Couch grass is a common weed found growing all over the world. Although it has many uses medicinally, it has been shown to have especially marked activity against conditions like gout and arthritis.
Many have even started calling it a herbal cure for gout.
Although we can’t call it a “cure” without long-term, large-scale clinical trials (which have not yet been done), couch grass is without a doubt one of the most beneficial of the botanical medicines for reducing the pain, inflammation, and occurrence of flare-ups in the gout-prone person.
Gout is directly related to the amount of uric acid traveling around the bloodstream, so the most direct route of treatment is to address the uric acid concentrations in the blood.
Since the route of elimination of this substance is mainly through the urinary tract, increasing urine output has become the mainstay of gout treatments worldwide.
Couch grass offers this benefit, along with a few others which we will explore in this article further.
The Importance of New Treatments Like Couch Grass For Gout
Gout is the most prevalent inflammatory arthritis condition in men, affecting 1-2% of adults in the developed world .
The presence of gout has been found to be a risk factor for all-cause mortality (heart disease, diabetes, hypertension, and metabolic syndrome) .
Its occurrence is on the rise all over the world, making new treatment options increasingly important in the coming years.
Couch Grass has been used in traditional medical systems for gout and other related conditions like inflammation, kidney disease, and arthritis, but has not been intensively studied in the modern era.
This means we lack a detailed and definitive understanding of how this herb actually works to reduce systemic concentrations of uric acid, and the symptoms of gout itself.
Based on traditional knowledge about herbs such as couch grass, we can identify the mechanisms and chemicals responsible for its effects against gout.
With more research, we will be able to understand how to maximize these effects and apply them to current therapies, making the treatment of gout more effective overall.
The Mechanisms of Gout
Gout is caused by an inefficient excretion of uric acid by the kidneys, leading to elevated levels inside the blood. In a healthy individual, uric acid is kept in balance and will not cause damage to the body.
In an individual with gout, however, uric acid builds up over time, causing an imbalance in this system and eventually an accumulation of “monosodium urate” crystals inside the joints.
This can build up over many years, and will eventually trigger an immune response, causing pain, inflammation, redness, swelling, and all of the various side effects of gout.
When a bout of gout flares up, what is really causing the pain and inflammation is the immune system attacking the joints laden with uric acid crystals.
Modern Gout Treatments
Based on the mechanisms causing what we know as gout, the treatment of often includes herbs or medications that can improve the ability for the body to eliminate this uric acid through the kidneys.
By allowing uric acid to leave the blood through the kidneys effectively, the crystalline deposits can be prevented from forming inside the joints of the body.
How Couch Grass Helps With Gout
Couch grass works in the same way that modern therapies work, with a few additional benefits. It is mainly a diuretic, using a special process called osmotic diuresis.
This basically means it increases urine output by inhibiting the reabsorption of water and sodium inside the kidneys.
This is an important difference to other diuretics because it works specifically on the part of the filtration process most commonly faulty when it comes to uric acid buildup.
As water and uric acid are filtered into the kidney, a healthy individual allows only the water and some of the uric acid to become reabsorbed into the system.
In an individual with gout, all of the uric acid is allowed to reabsorb into the bloodstream. Couch grass specifically inhibits this process.
The main chemical responsible for this in couch grass is a special type of sugar alcohol known as mannitol.
It’s commonly used as a sweetener in diabetic foods because it doesn’t cause blood sugar to spike after consumption, and is actually a common therapeutic agent for diabetes, and type one diabetic ketoacidosis .
This molecule has been shown in several studies to provide a significant increase in the amount of urine released from the kidneys, with some reporting as much as a 61% increase in urine flow .
What Is The Dose Of Couch Grass For Gout?
The short answer is 6-18 g of dried root per day. Which is worked out below. A tea can be made by gently simmering the dried roots for about 10 minutes.
Capsules can also be purchased, the dose of which should be followed according to the label because many manufacturers concentrate the herbs prior to encapsulating. Other options include liquid extracts or glycetracts.
Working Out The Dose
In couch grass, mannitol comes as a byproduct of another chemical known as triticin as it breaks down in the body. Triticin accounts for up to 8% of the makeup of couch grass rhizome.
Of this, about 2-3% of the byproducts yield mannitol, and a related sugar-alcohol inositol [5-7], making the total composition fo mannitol in couch grass about 0.25%.
In the previously mentioned study suggesting increases in urine flow up to 61% used a dose of around 75mg mannitol per kg. For the average human of 60 kg that would be roughly 4500 mg (4.5 g).
In couch grass, mannitol is about 0.25% of the total weight of the dried rhizome. In order to reach the therapeutic dose given in this study, roughly 18 g of dried root is equivalent.
This dose is fairly high and is likely overkill. Traditional dosing was around 6-10 g per day.
A good dose would be to start at about 6 g per day (or 6 ml of a 1:1 liquid extract), and slowly build up to about 15-18 g/day (or 15-18 ml of a 1:1 liquid extract).
Monitor how this makes you feel, and cap the dose off accordingly. Some people do best at a dose of 6, while others require a dose closer to the top range.
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3. Bragadottir, G., Redfors, B., & Ricksten, S. E. (2012). Mannitol increases renal blood flow and maintains filtration fraction and oxygenation in postoperative acute kidney injury: a prospective interventional study. Critical care, 16(4), R159.
4. Franklin, B., Liu, J., & Ginsberg-Fellner, F. (1982). Cerebral oedema and ophthalmoplegia reversed by mannitol in a new case of insulin-dependent diabetes mellitus. Paediatrics, 69(1), 87-90.
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6. Leung AY, Foster S. Encyclopedia of Common Natural Ingredients . 2nd ed. New York, NY: John Wiley and Sons, Inc.; 1996.
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