Godshaer.co.uk :: Goutless
herbs and gout
All About Gout
As early as the fourth century BC, Hippocrates (the 'father of medicine' and a professional herbal practitioner) wrote about gout as an affliction of old men and a product of high living. During the 17th to 19th centuries the links with rich living were a target for laughter, caricature and cartoons. Even the public perception of gout today is not dissimilar – yet nobody who has suffered from this extremely painful condition finds it in the least bit funny!
Gout occurs most frequently in men between the ages of 40 and 60, particularly in those who are overweight or genetically predisposed. Gout can be associated with diets that are high in protein and alcohol but this is by no means always the case. It is less often seen in pre-menopausal women, men under the age of 30, and rarely occurs in children.
Paradoxically, whilst the prevalence of gout has increased over the past two decades, public knowledge about this incredibly painful condition remains minimal. Yet, from the medical profession’s perspective, gout is a 20th century medical success story. Not only are its causes understood but attacks may be easily treated, recurrences possibly avoided and damage to joints and kidneys reduced.
Gout comes from the Latin gutta – which means ‘drop’ – with reference to the mediaeval “flowing down of humours”
What is gout?
Gout is a metabolic disorder that causes acute, intermittent and painful attacks of arthritis in the joints of the foot, knee, ankle, hand and wrist - especially the big toe. If left untreated, attacks become more frequent, more prolonged and more generalised.
• Facts and Figures
• Gout is the most common cause of inflammatory joint disease in men over 40 years old
• A joint in the big toe is the first joint affected in 70% of cases
• In most patients only one joint is affected while in about 10% of patients it affects more than one joint
• In a typical UK general practice of 2000 patients there may be 17 men and three women with gout
What causes gout?
Gout occurs as a result of excess uric acid (urate) in the blood and tissues. After prolonged supersaturation of the tissues, crystals of urate can form in and around the joints and kidneys. If uric acid crystals enter the joint, they may trigger the development of inflamation. The affected joint becomes red, swollen and extremely painful and tender. Infrequently, stones (calculi) may form in the kidneys. Most patients with gout have high levels of urate in their blood because they do not pass enough in their urine. In most cases this is caused by an inherited peculiarity of the kidneys, which is in other respects harmless. It can also be caused by high levels of uric acid in the diet or by some drugs eg. diuretics. Much less commonly, patients produce too much uric acid in the first place, owing to an inherited metabolic abnormality or disorders associated with greatly increased production of cells in the body.
What is uric acid?
Uric acid is the end product of purine nucleotide (nucleoprotein) metabolism in all cells of the body. The levels normally found in the blood and tissues are derived from both the breakdown of old cells and from the degradation of purine (nucleic acids) containing foods in normal diets.
Who is at risk?
Gout is a common joint disease affecting over five times more men than women. It is rare in children. In men, it can occur any time after puberty, whereas in women it is uncommon before the menopause. In around 10% of cases there is a family history of the disorder. People who are overweight, have high blood pressure, eat diets rich in protein and drink large quantities of alcohol have an increased risk of developing gout.
Can I prevent gout?
As gout can be triggered by environmental factors, there are some basic steps you can take to help prevent gout occurring in the first place or help prevent recurrent attacks.
Environmental trigger factors
• Prolonged stress
• Unusual physical exercise
• Surgical operations
• Severe illness
• Excess weight
• Crash dieting
• Diets containing high levels of purine (see below)
• Alcohol – especially beer and fortified wine
• Drugs – including diuretics and antibiotics which can interfere with the normal excretion of uric acid
There are several things sufferers can do to help prevent a recurrence of gout.
As uric acid is a by-product of purine metabolism a low-purine diet can be helpful. An excess of foods that are high in purine should be avoided. These include:
• meat – particularly red meat and offal, such as liver and kidneys
• seafood – especially mussels, herrings, sardines
• alcoholic beverages – including beer, lager, port and some red wines
In addition, yeast products, oatmeal, mushrooms, asparagus, spinach and some pulses - especially lentils - can all increase the level of uric acid in the body and should be eaten in moderate quantities. "Quick fix" slimming regimes, particularly crash and 'yo-yo' dieting and fasting, should be avoided. They can lead to uric acid retention by the kidney. This is due to lactic acid production and ketosis as a consequence of fasting. The solubility of uric acid decreases in acid urine, and therefore treatment with alkalis may be useful for the minority of gout patients who produce more than average amounts of uric acid. In order to decrease the tendency for stone formation a high intake of fluid (8-10 glasses of water each day) will also decrease the likelihood of crystals being deposited in the kidneys as calculi. There are other aspects of the diet which may require more detailed discussion with a health professional.
