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Gout and MTHFR Link

Gout is an inflammatory condition either from excess uric acid build up in your blood, or from the reduced ability to clear uric acid from your blood. On pathology results, we often see an elevated Uric Acid level in the blood, that may then crystallise and lodge in our joints, with the base of big toes being the most common location. Crystallisation doesn't always occur, but if it does, the condition is known as Gout, and the crystals are of monosodium urate (MSU) origin, and should not be confused with oxalate crystals.

Normally, uric acid is excreted in our urine, and poop, but excess uric acid can be caused by diet and lifestyle factors such as a heavy red meat, cured meat or shellfish diet, and excess alcohol consumption. Genetic factors discussed below can also be involved in the predisposition for gout, but can be effectively managed to reduce the likelihood of it occurring.

Infographic showing where gout impacts and dietary and lifestyle interventions that can help.
Symptoms and Treatment of Gout

Risk factors for Gout

  • Being overweight

  • Metabolic Syndrome

  • Eating red meats, shellfish, organ meats, cured meats (these foods are high in purines which are the nitrogenous bases found in DNA that are also found in meat as it was a live animal with its own DNA)

  • Excess alcohol consumption (especially beer) which depletes folate necessary for methylation discussed below

  • High blood pressure

  • Diabetes

  • Heart disease potentially related to elevated homocysteine levels from low Vitamin B12 and folate intake

  • Poor kidney function

  • Certain medications (low-dose aspirin on a regular basis, diuretics)

  • Recent surgery, or trauma (where uric acid released from cells)

  • Gut dysbiosis, SIBO and an imbalanced digestive status can contribute to problems in the breakdown of uric acid

  • Thyroid hormone problems can be associated with elevated uric acid levels (Cell Danger Response)

Gout and MTHFR Link

Why can some people have elevated uric acid levels in their blood, but not go on to form Gout? The possibility that the progression from increased uric acid levels to gout flares (uric acid crystallisation with episodes of acute, intense pain), is thought that it may be related to our genetics, where there is a strong familial history of gout. As always, even if you have a genetic link to gout, you can control the likelihood of getting it via dietary and lifestyle changes.

Your ability to methylate via the MTHFR gene may be compromised in people with MTHFR C677T gene variant. One of MTHFR gene's jobs is DNA methylation that regulates inflammation that can occur from cytokine production (which can be induced when our immune cells see elevated uric acid in our blood). This leads to oxidative stress. Poor DNA methyaltion, can mean poor inflammation regulation, and resultant oxidative stress, can contribute to gout flares.

Methylation is speculated to be 'the link' between genes predisposing people to gout, and their dietary and lifestyle factors.

Studies have shown that taking methyl-folate can help as folate inactivates Xanthine oxidoreductase (XOR) which is the enzyme responsible for the conversion of hypoxanthine to xanthine to uric acid.

Knowing your MTHFR gene status can be informative to understanding your predisposition to Gout, and how to control it.

Symptoms of Gout

  • Intense pain in joints that flares suddenly at night

  • Swollen, stiff and hot joints

  • Pain that lasts days or weeks

Complications of Gout

  • Destruction of joints

  • Kidney stones - that cause intense, pain, inability to pas urine, and potential infection

  • Damage to kidneys

  • Damage to nerves

  • Secondary infections

What you can do to avoid Gout

Treating gout is aimed at reducing painful flare-ups by addressing nutrient deficiencies, gut dysbiosis, SIBO, and lowering uric acid levels in blood. This is done by:

  • Address underlying causes through good nutrition and lifestyle changes

  • Reducing purine foods (shellfish, red meat, organ meats, yeast)

  • Eating an anti-inflammatory diet rich in Omega-3 (including wild caught salmon, nuts and seeds), citrus fruits (containing citric acid to make the urine more alkaline), celery, sour cherries.

  • Eliminating alcohol as alcohol dehydrates and reduces the ability to excrete uric acid Keeping hydrated with water to prevent crystal formation

  • Supplementation with the correct form folate may assist in people with MTHFR C677T gene variant. It is best to see a practitioner for guidance on this.

Foods shown in a wheel and their impacts on the body as 'anti-gouty' actions
Recommended food for 'anti-gouty' mechanism

If you would like to discuss reasons behind why you may have developed gout, or to discuss or test your MTHFR status, then please don't hesitate to book in for a consultation.

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