Stress and other factors leading to gout
I had my first attack in late 96 aged 42 - we had just moved house,in the middle of christmas etc and I was about to start a new job inthe middle east. All pretty stressful and then I dropped somethingon my toe!
At first I thought it was just bruising (probably was at first) butafter 3-4 days of increasing pain I thought I must have brokensomething. Went for x-rays and was diagnosed with gout. Unlike someothers here, my doctor immediately recommended Allopurinol as a longterm preventative but I cried off, suggesting I would control itthrough diet etc.
Just over a year later I had a recurrence - during Ramadan in themid-east when out of respect for colleagues I was also fastingduring the day which meant no water either. Almost certainly downto dehydration and I resolved to make sure never to suffer from thisagain.
Interestingly enough, on both occasions I was given a short courseof allopurinol to alleviate the condition although I now understandthis is no longer the practice (both attacks went within 3-5 days ofallopurinol and diclofenac).
Shortly after that last attack I got chatting to someone who hadsuffered badly in the past but who hadn’t had an attack in 10years or more. He reckoned by far the biggest cause was stress andthat if you can manage the stress in your life you will manage thegout at the same time. Sometimes easier said than done but withsome positive stress management and watching my hydration levels Ihave managed to go 6 years without an attack. Occasionally I felt atwinge in my toe and immediately drank 3-4 litres of water, findingit just went away.
Another stressful period arrived this Easter and I was off-guard alittle. Funnily enough I had had a blood test undertaken just 3weeks earlier when my UA reading was 4.7 and I agreed with my doctorthat losing some weight would probably resolve this and be generallygood for my health in other ways.
I had a hectic weekend just before Easter, and had friends round theSaturday evening with maybe a little too much wine and a fairly richdiet - all on top of a wedding luncheon earlier in the day.Interestingly, we had a Morrocan dish which contained quite a lot ofsaffron (more on that later).
Next day I could feel the gout coming and I probably was a littledehydrated from the previous day’s excesses so I followed theusual routine of drinking copious amounts of water but otherwise nomedication. The “Mini-attack” lasted perhaps a day this time- much longer than previously - but still went away completelywithout treatment. Later the same week and atypically I had arisotto alla Milanese (containing Saffron) and then on the Thursdaywe had the same dish I had prepared the previous Saturday, back bypopular request.
I had relatively little alcohol this time but on Friday I was inagony. Good Friday of course so all I had available was ibuprofenand the standard dose didn’t seem to do much. Naturally I wasalso drinking 5-6 litres of water daily. I saw the doctor Saturdaymorning and he suggested carrying on what I was doing but resting itmore.
It just got worse the next few days and by Tuesday I couldn’tvisit the doctor I was in so much pain but spoke over the phone andmy wife picked up the diclofenac they prescribed (75mg twicedaily). This started to ease it but at night time it was much worseand Wednesday evening was so bad I doubled the dose (which did thetrick) and hobbled into the doctor Thursday morning. He agreed tome keeping to this increased dosage for a few days and thankfully itis now going away.
In researching the possible triggers it occurred to me that thesaffron might be a factor, although I had never seen it mentionedanywhere in relation to gout. A linked search actually indicatedthat it is considered as a counter to the disease rather than acause and my doctor felt sure it was just coincidence. On the otherhand, if allopurinol is a preventative but can also induce theillness, why can’t saffron have the same effect? I am also prettysure I will have eaten plenty of saffron flavoured foods duringRamadan at the time of my previous attack, as the post-fast banquetscan be pretty lavish (but no alcohol as this was Saudi Arabia).
Where does all this leave me? Still unsure about taking allopurinoldespite the strong arguments made for it in this forum. If I watchmy hydration levels and lose weight steadily and improve my fitnessthen I reckon a natural approach has to be the preferred route. Iwould be interested to hear reports of the UA monitor device’seffectiveness as this would be a useful tool to make sure that I ammaking progress, if it can be relied upon. Meanwhile I will alsowatch the saffron intake and make sure it is an occasional treatrather than a regular part of my diet.