How do I know if I have gout?
Few things are as painful as a severe attack of gout. Gout is usually diagnosed on the basis of its distinctive symptoms and an examination of the joint. An acute attack of gout often develops during the night or early hours of the morning and reaches a peak within a few hours so that, with an affected foot, it is impossible to tolerate even the touch of bed clothes. The skin may be red and shiny and the inflammation may be so severe that the skin may peel. A mild fever, a loss of appetite and a feeling of tiredness can also accompany acute attacks of gout. An untreated attack generally lasts for a few days, then dies down and the joint gradually returns to normal. Throughout this time take regular doses of the GoutLess Herbal Tonic.
Will my doctor do any tests?
Usually not until the acute attack has subsided, after which a blood test may help to clarify the diagnosis. High levels of uric acid are usually found in patients with gout. However, the level is sometimes normal during an acute attack and the majority of people with raised blood uric acid levels do not develop gout. A more specific test that may be performed is the analysis of the fluid in the affected joint. Fluid from the joint space is aspirated (removed through a needle and syringe) and examined under a special type of microscope. The presence of needle-like, uric acid crystals confirms the diagnosis of gout. However, this approach may not be practical if the joint is a small one. Gout patients have greater than average risk of developing vascular problems such as heart attacks and strokes. Therefore when someone develops gout, this should be taken as an opportunity to look at other aspects of his or her health - such as blood pressure, obesity, cholesterol and sugar levels - all of which can be associated with increased risks of vascular disorders. There are excellent herbal alternatives to help with these associated conditions; click here for blood pressure, high cholesterol, obesity, high sugar levels, vascular disorders.
How is gout treated?
The goals of treatment are threefold: The first step is to reduce the pain and inflammation of the acute attack. The second is to reduce the likelihood of future attacks by lifestyle modification and the third is to lower urate levels and so prevent the development of the complications such as joint damage and kidney disease.
Step one – treatment of the acute attack
During the actual attack, the most important thing to do is relieve pain by controlling the inflammation and immobilising the joint. Currently conventional medication include non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, diclofenac or indomethacin are used as first-line therapy. NSAIDs with a short half-life, such as indomethacin and ibuprofen are most popular because of their rapid onset of action - although their use should be avoided in patients with a history of peptic ulceration, gastric haemorrhage and renal insufficiency. There are very useful anti-inflammatory herbal medicines that can be used instead or alongside a reduced dose of the NSAIDs. There herbs are found in strength in the GoutLess Herbal Tonic.
The risk of gastric haemorrhage may therefore be reduced by the use of some of the newer NSAIDs such as coxibs. Colchicine therapy was formerly the treatment of choice and still has a part to play where NSAIDs are contraindicated. However, it frequently causes gastrointestinal side effects (diarrhoea) and has to be used carefully. If only one or two joints are affected and patients have multiple medical problems or are unable to take oral medications, a corticosteroid suspension may be injected through a needle into the joint space in order to reduce inflammation. But we recommend you go on a high dose of the herbal medicine GoutLess Tonic first.
Step two – reducing the likelihood of recurrences by lifestyle modification
Once the attack has passed, the next step is to help prevent recurrences by addressing trigger factors that can be modified. Patients are advised to lose weight if they are obese, to reduce alcohol consumption (especially beer) and to eat smaller amounts of purine-rich food. The herbal medicine WeightLess Tonic has been found to be a great help in losing weight slowly and consistently, about WeightLess click here. To lose weight more quickly get on the ABCLemon Detox Diet, for more info, click here.
Step three – lowering uric acid levels
This is best done with a natural diet - low in uric acid, low purine, low fat, and no alcohol. In general the diet should consist of 75% raw foods, with the greatest portion of these being non-starchy vegetables. Vegetables to include in large quantities are celery, carrots, alfalfa sprouts, kale, cabbage, parsely, and any other green leafy vegetable (but not spinach) fruits especially useful are bing cherries, bananas, and strawberries (and no rhubarb or sour plums).
