gout

Brief Description

Gout is a form of arthritis characterized by sudden, severe pain, swelling, and redness in the joints, most commonly affecting the big toe. It occurs when high levels of uric acid in the blood form sharp crystals in the joints, leading to intense discomfort. Gout attacks can be triggered by factors such as a diet high in purines (found in red meat, shellfish, and alcohol), dehydration, or excessive stress.

Traditional Chinese Medicine (TCM) views gout as a result of internal imbalances, such as dampness, heat, and stagnation of Qi and blood, which require both symptomatic relief and holistic treatment to restore balance and prevent future flare-ups.

Common Misconceptions

  • Focusing Solely on Uric Acid Levels: Many people fixate on lowering uric acid levels, believing that this alone will resolve gout. However, a decrease in uric acid does not necessarily mean all underlying issues related to gout are addressed. Treatment should consider the unique conditions of each patient.
  • Taking Unverified Medications: Some patients inquire about or take medications they've heard can treat gout, without knowing their potential toxicity. I advise against using such unknown treatments, as even if they appear effective, they may cause hidden damage to the body. It’s important to prioritize safety and consult a professional before taking any medication.
  • Although some types of gout have local redness and swelling, the overall condition is purely cold, but they are still treated with the method of clearing heat and reducing inflammation, which is completely counterproductive.

TCM Diagnosis

Typical Tongue

gout-tongue picture

Typical Pulse

The pulse can be deep and slow, or taut, soggy when it is cold-damp. The pulse can be fast, floating, soggy when it is damp-heat.

TCM Pathogenesis

In Traditional Chinese Medicine (TCM), gout is often attributed to several internal imbalances. One major cause is damage to the Spleen and Stomach, leading to an accumulation of cold and dampness in the body. This weakens the digestive system, impairing its ability to process fluids and food, which in turn creates dampness. On the other hand, a diet rich in oily, spicy foods contributes to damp-heat accumulation, further aggravating the condition.

Other common TCM pathogenesis includes stagnation of Qi and blood, which obstructs the meridians and causes pain. In some cases, underlying deficiencies of the Kidney or Liver contribute to the body’s inability to properly regulate uric acid, leading to flare-ups. Therefore, gout requires a multi-faceted treatment approach that addresses these internal imbalances.

TCM Treatment

General Principle

In Traditional Chinese Medicine (TCM), gout is generally categorized as "Bi Syndrome" or "Li Jie" (joint disorder). Treatment varies according to individual patterns, commonly classified as cold, heat, or a combination of both. Pathological factors such as dampness, phlegm, fluid retention, and blood stasis are also considered. In terms of the Six Channel Syndrome Differentiation, it primarily involves Shaoyang, Yangming, and Taiyin patterns.

Given the complexity of these classifications, relying solely on a single medication is unlikely to address the root cause. Effective treatment requires a holistic approach that targets both the underlying imbalance and the specific symptoms, which is the strength of TCM’s personalized treatment plans.

Unique Therapies We Apply

  • Classical Formula: Based on syndrome differentiation, I generally use classical formulas for treatment. This approach addresses the root cause, eliminating dampness, phlegm, heat, and toxins from the body. It does not directly aim to lower uric acid levels, but once the underlying pathogenesis is resolved, uric acid will naturally decrease.

Treatment Plan

  • Acute Phase: The focus is on medication, combined with acupuncture and bloodletting to relieve local pain. Acupuncture is recommended daily or every other day to manage symptoms effectively.
  • Chronic Phase: As medication and treatment take effect, the pain decreases. Continued medication for 1-2 months is necessary. Even after the pain has completely subsided, intermittent medication for an additional 1-2 months is recommended to eliminate the root cause and prevent recurrence.

Precaution

  • Dietary Habits: Many gout patients have a history of poor dietary choices, such as overeating, drinking alcohol, and consuming junk food. Changing these unhealthy habits is crucial for treatment success and long-term prevention.
  • Discontinuing Treatment Prematurely: When the pain subsides, many patients struggle to continue treatment, but the root cause often remains. Without proper follow-up, gout is likely to recur when triggered by certain conditions, contributing to its chronic nature.
  • Bloodletting should be used with caution in patients with gout of deficiency syndrome.

Summary

Gout is a complex condition that requires a comprehensive treatment approach in Traditional Chinese Medicine (TCM). Beyond focusing on reducing uric acid levels, TCM addresses the root cause of gout, such as Qi stagnation, dampness, and blood stasis.

Treatment plans are tailored to individual needs, with a combination of classical formulas, acupuncture, and dietary changes. In the acute phase, pain relief is achieved through acupuncture and medication, while long-term recovery requires continued treatment to eliminate the underlying imbalances. A common challenge is the recurrence of gout due to dietary habits and premature discontinuation of treatment. Patients need to stay committed to both lifestyle changes and completing their treatment to prevent future flare-ups.

TCM Dr. Ma

The Traditional Chinese Medicine treatment approaches outlined above are derived from my clinical experience, and I acknowledge there may be areas not fully covered or that require further refinement over time.

This content is intended to provide a learning reference for professionals and enthusiasts in Traditional Chinese Medicine and to help patients gain a better understanding of their conditions and common misconceptions.

However, I must emphasize that this information does not constitute specific treatment guidance. All TCM treatments must be tailored to the individual through thorough diagnosis by a qualified practitioner. Non-professionals should not attempt self-treatment based on this information, as any treatment conducted without professional supervision may carry potential safety risks.