Gout Disease: The Definitive Guide

This is the ultimate guide to eliminating gout disease.

And let me be clear about something:

This is NOT a lame “Gout” post written by someone who has not experience a gout attack before.

Instead, you’re going to see tested home remedies for gout pain that are working…

So if you’re looking to the road of gout recovery, you’ll love this guide.

Let’s dive right in.

gout disease the definitive guide



What is Gout ?


Pay Attention to Gout Symptoms


How to Reduce Gout Pain That Actually Works

chapter-how-to- identify-the-forbidden-food

How to Identify The Forbidden Foods That Cause Gout ?

chapter-how-to- enjoy-good-food-when-you-have-gout-before

How to Enjoy Good Food After Your Gout Attack

chapter-my favourite-ph- levels-test-tips

My Favorite pH Levels Test Tips

Chapter 1
What is Gout?

In this chapter, I’ll cover the basics.

First, you’ll learn exactly what a gout is.

I’ll also explain to look at the positive side and why gout  disease is a great signal on the condition of your health.

What is Gout? 

Gout is an inflammation caused by a buildup of uric acid crystals in the joints.

This high level of uric acid in the blood is triggered by the purines released in the food you eat. 

Interesting fact:

  • Men has higher uric acid in the blood than women. That explains why gout disease is more common in males than in females — 8 in 10 (81%) people with gout are males. (Source)
  • Most men are stricken with their first gout attack between the ages of 30 to 60. Most women are affected only after reaching menopause. (See Reference #1)

Gout 'Speaks' about Your Health Condition

Like I mentioned, gout is basically triggered by the food you eat. Each high purine food tells your digestive system:

“This food contains high purine content, and let’s make more uric acid.”

Because gout disease is related to uric acid, it is helpful to understand how uric acid works.

Most of the time uric acid dissolves and goes into the urine via our kidneys.

However, if your body is producing too much uric acid (high chance your kidney is not capable to remove any more uric acid), it builds up.

high uric acid

When the high uric acid becomes supersaturated, crystals begin to form, like ice crystals that form in freezing water.

These crystals can form anywhere in the body and fill the gap between the bones of the joints. Common areas include big toe, ankle, knee or fingers.

gout attack body areas

Now, let’s say you don’t treat your first gout attack. Or worse, you continue to eat like there’s no tomorrow.

What will happen?

What Happens If Gout is Not Treated

If gout disease isn’t treated over long periods of time, the affected joint bone may start to erode and weaken. 

Also, the sharp needle-like crystals can form harden lumps under the skin around the joint. 

They don’t hurt, but they can affect the way the joint looks.

In fact, the lump may look scary to the faint-hearted. By then, it’s more difficult to remove them naturally. 

And if the crystals accumulate in your urinary tract, they can form kidney stones.

Moreover, the high uric acid continues to find other joints in your body and produce more crystals again. During this stage (advance gout), you can expect more frequent and painful gout attacks. To the extent that the pain continues even between attacks. 

Get The Right Mindset First

Let’s get the mindset right first.

Like the saying goes, in the midst of every crisis, lies great opportunities.

Yes, gout is very painful. It's like having a hammer that keeps hitting your affected joint continuously. You probably can't function well and has no mood to do anything. Correct?

If you look at this crisis positively, this is the best time to improve your health.

Treat gout disease as a fire alarm.

When you don’t take care of your own health, gout attacks haunt you on unexpected days.

It’s embarrassing especially when you got a very important occasion. On the contrary, gout will not show up if you put in a little more effort on your health. 

As a result of your discipline, the rest of the other health-related issues like obesity, bloatedness are taken care of too.

Once you’re agreeable to renew your mindset on this, let’s find out the gout symptoms.

Chapter 2
Pay Attention to Gout Symptoms

If you’re unsure if you’ve gout disease, you come to the right place.

In this chapter, I’ll show you how to identify the gout symptoms.

You’ll also get to see the 4 stages of a gout attack.

So that you know how to handle the treatment of gout to prevent new flares.

Identify The Gout Pain Level

How is gout pain like ?

The symptoms of gout almost always occur suddenly, and often at night. They include:

Slight Pain

You feel slight pain when you try to move the affected body part.

For example, if it’s your big gout toe, you’ll feel slight pain even just resting on the ball of your foot. 


The affected joint or joints become a bit swollen, tender, warm and red.

You may still be able to walk, or even run at this phase.

Intense Joint Pain

You cannot stand or walk or sleep now. There's sudden and severe pain in the joint.

Also, the pain is increasing, and it comes like waves rhythm. (low pain turns to medium and high pain, and back to low pain).

This attack happens usually in the middle of the night or early morning.

The pain is likely to be most severe within the first 6 to 12 hours after it begins. 

In severe attacks, you may even experience fever and chills. 


