Gout Diet Blog

This gout is a strange, peculiar type of ailment. I’m 62 yrs old, male, andhave had gout since I was 28. I’ve tried a number of medicines, done a lotof reading, and feel today I know about as little about it as I did beforemy first attack. I take allopurinol, and can woof down all foods exceptliver (I get a moon shot if I eat liver). I can swill booze with no problem(goutwise).

The one certain thing is there are many manifestations of gout, manytriggers, and a number of things that help some individuals. Some peopleare very diet sensitive, others are not. Some people can tolerate certainpreventatives and pain reliefs, some cannot. Certain medicines work wellfor some people, while others aren’t as effective with them.

Gout can hit us just about all over the body. I’ve had attacks in the jointat the base of the big toes in both feet, both ankles, both knees, bothhips, and my lower back. Recently, I read about someone who had it inhis/her wrist. I’ve also had what I thought were gout attacks in mytendon/heel area on my feet. Some reports tell me this is more likelypseudogout. I don’t know.

Gout seems to occur because of uric acid crystal concentration between thelinings of impacted joints. This causes intense pain, some swelling, andinflammation (that’s those hot, pink skin areas where the pain is). The onething I haven’t found explanation of is why, in gout sufferrers, our bodssuddenly begin a runaway overproduction of uric acid. Maybe the why of thisis unimportant. I don’t know.

Now, if you look closely at the timing/sequence of events in a gout attack,you’ll see why, in many people, lab tests of blood drawn during a goutattack can come back normal in uric acid levels. What happens is that, inmany of us, the attack develops so quickly that the spike of uric acid haspeaked and subsided very quickly, and is back to normal while the crystalsprecipitate and gravitate to the joint area they will eventually inflame.By the time you start agonizing, and someone draws blood,voila—-everything’s back to normal. In others, things progress moreslowly.

What pharmacology will help us prevent gout? There is one drug (I’veforgotten the name and need help here) that helps our bods not produce anoversupply of uric acid. Then, there’s allopurinol, which helps our bodseliminate over productions of uric acid. Allopurinol, incidentally, seemsto be tolerated well by most, and has few adverse side effects.

Then there’s the pain of gout attacks. Pain relief falls into three maincategories. One is non-specific analgesics (NSAIDS) [[[can’t remember whatthe full accronym stands for; need help here, too]]]. These includeaspirin, tylenol, etc. DO NOT take aspirin or aspirin based compounds forgout pain relief. The aspirin base fights with the inflammation from gout,and makes the pain worse. I can get fair relief by gobbling lots oftylenol. Others say tylenol doesn’t help them one bit. Another of thesecommonly used is Indomethicin. Indo is very effective in most people, butgives rather pronounced indigestion and tummy upset.

Another category of gout pain reliever are steroids. Steroids, as a class,are pretty good pain relievers. Be aware of prolonged use, though, becausethey tend to have adverse side effects, such as bone marrow attacks, waterretention, etc.

Then there are narcotics. Narcotics are very effective at knocking down thepain, but we all know what trails those can too easily lead down. Narcoticsare rarely prescribed for gout pain.

One of the things that tends to pop up recurringly is the thing aboutcranberry juice. The role of cranberry juice is interesting, but doesn’ttie directly in with gout. What happens is that cranberry juice relieveskidney discomfort in many people. We can get kidney discomfort from manycauses, including gout.

The high uric acid levels during/preceding gout attacks have to be dispensedwith somehow. Well, that overload gets filtered out through the oldkidneys. Is some cases, this causes discomfort to the kidneys. Thus,cranberry juice can help relieve that discomfort in some people. But, ithas nothing per se to do with gout, only indirectly.

I forgot to comment on Colchicine. Colchicine is definitely effective inaborting (cutting one short once it starts up) a gout attack in some people.The problem with Colchicine is that to be effective, the docs have to bringit to a low threshold toxic level in the body before it does it job right.In this process, it makes you ill with stomach upset and diarhea. So, younot only have a hurting hoof or whatever, but then you’re also made sick atthe same time. Of course, if you’re one of those that the Colchicine helps,you then get better. I think the docs taper off on the Colchicine once youstart getting better. Colchicine is an almost archaic med for gout. Itwas the only drug around for years.