Foods to cut out: anchovies, meats, heart, herring, kidney, liver, mackerel, mussels, porridge oats, roe, sardines, scallops, sweetbreads, yeast, spices, organ meats.
Moderate intake of: bran, fish, fowl, shellfish, shellfish, asparagus, cauliflower, beans, lentils, mushrooms, peas, whole wheat.
Low purine foods: rice, millet, green veg, nuts, goat's milk and yoghurt, low-fat cheese, eggs, cornbread, sea veg, sprouts like alfalfa, lentils and sunflower, fruit.
Fluids: high intake is essential, including fresh veg and fruit juices from your juicing machine especially celery, carrot, kale, cabbage, apple, grapes, strawberry.
It is highly recommended you continue with a long-term intake of the ABC Daily NutriPowder Plus.
In most patients who have repeated attacks, long-term drug treatment aimed to lower the level of uric acid in the blood is required. This can only be started when the acute attack has settled. This treatment is then continued. The drugs that are used include:
• Allopurinol is the drug that is prescribed to reduce production of uric acid in the body. This is especially helpful to people who have abnormally high uric acid levels and kidney stones or damage, but it must be used with extreme caution in patients with kidney failure. Godshaer Herbalist has a herbal medicine, GoutLess Tonic, that contains the most important herbs, including burdock, celery seed and white bryony, that have been found to help with the symptoms and help clear uric acid build up combined with the diet mentioned above.
• Uricosuric drugs, such as probenecid, which lowers urate levels in the blood by increasing the excretion of uric acid in the urine. They may not be effective in patients with kidney failure.
• It is important not to start treatment with uric acid lowering drugs until the acute attack has been settled for at least a week. As there is an increased likelihood of developing further acute attacks of gout immediately after the initiation of treatment with allopurinol or uricosuric drugs, small doses of colchicine or NSAIDs are frequently prescribed along with the uric acid lowering drug for at least three months to prevent recurring attacks. Long term low-dose use of GoutLess Herbal Tonic has been found to be very helpful to preventing attacks.
Does gout recur?
Some people never experience another attack. If the uric acid level remains high most may have a second attack between six months and two years after the first. Subsequently, attacks become frequent and more prolonged and may result in joint damage if the uric acid level is not controlled. It may be necessary to take GoutLess Herbal Tonic on a long-term low-dose basis. Also take a potassium broth at least once a week, see below.
With thanks to the UK Gout Society
The UK Gout Society raises awareness about the challenges of living with gout. It also provides educational materials for people with gout and their families. For further information on the work of the Society, and information on gout, please contact:
PO Box 527, London, WC1V 7YP or email us at: email@example.com. UK Registered Charity Number 1093748
Thanks for sending my latest order so promptly, I thought I’d take a few moments out to tell you about my experiences with your Goutless product.
My initial meeting with you was something of an accident, during a weekend away in Christchurch my partner and I wandered along Ducking Stool Lane and read the information sheets on your practice window. Having suffered from Gout with varying degrees of severity for the best part of twenty years and having tried what seems to have been every medication in my GP’s arsenal with little success (He had just doubled the dosage of a drug I’d been taking for a long time, this particular drug was known to be a cause of high blood pressure) I thought “what the hell give it a go”. After a pleasant chat with you about the severity and frequency of my gout you recommended Goutless. At that time I must own up to being a bit sceptical about the whole thing and chose to buy the smallest bottle you supplied, after all if my GP couldn’t fix it how could a mixture of strange sounding plants help. How wrong can you be?
It sounds rather trite to say that coming into your practice was a life changing moment but that’s exactly what it has proved to be, I have now been free from gout for over a year and all I have to do is take a small quantity of the mixture morning and evening with a glass of water and that’s it, if I feel the beginning of an attack I simply increase the dosage from twice a day to three times a day. I no longer suffer the extreme pain of a gout episode, I’m not losing time from work and I have it from my partner that I’m far less grumpy than before.
In closing I’d like to thank you for your expertise, your excellent service and above all making yourself available to give advice during what I’m sure are very busy days.
Please feel free to use this letter as a recommendation to all your products and not just Goutless. Should any of your clients want a “from the horses mouth recommendation” than I’d be most happy to speak to them.
Alan, once again many thanks.
