Gout Diet Blog

So tree bark licking is out of the question, yes?

Today, I received news from my rheumatologist, and I don’t know howto feel about it. Last month, I had a more tests focused on mykidneys. Though, my uric acid level tends to be low and the medicineseems to be working, the doctor noticed that my levels of creatininewere consistently elevated.

One of these test consisted in an ultrasound that found no problemswith my kidneys. The other test was a urine test and it showedevidence of protein and blood in it. He also told me that he cannotdo anything more, and that I should be referred to a nephrologist(kidney specialist).

I hope that I have nothing to worry about, and that this is only tomake sure that nothing really bad is going to come and bite when Iam older. If you have had any similar experiences, please drop me anote.

My background: I am 30 years old, I had my first attack when I was27, and the attacks generally come when I loose wait suddenly (don’tworry, I always loose wait through exercise and proper diet, no faddiets for me, always with the help of professionals).

Would like to know if anyone had problems with colchicine in possiblycausing bone marrow suppression/severe anemia after using it on and offfor many years.

I urge you to read the paper,http://www.niaaa.nih.gov/publications/arh21-1/84.pdfby Murray Epstein, titled “Alcohol’s Impact On Kidney Function”.Compare his clinical and laboratory findings with your ownexperience.The bottom line of the rather long and complicated article is thatwhereas your rate of liquid removal with alcohol is increased, i.e.you gotta go to the head more often, the rate of removal of thingsyou want to get rid of, is dramatically reduced. In other words withalcohol, your body starts to dump water but stops removing theimpurities. This has the effect of increasing your monosodium urateconcentration in your blood and creating a problem. Water will indeedhelp the situation but until the liver can metabolize the alcohol,your kidneys take a vacation from impurity remocal, so to speak. thatis they stop removing urate from your system. If you are not in thethrows of an attack, it will probably not hurt you, however, if youare on the edge of an attack or in one, it will be a bad idea todrink alcohol. During my first attack I drank about a liter of winethinking that it would numb the strange pain I had in my toe.I can testify, under oath, that it did not help. I think I actuallysaw it swell as the wine disappeared.

How high in purines are potatoes?

I have just placed a prescription for colchicine with my doctor.Because my gout is being stubborn and the pain wont clear up,What are the pitfalls etc of taking this drug, is it best used overa short period to get over the worst?

Recently I had my worst gout attack ever, which lasted almost a month. Afterwards, I noticed a new phenomenon (for me). The gout lingered on for along time on a low level. There was no pain except when the joint was toucheddirectly. The area around the joint remained red. This lingering, low-gradegout is something I have never experienced before. Anyone have any suggestionson how to get rid of it?

Also, I picked up a few tips from my last attack. I found out that if you aretaking prednisone for gout, you might have to double or triple the strength ifit suddenly becomes ineffective at the original dose. I also noticed thatexercise seems to help during an attack if you can figure out a way to do itwithout involving the sore joint. And I found that wearing my slippers to bedduring the attack gives the toe some added warmth and protection.

Urate level in your blood, taken over time, is a good measure of yourkidney’s ability to rid your system of urate.

Sodium urate, to be precise mono sodium urate, is sparingly solublein water, or blood, and a number of 7 suggests that you are at asaturated level. If you are having an attack your level will almostcertainly be 7 because that is where it is when things are inequillibrium. The Solid monosodium urate (MSU) is in equillibriumwith the dissolved MSU and untill your system can get the blood MSUto go down, it will be very hard for the crystals to redissolve.

If you have a large excess of uric acid in your system, such asarnoldtheskier apparently has, enough to form trophi by the way, theneven though you stop the production of uric acid with allopurinol,there can be enough uric acid in your fatty tissue, to keep youmiserable even if nothing is coming in because allopurinol is beingused.

When your blood urate level has dropped to say, 5 or less, then thereis a capacity for the blood to dissolve any remaining urate crystalsand it can also excrete some of your uric acid that is converted intosodium urate from the excess you have in your body. Thus, bymaintaining a lower than 7 urate level in your blood, if you can infact get to that point, you will be able to rid your system of theexcess and reasonably expect to live gout free.