The pain continues even when you’re not moving the gout area.

You’ll probably scream in pain when someone gently touches the affected stiff area.

Lingering Discomfort

The severe pain should gradually subside within a week.

You may still experience some joint discomfort and may not be able to move your joints normally.

What's next after you’ve endured the severe pain?

Now, it’s the time for you to take massive action to prevent such gout attacks again.


Later attacks are likely to last longer and affect more joints.

The Four Stages of Gout

Gout disease occurs in four stages.

The good news is... 

If you take care of your body well, not all cases progress to the final stage. 

Identify the stage you are in right now.

Over a period of years, gout attacks become more frequent and painful. Eventually, the pain continues even between attacks. 

Stage 1: Asymptomatic Hyperuricemia

Don't be fooled by this BIG word. 

Asymptomatic hyperuricemia refers to having high levels of uric acid in your body, WITHOUT experiencing any symptoms. 

Gout disease may only develop in people who have asymptomatic hyperuricemia for years or even decades. 

About 20% of people with this condition go on to develop gout. (See Reference #1)

Stage 2: Acute Attacks

An acute gout attack occurs when your body fluids can no longer sustain the high uric acid concentration. 

What happens next?

Urate crystals begin to form. These crystal can form anywhere in the body with synovial fluid. 

These synovial fluid is the liquid that fills the gap between the bones of the joints. For example, toe, ankle, knee or fingers. 

Why do you feel such extreme pain when such crystals are formed?

Here's what goes on in your body: 

You see, when your body immune system sees these newly form urate crystals, and assumes they are the 'bad guys'. 

So, very quickly the white blood cells (aka soldiers) are sent in to attack the 'bad guys'. 

white blood cells fight with urate crystals

But, when the white blood cells try to devour them, the large rigid crystals burst the cells, just like popping balloons. 

As the white blood cells die, they release proteins and tell your immune system,

" We lost the fight with the 'bad guys'. Send in more reinforcements! "

white blood cells lost

However, this released proteins also cause an increase in the fluid acidity of the joint. This makes more urate crystals to form. 

More white blood cells are killed by the 'bad guys', causing even more proteins to be released and more crystals to form. 

urate crystals become bigger

The vicious cycle repeats and causes the extreme pain of gout attack.

This acute attack reaches a peak within 6 to 12 hours. 

gout pain

Stage 3: Intercritical Period

The time between acute attacks is called intercritical period. 

If your uric acid level is still high after an acute attack, another attack can occur at any time. 

During this period, tophi may be forming. 

What is tophi?

Tophi is the masses of urate crystals and can be large in size. When you poke these tophi, chalky white or yellow urate crystals are oozed out. It's more disgusting than squeezing an acne. 

With more gout attacks, bony changes called 'lesions' start to form around the joint. These lesions usually grow and harden over time, and limits the flexibility of your joint. 

Stage 4: Advanced Gout

Advanced gout is the constant pain caused by years of urate crystals degrading the joints. 

Joints are damaged and even destroyed completely by these crystal deposits. 

At this stage, extensive and permanent damage has occurred and cannot be reversed. 

Chapter 3
How to Reduce Gout Pain That Actually Works

In this chapter, I’ll reveal some of my favorite “quick & dirty” strategies on how to get rid of gout pain fast.

Use them as soon as you suspect gout is coming. 

The best part?

None of these strategies require you to spend TONS of money. 

Let’s dive right in…

How to Treat Gout Pain Fast with 4 Proven Ways

Action #1 : Baking Soda (3 minutes)

  • 1
    Get a box of baking soda - Make sure it is not expired. Any brand is fine. You can buy one here.
  • 2
    Prepare a cup of warm water - 300ml or 10oz of water is fine.
  • 3
    Take a teaspoon of baking soda - 2.5ml to start with as you may not like the taste. 
  • 4
    Mix the baking soda into the cup of water - Make sure you stir well.
  • 5
    Drink it finish - Repeat this every 4 hours and stop once the pain subsided.

How this can change your life: This is the fastest way to neutralize the uric acid. Because, this can help to dissolve the crystals that have already formed and also work to keep the uric acid that hasn’t crystallized in solution.

Action #2 : Soak in Warm Water (30-45 minutes)

  • 1
    Get a big pail  - Make sure you can put your affected area (eg. feet) into the pail.  
  • 2
    Fill the pail with warm/hot water - The level of water should cover the affected area, such as your whole feet. Personally, I would suggest the water to be a bit hotter, depending on your comfort level.  
  • 3
    Add Epsom salts - Helps to soothe the pain. This is how it looks like.
  • 4

    Soak - Dip your affected gout area slowly and gently into the water. Make sure the whole area is covered with water. You may feel unbearable for a start. Soak for 10 minutes. Try to wriggle the affected area (eg. toes, hand, fingers) during the soaking. 

