Why the Big Toe?
Almost every type of food contains purines in varying amounts. The human body breaks purines down into uric acid, which is carried through the bloodstream. The kidneys filter some of it out, but if they can't adequately remove this toxin from the body, then the blood becomes saturated with uric acid. Then at lower temperatures the uric acid precipitates, and crystallizes around joints. That explains why most people experience their first gout attack in the middle of the night, at their big toe. The uric acid crystallizes where the body is the coldest (at the feet), at the time when the body has a low overall temperature due to slower circulation (while sleeping), at a location where crystals can become trapped and grow (the joint of the big toe).
What causes the intense pain?
Uric acid crystals often grow undetected for months or even years. Then one day a trigger food is eaten. Usually, that means a food or drink is consumed that causes a higher-than-usual rate of crystal formation. At this point, the body is alerted to the uric acid "intruder" which it sees as an infection. This autoimmune defense mechanism is what causes the pain of gout. As the body continues to wage a full-scale war on itself during the gout attack, the pain continues to intensify.
Over the next several days, the attack continues. During this time, however, proteins begin to cover the uric acid crystals. Once the crystals are adequately hidden from the immune system, the body's immune response subsides and the gout attack ends. However, the crystals are still present and contain the potential for a repeat attack when the next trigger hits.
Even when the body is not experiencing an attack, uric acid crystals are doing irreparable damage to joints. Therefore, it is important to stop the building of crystals and begin the process of removing them. There is only one way to do this: Lower the blood uric acid level. Below the uric acid solubility point of 6.8 mg/dL, crystals will once again dissolve into the bloodstream. From there, the kidneys can filter out the uric acid and allow it to pass from the body through urine.
Some foods can raise your uric acid level more than others, but not necessarily the ones with more purines. It turns out that the type of food also matters.
Research shows that higher purine contents do not always translate into higher uric acid levels or more gout attacks. Some foods contribute to the long-term buildup of uric acid crystals, while others increase the likelihood of an immediate attack... Read More →
Chicken vs Hamburger