This is excellent for helping to improve the symptoms of gout and arthritis, and used as a preventative.
Take thickish outer peelings of potatoes (include the skin), fresh parsley, unpeeled carrots, beet greens, onions, garlic, and any other organically grown green vegetables. Prepare the broth by washing and chopping the vegetables and then simmering in a large covered pot of water for 40minutes. Strain and drink the soup, discarding the vegetables. Store the excess in glass containers in the refrigerator for up to 2 days.
Specific Herbs for Gout
Herbs have been used to eliminate uric acid since the time of Hippocrates the father of (herbal) medicine. We can supply an effective herbal medicine to help with the symptoms and causes of gout and to help prevent future attacks (taken long term on a low dose), GoutLess Tonic. To order click here
To make a donation to Godshaer Herbalist via PayPal click here
Our herbal tonic medicines are carefully prepared on a personal and individual basis for your healing by medical herbalist Alan Hopking MA MNIMH MRCHM FINEH.
Only whole herbs are used in our herbal medicines. Nothing else is added. If you have symptoms which you consider might be helped with herbal medicine please contact herbal practitioner Alan Hopking for a friendly confidential professional consultation. Telphone using our freephone 0500 90 96 97.
Once you have received your herbal prescription you can contact Alan Hopking at any time for more free advice (preferably by email). When you have completed your bottle of herbal medicine and if you want a repeat prescription you are requested to phone or email so that your progress can be assessed and adjustments made if necessary so that there is no break in your treatment. To order or re-order, click here.
General advice to consumers on the use of herbal remedies from the Medicines
Healthcare products Regulatory Agency
From the website of the Medicines Healthcare products Regulatory Agency (www.mhra.gov.uk) Department of Health, UK
• Remember that herbal remedies
are medicines. As with any other medicine they are likely to have an effect on the body and should be used with care.
• Herbal remedies may sometimes interact with other medicines. This makes it particularly important to tell your doctor or pharmacist if you are taking a herbal remedy with other medicines such as prescribed medicines (those provided through your doctor or dentist).
• Treat with caution any suggestion that a herbal remedy is '100% safe' or is 'safe because it is natural'. Many plants, trees, fungi and algae can be poisonous to humans. It is worth remembering that many pharmaceuticals have been developed or derived from these sources because of the powerful compounds they contain. Any medicine, including herbal remedies, which have an effect on the body should be used with care.
• Treat with caution any herbalist or other person who supplies herbal remedies if they are unwilling or unable to provide written information, in English, listing the ingredients of the herbal remedy they are providing.
• If you are due to have a surgical operation you should always remember to tell your doctor about any herbal remedy that you are taking.
• Anyone who has previously experienced any liver complaint, or any other serious health complaint is advised not to take any herbal remedy without speaking to their doctor first.
Few conventional medicines have been established as safe to take during pregnancy and it is generally recognised that no medicine should be taken unless the benefit to the mother outweighs any possible risk to the foetus. This rule should also be applied to herbal medicinal products. However, herbal products are often promoted to the public as being “natural” and completely “safe” alternatives to conventional medicines. Some herbal ingredients that specifically should be avoided or used with caution during pregnancy. As with conventional medicines, no herbal products should be taken during pregnancy unless the benefit outweighs the potential risk.
Many herbs are traditionally reputed to be abortifacient and for some this reputation can be attributed to their volatile oil component.(6) A number of volatile oils are irritant to the genito-urinary tract if ingested and may induce uterine contractions. Herbs that contain irritant volatile oils include ground ivy, juniper, parsley, pennyroyal, sage, tansy and yarrow. Some of these oils contain the terpenoid constituent, thujone, which is known to be abortifacient. Pennyroyal oil also contains the hepatotoxic terpenoid constituent, pulegone. A case of liver failure in a woman who ingested pennyroyal oil as an abortifacient has been documented.