  • Creative Tip: If the affected area (eg. knee, elbow) cannot be dipped in, soak a towel in the warm water and wrap around it.
  • 5
    Icepack - After 10 minutes, wrap the ice pack around the affected area. Do this for another 5 minutes.  
  • 6

    Repeat the whole process - Do this for another 2-3 times, or until you find more comfort.  If the water in the pail turns cold, replace or add new warm/hot water.

  • Creative Tip: If you don’t have an ice pack, wrap ice cubes with another towel. Or, you can place ice cubes in a plastic bag first. Wrap them with another clean towel, to prevent water from dripping all over the place.

How this can change your life: With Epsom salt, this helps to soothe the tension in the gout area.

Epsom salts are very high in magnesium, a soothing balm for tired, aching muscles. It’s often used in spa massage to ease the body muscles. The warm water helps to soften any harden crystals that are already formed. 

Action #3 : Cherry Juice (1 minute)

  • 1
    Get a cherry juice - If you cannot find a pure cherry juice, ready-made mixed cherry juice works fine too.
  • Tip: If you prefer tablets form as you need to travel around, get a tart concentrated cherry.   
  • 2
    Drink it - Hydrate yourself with cherry juice after you pee.  

How this can change your life: Cherry juice is an antioxidant and alkalizing food. This is another way that I used to neutralize the uric acid.  

Action # 4: Ionized Alkaline Water (1 minute)

  • 1

    Get alkaline ionized water - Some mineral water bottle is alkaline. But, not every alkaline water are effective. You’ve to make sure it’s also ionized.

  • Tip: I prefer making my own alkaline water in a bottle. This is one of my best lifesavers especially when I need to travel or hydrate.  
  • 2
    Drink it - Drink 8oz every half hour until all knee gout symptoms have completely disappeared.  

How this can change your life: Your body is acidic due to the food you eat. By drinking alkaline ionized water, this really helps to neutralize the uric acid.

Chapter 4
How to Identify The Forbidden Foods That Cause Gout

If you have frequent gout attacks, it may be because of your love for foods that cause gout. 

You see, eating food that contains a high content of purine is one of the leading causes of gout attacks.

Fortunately, there are some simple tips that you can eat to improve your health.

And I’ll cover my favorites for you in this chapter.

Look Out for High Purine Content

What you see in the chart below, the purine content is based on each individual food.

The total amount of purine content depends on how you prepare the food.

To calculate this, it can be very complex and challenging. For simplistic sake, you should avoid completely or reduce the portion that you eat. 

Top 30 Food with High Purine Content 

Here's the list of food to avoid with gout flare up. It's sorted in descending order, with highest purine content on top. 

  • 1
    Yeast, brewer (1810)
  • 2
    Neck, calf (1260)
  • 3
    Sprat, smoked (840)
  • 4
    Spleen, sheep (773)
  • 5
    Yeast, baker's, compressed (680)
  • 6
    Liver, ox (554)
  • 7
    Heart, pork (530)
  • 8
    Spleen, pork (516)
  • 9
    Mushrooms, boletus, dried (488)
  • 10
    Liver, calf (460)
  • 11
    Spleen, ox (444)
  • 12
    Lung, pork (434)
  • 13
    Anchovies, raw (411)
  • 14
    Sardines, canned (399)
  • 15
    Lung, ox (399)
  • 16
    Herring, canned (378)
  • 17
    Sardines, raw (345)
  • 18
    Spleen, calf (343)
  • 19
    Kidney, pork (334)
  • 20
    Anchovies, canned (321)
  • 21
    Liver, pork (289)
  • 22
    Kidney, ox (269)
  • 23
    Heart, ox (256)
  • 24
    Salmon, raw (250)
  • 25
    Mackerel, canned (246)
  • 26
    Chicken Liver (243)
  • 27
    Ocean perch - redfish (241)
  • 28
    Liver, beef, boiled (237)
  • 29
    Liver, beef, broiled (236)
  • 30
    Shrimp, canned (234)

Note: The number in brackets indicates milligrams of uric acid per 100g of food. (See Reference #1)

At this point, you may wonder what else can you eat since the chart seems to cover most of the delicious food.

I asked myself the same question too.

The good news is you can still eat the food that you enjoy. And I’ll share that more in the next chapter. Stay tuned.

Chapter 5
How to Enjoy Good Food After Your Gout Attack

To prevent the next gout attack, you need to at least know what you’ve eaten previously. 

Maybe you have had one too many seafoods, or your craving for steak has increased.

You know you must do something to rectify the situation, but unsure of where to start.

Fortunately, how to prevent gout disease isn’t hard or complicated.

And in this chapter, I’m going to lay out a few different ways that you can discover your own body  (with a gout diet focus to make a fresh start).

