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Gout is caused by the build up of uric acid crystals in joints - especially big toe joints, knuckles, knees and el99ws - due to diet, genetic predisposition, diuretic drugs, or conditions such as psoriasis and leukaemia. Uric acid, the unwanted end-product of protein breakdown, is excreted by kidneys, but if kidney functions is impaired or if more uric acid is produced than the kidneys can cope with, crystals accumulate in spaces between joints, causing gout. Crystals can accumulate in kidneys themselves, causing high blood pressure, or even kidney failure.

A first attack of gout usually affects one joint only; joint becomes red, shiny and excruciatingly painful, often within a matter of hours; moderate fever may develop as well. Attack wears off after a few days and may never recur. Often, however, attacks do recur, at decreasing intervals and affecting more joints.

If untreated, joints may be permanently deformed. Orthodox treatment consists of painkillers and non-steroidal anti-inflammatory drugs, or drugs to increase excretion or reduce production of uric acid. Homeopathic treatment is constitutional, but during an attack one of the remedies below may help.

Specific remedies to be taken every 15 minutes for up to 10 doses

Person depressed, irritable, weak and nauseous, affected joint excruciatingly painful, especially at night or when an attempt is made to move it Colchicum 6c

Joints feel bruised and painful Arnica 30c

Affected joints slightly swollen, with a cold feeling in them, discomfort lessened by cold bathing, increased by movement Ledum 6c

Affected joints burn and itch Urtica 30c

Symptoms accompanied by strong-smelling uring Benzoic 6c

One foot hot, other foot cold, symptoms worse 4-8 pm Lycopodium 6c

Pains flit from joint to joint Pulsatilla 6c