I personally don’t like Colchicine. I know it’s effective for some,but there are better ways of getting rid of excess uric acid, for me. Thatis, of course, allopurinol. The reason I don’t like Colchicine is that theyou have to take it to the point of toxicity before it becomes effective.That means diarrhea and stomach nausea. In other words, it has to make yousick before it can make you better. This is typically superimposed on avery painful gout attack, which is no fun at all to begin with. I think Ihave heard that allopurinol may not be effective until you’re pain free fora few days. I don’t see how it could hurt to take it anyway, if you havesome handy. I keep taking mine during any attacks I get. While takingallopurinol, my attacks are much fewer, and the ones I do occasionally getare mild, and are over quickly. I used to have severe pain with my attacksfor two weeks or so.

There is some medicine which helps keep the old bod from cranking up excessuric acid. Can’t remember the name of it. I’ve always felt that it andallopurinol together would be the perfect combo, because allopurinol causesthe bod to eliminate excess uric acid, once it starts cranking it up

One other interesting thing. Some literature says that there is a window inmany gouties from age 45-60 in which you’re essentially attack free. Thisdid in fact happen with me. As soon as I hit 60, the attacks jumped back onme with both feet, and that’s when I resumed allopurinol

Some of the people on this list, and some literature says taking a couple ofspoonfulls of unsweetened cherries every day will significantly help preventgout attacks. Never tried it, but have heard this more than once. It’s notthat hard to do, as you can get cans of these kinds of cherries in anygrocery store. They’re quite available.

The thing I read on the gout email list recently is the first explanationI’ve heard as to why the docs are apprehensive when it comes to havinggouties lose weight. I know that there is a medical consensus that there isa reason to be concerned when they start having an overweight gout suffererlose weight. And, someone on our list finally explained it, and it makesperfect sense. I didn’t know that uric acid concentrations are in all ourfat cells. Given that, it stands to reason that breaking down fatty tissue(weight loss) floods us with uric acid, thereby almost certainlyprecipitating an attack.

It’s ironic. Losing weight is supposed to help ease the joint impact ofbody mass, thereby helping minimize damage from gout attacks. But, losingweight may well precipitate/cause gout attacks (during the weight lossperiod).

And yes, that stuff can attack us just about anywhere in the old bod thereare joints to get inflammed.

OK, as to pain relief. May not work for you, but does help me some. Largedoses of Tylenol. The trick is to take several at once, and then severalmore every 3 hours or so. Like I’ve said, DON’T take aspirin. Aspirin willmake your inflammation/pain worse because the acid base in it fights withthe uric acid

I had to quit taking Indo because it is too rough on the tummy.

A problem with gout is that you can get consumed with trying to managetreatments while the attacks are coming along rapid fire, at times. Trythis, try that, this one doesn’t work–that one doesn’t work, etc.

I finally simplified it all down to taking allopurinol for control, andTylenol for pain. With the Tylenol, I don’t have to worry about seeingdocs, or fetching prescriptions and getting them filled, etc.

Another thing: I always tried to keep trucking along. I didn’t let goutpain stop me from doing things, although it did slow me down at someendeavors. I am very active, and gout was a major irritant to me; a realpain in the patootie, figureatively and literally speaking. I can wellimagine there are some jobs where having gout would be a significantnegative impact on your income. These are the people I really sympathisizewith.

Our gout attacks are caused by a “surge” of overproduction of uric acid.This surge has to finally be eliminated, and is done so through the kidneys.Although the incidence is not common, there is an enhanced risk of theformation of kidney stones as a result of gout attacks in individuals whoare predisposed to them anyway.

The workout our kidneys get can cause mild kidney distress and/or pain.This is where the thing comes into play about drinking cranberry juice.People can have kidney pain from a number of causes, uric acid being onlyone of those. There are credible accounts that drinking cranberry juicehelps alleviate kidney discomfort, in some cases.

But, it doesn’t do anything for our gout.

For some reason, the overproduction of uric acid is statistically linked tooverweight (arrow through my heart). When overweight people start havinggout attacks, the seemingly logical things is for the docs to tell them tostart shedding pounds. There really are two reasons for this. One is thatfew “thin” people have gout symptoms. The other is that unloading thejoints helps minimize joint damge which naturally occurs during goutattacks.

In the case of some overweight people having gout attacks, the docs arereluctant to order a sudden and rapid weight loss. On the surface, thisseems illogical. However, this is sound medical basis for this. Let’sexamine the situation.

Our fat cells are loaded with uric acid. If we start heavy dieting withrapid breakdown of these cells through ketosis, we release a virtual floodof uric acid, and, voila, a gout attack.

So, the docs first want to try and get our gout under control, then reducebody weight s l o w l y.