A stimulant or spasmolytic action on uterine muscle has been documented for some herbal ingredients including blue cohosh, burdock, fenugreek, golden seal, hawthorn, jamaica dogwood, motherwort, nettle, raspberry, and vervain. Herbal Teas Increased awareness of the harmful effects associated with excessive tea and coffee consumption has prompted many individuals to switch to herbal teas. Whilst some herbal teas may offer pleasant alternatives to tea and coffee, some contain pharmacologically active herbal ingredients, which may have unpredictable effects depending on the quantity of tea consumed and strength of the brew. Some herbal teas contain laxative herbal ingredients such as senna, frangula, and cascara. In general stimulant laxative preparations are not recommended during pregnancy and the use of unstandardised laxative preparations is particularly unsuitable. A case of hepatotoxicity in a newborn baby has been documented in which the mother consumed a herbal tea during pregnancy as an expectorant. Following analysis the herbal tea was reported to contain pyrrolizidine alkaloids which are known to be hepatotoxic.
A drug substance taken by a breast-feeding mother presents a hazard if it is transferred to the breast milk in pharmacologically or toxicologically significant amounts. Limited information is available regarding the safety of conventional medicines taken during breast-feeding. Much less information exists for herbal ingredients, and generally the use of herbal remedies is not recommended during lactation.
Herbal remedies have traditionally been used to treat both adults and children. Herbal remedies may offer a milder alternative to some conventional medicines, although the suitability of a herbal remedy needs to be considered with respect to quality, safety and efficacy. Herbal remedies should be used with caution in children and medical advice should be sought if in doubt. Chamomile is a popular remedy used to treat teething pains in babies. However, chamomile is known to contain allergenic sesquiterpene lactones and should therefore be used with caution. The administration of herbal teas to children needs to be considered carefully and professional advice may be needed.
The need for patients to discontinue herbal medicinal products prior to surgery has recently been proposed. The authors considered eight commonly used herbal medicinal products (echinacea, ephedra, garlic, ginkgo, ginseng, kava, St John’s Wort, valerian). On the evidence available they concluded that the potential existed for direct pharmacological effects, pharmacodynamic interactions and pharmacokinetic interactions. The need for physicians to have a clear understanding of the herbal medicinal products being used by patients and to take a detailed history was highlighted. The American Society of Anaesthesiologists (ASA) has advised patients to tell their doctor if they are taking herbal products before surgery and has reported that a number of anaesthesiologists have reported significant changes in heart rate or blood pressure in some patients who have been taking herbal medicinal products including St John’s Wort, ginkgo and ginseng. MCA is currently investigating a serious adverse reaction associated with the use of ginkgo prior to surgery. In this case, the patient who was undergoing hip replacement experienced uncontrolled bleeding thought to be related to the use of ginkgo.
From the website of the Medicines Healthcare products Regulatory Agency (www.mhra.gov.uk) Department of Health, UK
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Alan N Hopking MA MNIMH MRCHM
Advanced Botanical Centre of Medicine
5 Station Road
+44 (0) 1425 839280
Freephone UK 0500 909697
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Disclaimer and pledgeAs a professional herbal practitioner I am in practice in conformity with the laws of England and the 1968 Medicines Act. The UK legislative provisions for herbal medicine are to be found in the Medicines Act 1968, Section 12, paragraphs 1 & 2, and Section 56, paragraphs 1 & 2. Section 12:1 specifies exemption for herbal medicines from licensing provided that they are supplied subsequent to private personal consultation. Section 12:2 exempts herbal medicines provided that they are produced according to standard traditional, non-industrial methods. It also specifies that no written claims may be made for the use of the remedy. Therefore at HERBACTIVE no claims about any medical condition regarding the herbal medicines prescribed by Alan Hopking are made. Indeed, be it a doctor, surgeon or herbal practitioner, the successful outcome of our treatments cannot with any certainty be predicted, let alone guaranteed. Further, following UK and EU law, the information on this web site attach no medical claims and no claims concerning the medicinal herbs mentioned relating to any medical conditions listed. All the herbal prescriptions are unlicensed and made by Alan N. Hopking at the address of HERBACTIVE for patients of Alan N. Hopking. I pledge that, I shall do all I can, using my knowledge of herbal medicines and natural treatment, to help you regain your deserved health.
Alan Hopking MA MNIMH MRCHM All our herbal medicines are made from the raw herb at our dedicated clinic and dispensary at HERBACTIVE Botanicals. We collect the fresh herbs, or import the dry herb. They are organic if at all possible. We only use whole herbs. We are against the use of standardized extracts, or the concentration of herbs by adding more of the active constituent. We recommend you do not use such products in any form (dry, in capsules or as tincture extracts). To use our herbal tonics you should follow the prescribed dose. Any side effects or problems should be reported to us.