Record Down Your Food Intake

Many doctors advise you to totally stop eating that food with high purine content.

But the problem is…

There’s a lot of food with high purine content.

And we can’t possibly stop eating them at all, especially when you eat out.

Your body is different from the rest. You just have to know what food that will trigger gout in your body. The key is to have a balanced lifestyle and moderate your eating habits.

When it comes to reducing gout while enjoying good food, you’ve got 3 steps.

Recall What You Eat Before Gout Attack

Remember the day you’ve got last gout attack, what have you eaten?

Whether it is beer, burger, steak, seafood or pig liver, write them down.

This is what I list down the 'food culprits' just before the gout attack. 

  • Six big tiger prawns
  • One bowl of pig organ soup
  • 300ml of protein shake
  • Frown
    One 200g steak (medium well done)

Isolate The 'Food Culprits'

I suggest you stop or reduce the portion of the 'food culprits' after you recover from your gout. 

Ask yourself this question:

So, does the smaller portion triggered any gout attack?

If didn’t, good for you! The tip is to cut down the food portion. And, drink lots of water to flush out any high uric acid in your urine. 

On the other hand, you mark down that food and refrain from eating it again if you experienced the initial gout symptoms. Remember to use the tips given in Chapter 3 to reduce the pain quickly.

Keep a Food Journal

Do you know that beer, animal organs & canned sardines aren't good for you?

Of course, you do.

High in purine content and preservatives, they provide little nutritional content and also lead to acute gout attacks.  

One of the simplest ways to be aware of the food you take is to write down what you eat everyday.

Yes, every single of them. Even if you hide in a corner and eat one peanut, write it down. As you make this effort, you are conscious of your food habits and make healthy changes. 

Since you carry a mobile phone everywhere you go (some even brings to toilet), I find that it's easier to note down the food you eat on a mobile app.

I recommend using myFitnessPal. And, this is how I note down my food intake for a day. 

This app also gives you an awesome daily food summary. 

So if it tells you that you've an overdose of sodium for the day, then you are conscious to cut down food that contains lots of sodium. Or don't take such food the following day. 

Chapter 6
My Favourite pH Levels Test Tips

You might already know that in order for your body to be healthy, it needs to have acid-alkaline balance. 

The question is:

How do we know this?

Well, that’s exactly what you’re going to learn in this guide.

What is pH levels in body? 

Your body concentration of acidity or alkalinity is denoted by a figure known as ‘pH’ that works on a scale of 1 to 14.

Anything less than 7 is acidic. 7 is neutral. And, above 7 is alkaline.

Although 7 is the neutral reading, for optimal health you should be slightly alkaline - ideally around 7.3 or 7.4. 

This is to counter the increase in acidity that comes with ageing and diet. (See Reference #2)

How to know if your pH levels are off? 

You can test your own acid/alkaline balance using your saliva and pH paper (also called litmus paper).

Pro Tip: Test yourself on a daily basis at home every morning shortly after you wake up and before eating anything. 

Here's how to test body pH level at home? Here's two ways. 

Using Saliva Test

The pH of your saliva is affected by what you have eaten or drunk recently. 

You can generally expect a higher alkaline reading from your saliva. 

This is how you can perform a simple test (see Reference #3):

  • 1
    Wait at least two hours after eating
  • 2
    Fill your mouth with saliva and then swallow it
  • 3
    Repeat this step to help ensure that your saliva is clean.
  • 4
    Spit some saliva onto the pH paper
  • 5
    The pH paper should turn blue if your saliva is slightly alkaline.
  • 6
    If the pH paper does not turn blue, compare the color you get with the chart that comes with the pH paper. And, see how acidic you’ve become.

Take Urine Test

I prefer urine pH test. 

Testing your urine will give you a more accurate reading as it is a better indicator of how well your kidneys are eliminating acid. 

The pH levels in urine is affected by two things:

  • 1
    How much water you have consumed
  • 2
    The amount of acid forming foods you have eaten

For this reason, it is best to test urine first thing in the morning. 

Action: Pass a small amount of urine into a cup and dip the litmus paper briefly into the liquid. Compare the result with a pH colour chart. 


#1: Beating Gout by Victor Konshin

#2: The Alkaline Cure by Dr Stephan Domenig

#3: Joshi's Alkaline Diet by Nishi Joshi


So that’s it for my guide to gout.

I hope you enjoyed it.

Now I’d like to hear your take:

Which method did you use to reduce the gout pain?

Or maybe you have a question about something from today’s guide.

Either way, let me know by leaving a quick comment below.

About the Author Cheefoo

Cheefoo specializes in overall wellness, with particular interests in health for men and women above age 30s. He is pursuing his personal certification in human health (Diet & Nutrition) in 2018. In his free time, he enjoys reading on mindset and exploring technology.

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