a side-note, when it comes to the moderately high-purine vegetables like asparagus, beans or spinach, there is no reason for you to avoid them in raw form, provided you keep your portion sizes down. That’s the key with the meats and fish on the list, is to keep the portions small, we all heard the general rule for meat portion sizes should be  the size of the palm of your hand.  I personally use to buy rib steaks cause it obviously had more flavor from the marbled fat that juiced it while cooking it but now I mostly choose leaner red meats with less marbling, while they are harder to chew and taste more rubbery, they have less fat and are metabolized easier by your kidneys, lowering your risk of increasing your uric acid levels. But more than that, a high protein meat based diet has proven that it will kill you earlier. We will be examining that in a future post.

Finally here are low purine foods:

• Peanuts, walnuts, almonds
• Peanut & almond butter
• Milk, cheese & ice cream
• Whole wheat bread
• Pasta
• Rice
• Apples, bananas, pineapple, grapes, strawberries, pumpkin
• Lettuce, romaine
• Coffee and tea
• Chocolate
• Eggs
• Non-green veggies

Which foods are beneficial for gout sufferers?

One of the best fruits to eat when suffering from gout is cherries. Research has shown that consuming about 250 grams of cherries each day lessens or eliminates gout attacks by reducing blood uric acid levels. Drinking cherry juice is just as beneficial to gout sufferers as eating cherries. If you find it hard to drink so many glasses of water each day, substitute cherry juice for 2 or 3 glasses of water instead.

Dark berries may contain chemicals that lower uric acid and reduce inflammation. All berries that are dark red or blue contain flavonoids and anthocyanidins, beneficial antioxidants that enhance the collagen content of tendons and cartilages surrounding affected joints.

Tofu which is made from soybeans may be a better choice than meats. I like to cook it with basmati rice which is lower on the Glycemic Index and add various vegetables like broccoli, carrots, dried tomatoes etc…

Fatty acids found in certain fish such as salmon, flax or olive oil, or nuts  possess some anti-inflammatory benefits. The famous Omega 3 and 6 fatty acids that are soooo good for us…I use olive oil every day and my doctor has personally told me when doing my blood tests couple of years back, that he has never seen HDL cholesterol so high in years in any of his patients which can protect you from a heart attack and/or cardiovascular disease including arterial plaque buildup.

In conclusion,  a low purine diet is key to maintaining low uric acid levels for all gout sufferers. Purines are found in all protein foods and it is not recommended that all purines should be eliminated from your diet. Cut back on purines to control recurring gout attacks and if you notice that you get an attack after eating a certain type of food, experiment by cutting it completely from your diet, talk to your doctor about it too, to see if you might be allergic to that food.

Treating gout with apple cider vinegar

In this post I’ll be discussing a home remedy that I have been using for a few years now and a internet favourite remedy on health forums and websites, used as a cure-all to treat anything from diabetes, weight loss, blood pressure, acne, dandruff and of course gout. I’ll be discussing the age oldApple Cider Vinegar which has been used for at least 10 000 years to treat many different ailments and having been used as a condiment and preservative, utilized also for flavouring and healing purposes, deodorant, healing tonic and a preserver of youth. Christopher Columbus had barrels of apple cider vinegar on his ships to prevent scurvy and it was also used in the American Civil War to disinfect and heal wounds. All in all you can see that apple cider vinegar has many uses and you as a gout sufferer should include it in your diet.

Apple Cider Vinegar otherwise also known as cider vinegar or AVC, is a type of vinegar made from cider or apple must and has a pale to medium amber color. ACV is used in salad dressings, marinades, vinaigrettes, food preservatives, and chutneys, among other things. It is made by crushing apples and squeezing out the liquid. Bacteria and Yeast are added to the liquid to start the alcoholic fermentation process, and the sugars are turned into alcohol. In a second fermentation process, the alcohol is converted into vinegar by acetic acid-forming bacteria (acetobacter). Acetic acid and malic acid give vinegar its sour taste.

 Apple cider vinegar is full of nutrients like potassium, which helps remove toxins and excess water, iron, calcium and amino acids that reduce toxin buildup and serve as antibiotics. The main ingredient thought to be the most effective in treating and preventing gout is acetic acid. What happens is acetic acid is turned alkaline inside the body forming a pH balanced environment that prevents gout whereas having a pH balance that’s acidic can cause gout but shifting your pH balance toward alkaline can cure you of gout and prevent it from coming back. Do note that no research has been done to verify these claims.

Drinking apple cider vinegar breaks up the uric acid crystals and prevents them from reforming in the joints by aiding blood circulation and purification. It reduces inflammation and swelling in the joints allowing for better flexibility of the joints. AVC contains higher amounts of malic acid which explains the fact that consuming AVC in appropriate quantities is more beneficial to you than eating an apple directly. Many people have experienced relief from gout symptoms a few hours after using apple cider vinegar, while others have reported relief after a few days.

How to gout sufferers use apple cider vinegar?

For a full therapeutic effect one must take 2-3 tablespoons, 2 to 3 times a day. If you can manage to take it straight up with no dilution or sweetening, then go for it but if you do need to make your gout concoction taste better, mix it in a glass of water. You can also add a teaspoon of raw honey (not recommended for diabetics) and mix the AVC with your water or why not use some cherry juice with it for that double punch! Don’t forget to dress your salad with it too!

What type of AVC do I buy?

Make sure the AVC you buy at the store is organic and non-pasteurized, non-fermented making sure that it has not been processed and heated while still containing the nutrients, minerals and enzymes required to combat your gout symptoms. The clear AVC which you see at the supermarket and is cheaper than the organic-raw type has been heated and distilled removing many of the health benefits of apple cider vinegar. The raw type contains what we call “mother of vinegar”, which is a strand-like structure of living bacteria that is found in AVC and don’t forget to check the acetic acid content on the bottle. In addition, make sure not to use AVC as a substitute for other treatments or without a doctor’s consent and if you are allergic to apples this obviously won’t work for you.

As a topical treatment, when dealing with a gout attack, you can soak your foot for about 30 minutes in a bucket full of 4 cups of hot water and 1 cup of apple cider vinegar. You can also soak a clean, dry cloth in apple cider vinegar and wrap it around the affected area for about 15 minutes.

Apple cider vinegar can be very effective in relieving gout symptoms for many people. But not everybody will experience the same level of relief with ACV. I personally have used it for many years; I take it daily without fail. Apart from gout, I also use to have a problem with my oesophagus, with very bad heartburn. Since consuming AVC, I haven’t suffered from heartburn since. I strongly recommend this super-food in your daily diet.