Gout is a common, painful form of arthritis associated with excess uric acid in the blood. According to MedlinePlus, gout causes swollen, red, hot and stiff joints. Niacin, or vitamin B3, is found in many foods, including yeast, meat, fish, milk, eggs, green vegetables, beans and cereal grains. It is often used in supplement form to help control cholesterol, but it also can interfere with the elimination of uric acid causing gout, or making it worse.
How It Works
Gout occurs when uric acid builds up in your blood. This happens if your body produces extra uric acid or does not eliminate enough uric acid, or if you eat too many foods with purines. Organ meats such as liver, kidneys and brains, seafoods such as anchovies, sardines and crab, as well as dried beans and some other vegetables are high in purines. Niacin, or vitamin B3, works with other B vitamins to release energy from carbohydrates. It also helps with digestive system function and with maintaining healthy skin and nerves. Niacin is converted to niacinamide when it is taken in amounts greater than what is needed by the body. Niacin and niacinamide are considered safe for most people when taken by mouth. When taken in high amounts, however, niacin competes with uric acid for bodily excretion, which can reduce the elimination of uric acid, according to an article in Nutrition Science News.
Niacin Side Effects
According to the National Institute of Arthritis and Muskuloskeletal and Skin Diseases, a number of medications may put people at risk for developing excess uric acid, or hyperuricemia, resulting in gout. Niacin is one such drug. When taken in doses of over 3 g per day, more serious niacin side effects can occur. These include liver problems, gout, ulcers of the digestive tract, loss of vision, high blood sugar, irregular heartbeat and other serious problems. Consequently, if you are experiencing gout, your doctor may have you stop taking niacin.
Symptoms of Gout
According to MedlinePlus, symptoms usually involve only one or a few joints and develop suddenly. Big toe pain is a common initial sign of gout, but pain can also occur in the knee or ankle joints. The pain frequently starts during the night and ranges in intensity from throbbing to crushing or even excruciating. The joint appears warm and red. It is usually very tender. There may be a fever. The attack may go away in several days but may return from time to time. Later attacks commonly last longer.
Gout Diagnosis
Because gout is caused by high levels of uric acid in the blood, blood and urine tests for uric acid are common preliminary tests for gout. However, many people with high uric acid levels do not develop gout. To confirm that the symptoms are caused by gout, MedlinePlus says your doctor will check the joint fluid, called synovial fluid. The physician will insert a needle into the affected joint to extract fluid for examination under a microscope. If the fluid contains tell-tale monosodium urate crystals, then a diagnosis of gout is confirmed.
Treatment
Depending on whether you have had only an initial gout attack or whether you have had several episodes, MedlinePlus says your treatment will likely involve a combination of lifestyle, dietary and medical approaches. Reducing alcohol consumption, limiting foods high in purines and reducing intake of fatty foods are often recommended to reduce production of uric acid. Nonsteroidal anti-inflammatory drugs such as aspirin, ibuprofen and naproxen may be used to reduce inflammation. If you have several attacks during the year, your doctor may prescribe drugs to reduce uric acid levels in the blood.
