The question, “what does gout look like?” comes up a lot these days. It is usually in conjunction with a slow and painful incident in one of the joints of the body, often the one at the base of the big toe.

There are some important aspects of gout that need explaining beyond just what it looks like; understanding the cause of gout symptoms and how to prevent them in the future are better questions to ask.



The way to describe a gout attack requires a step-by-step explanation to cover it completely. It starts with an unusual tingle or ache in one of the joints of the extremities; the toes or fingers, feet or hands, ankles or wrists, knees or elbows.

What a gout attack looks like is often depicted as a very red, hot, swollen and inflamed joint. However this description is more typical of the advanced stage of an attack.

When someone is not well acquainted with gout symptoms, the initial tingle or ache progresses into stiffness and immobility. This is when the famous pain associated with gout really starts to take hold.

With no intervention, the swelling continues and the affected joint becomes quite hot with severe redness. Another common hallmark is that the skin becomes tight and shiny. The heat produced by the inflamed joint is remarkable and general fever is possible.

At this point the pain is unbearable. It is due to uric acid continuing to crystallize in the joint and it may take weeks for the pain and inflammation to subside.

No major flare ups, plus I lost 30lbs!

Hi Bert, Just wanted to check in and let you know things are going pretty well.  No major flare ups.  Your advice has given me a new outlook on my health.  I have not eaten any chicken meat or fish since Thanksgiving.  I have lost around 30 lbs. and counting.(need about 100 more)  But I am heading in the right direction.  I have recently incorporated chia seeds into my diet and was wondering if you had an opinion of them.  They seem to be at very least a great source of fiber.

Thanks again ~ Jim


To adequately explain the stages of gout, a brief summary of what causes gout is in order.

Contrary to popular belief, gout is not “caused” by uric acid – the “pain” of gout is caused by uric acid. Uric acid is an acidic substance that becomes overly-abundant in the bloodstream due to reduced capability of the kidneys.

While uric acid is produced and used by the body as a protective antioxidant, when it becomes excessive due to temporary poor kidney function, it can become a dangerous problem. The biggest danger comes from kidney stones made of urate crystals and therefore a source of renal complications.

The alternative created by the body is to allow the excess uric acid to deposit or “crystallize” in one of the joints far away from the vital organs.


Hyperuricemia is characterized by high levels of uric acid in the bloodstream but no gouty events have yet taken place. According to Medscape, many people in our modern times have hyperuricemia and are unaware of it.

Acute Gout

Acute gout is when excess uric acid has finally progressed into a full-blown gouty event. This stage can last for months or years because after the initial gout attack, the others follow slowly then increase in frequency.

Chronic Gout

Gout becomes labeled as chronic when it begins to occur with greater frequency and severity. At this point the blood uric acid levels are generally quite high and pharmaceutical medication to lower it, (Urate Lowering Therapy) has been prescribed.

Tophaceous Gout

The final stage of gout, called tophaceous gout, is characterized by lumps or nodules of urate crystals, which are large and visible and growing under the skin around the joints and other sites on the body. This is a very advanced form of gout that occurs because the seriousness of the condition has been ignored and untreated.

Who Gets Gout?

Gout typically affects men more than women; however the incidence increases in women after menopause due to reduced estrogen production.

Once upon a time, gout disease seemed to be reserved for middle-aged or older men. Because of the massive exposure to processed foods and toxic environmental chemicals, the first occurrence of gout is now common for young men in their twenties and even in their teens.


With the enormous rise in gout over the last two decades, new technological advancements are being introduced to the market to identify and diagnose gout. These measures are generally a waste of resources because gout is easily diagnosed; when you have a big, red, swollen toe or any other joint, and high blood uric acid levels, it is easily identified as gout.


There are two basic schools of thought for how to treat gout : Allopathic and Holistic.

While there are a number of different pharmaceutical drugs to address gout, there are fundamentally two distinct modes in which they operate:

  1. Inhibit the production of uric acid
  2. Relieve the inflammation and the corresponding pain

Allopurinol is the industry standard as a xanthine oxidase inhibitor. It attempts to manipulate the uric acid levels but does not take care of the over-acidic root cause of gout.

For inflammation, the two most common drugs are colchicine and indomethacin.

Colchicine is an anti-inflammatory compound derived from the autumn crocus plant and has been well known and used to relieve the inflammation of gout and other rheumatoid arthritis afflictions.

Indomethacin is a non-steroidal anti-inflammatory drug (NSAID) that is available in different brand names but is relatively no more effective than generic ibuprofen.

By contrast, how to treat gout holistically, involves addressing the root cause of the problem by correcting metabolic imbalances known as acidosis.

Because gout is a condition of an overall acidic inner body environment, different minerals and vitamins provided by proper diet and/or supplements is a far superior natural gout treatment. Alkalizing agents like Epsom salts can be used topically and various herbal decoctions can be consumed as teas, in capsule forms, or made in to topical poultices to relieve swelling and pain.

The proper way to remedy gout is by bringing the pH of the body chemistry back into balance by taking advantage of natural elements that neutralize the acidic inner body condition.

Preventing Future Attacks

There are three nutrients that the body needs most of all to stay in balance:

  1. Oxygen/Air
  2. Water
  3. Minerals and vitamins provided from healthy food sources

With focused breathing techniques, proper hydration, eating fresh whole foods, and avoiding denatured processed foods, gout can easily be managed.

   Remember!  “What does gout look like?” is not nearly as important a question as “How do I prevent gout?”


Bert Middleton

“I know your pain. Let me help you kill your gout for good!  And teach you to advocate for yourself and take ownership of your gout recovery, by showing you how to live the gout-free lifestyle.” Two decades ago, Bert Middleton found himself diagnosed with gout. Like 8.3 million other people in the United States (approximately 4% of the population), he struggled helplessly with the physical, emotional, social, and financial impact that gout left unchecked can have on your life. Prescription drugs were of limited help… And the terrible pain of regular gout attacks left him unable to enjoy even the simplest daily pleasures. His marriage was suffering. His finances were spiraling due to the impact gout had on his ability to work. And maintaining a social life was often nearly impossible. Tophi surgeries left him in terrible pain.  And he found himself depressed … and angry … that gout was stealing years of his life.

Until one day, after hundreds of hours of research and self-experimentation, Bert finally had a breakthrough and created a blueprint for a way of living that would prove to be “the answer” to living gout-free for nearly a decade now. Today, Bert and his “Gout Wife” Sharon devote their evenings and weekends to educating other gout sufferers on how to live the gout-free lifestyle. Showing others his 911 Emergency Response Gout Recovery Plan for getting PAINFUL gout attacks under control in as little as 4 hours. And then, how to make daily choices that keep gout under control for GOOD! So you can finally start LIVING again!