Understand this however, the urate level in your blood is not anindicator of how much uric acid you have in your system. The acidform of uric acid is an organic compound that hides in your fattytissue, or as a deposit in your joints as trophi, and it can remainthere for years and years. You could, for example, be on allopurinolfor 3 years, be 30 pounds over weight, have a blood urate level of 5-a good number, and still get a bad attack of gout when you lose 15 ofthose 30 pounds really fast.

It is the mono sodium urate dissolved in your blood that crystallizesout of solution that causes your gout attacks. It is possible tomaintain high systemic levels of uric acid and not ever get into thegout crystal formation stage.

Long term, take allopurinol, monitor your urate level in your bloodand alter the dosage of allopurinol until your urate level begins todrop. As arnholtheskier mentioned, this can be 900 mg for some severecases but most men are brought back to a maintenance dosage ofbetween 200-300mg long term.

A final editorial comment, I also resisted taking allopurinol and Iam only on a 100 mg per day dosage and suspect that I will have to gohigher to finally clear up my gout attacks. But there is no questionwhether anyone who has had a second attack should do it. The longterm effects of allopurinol may be some liver and some kidney damage.Your gout will only get worse and you are not going to be able tocontrol it with diet or water or preying. If you have severe sideeffects then you may have to get really strict with yourself but formy money, it is just plain silly to avoid allopurinol treatment ifyou have had a second attack.

My situation is this: I am aged 38 and have suffered with gout for about 6-7 years, gradually getting worse and more prolonged. The doctor I had at the time did not want to put me on the Allo as he thought I was too young (Something I now wish I had argued!!)After going through about 5 doctors and when I was now getting the attacks in my knees and eventually my elbow, I was reffered to a specialist in the rhemeotology department at the hospital, who Immediatly gave me an injection (Dont know what it was but it worked!) and put me on the allo 100mg a day rising to 300mgs over the next few weeks.I started taking the Allo in September this year and since then I would say that I have had more attacks than before I started on it, Although they do not seem to be as acute or prolonged than I have had in the past, they also always seem to be in places where I have had bad attacks in the past.Now this is where Arnolds posts have got me wondering, The day before the post on the old deposits I went back to my regular doctor and told him that Im getting attacks at least as frequently as before I started on the allo. His diagnosis was: I drink too much, thats why the tablets arnt working!!! He then pulled out a book and started searching through it and came up with……….”The maximum dose of allopurinal allowed per day is 900mgs so I am increasing your dose to 600mgs a day”This is not what I wanted to hear and have not yet started taking 2×300mgs a day it seems completely over the top.The question is as I have only been on the allo for about 3 months is it likely that its these old deposits are causing me the grief and am I better to stay on the 300mgs a day and give them more time??I think I would rather take you guys advice than trust these doctors who all tell you something different each time!!Incidentally If I do stick to the 300mgs Im going to have an awful lot of spare tablets as hes now prescribed me 112×300mg at a time!!!!

Calcium must play a crucial role in gout and gout attacks butinformation about what it’s role might be is just not there.

I questioned Dr. Enzenauer, specifically about calcium, and hereplied that he did not know whether it played an active role or not.He specifically recommends that his female patients take a minimum of1000 Mg of calcium a day but this is a general recommendation forolder women because women suffer much mofe from osteoperosis, bonemass loss, as they age and the extra calcium for women is aprophelactic against this loss.

My belief is that calcuim, probably the surface of a bone in a jointin our toe, that is rich in calcuim, probably serves as a catalyticsite for urate crystal formation.

Why do I suspect calcuim in the bone?

First it is because the attack is always so specific to a bonerelated area and not a tissue ralated area syuch as a muscle, otvicera etc. Knees, toes and even leg when a break occures.

Second and probably more important is the well documented bone loss,specifically in the affected area of a gout attack. This bone loss isdirectly related to the severity and length of the gout attack.

Third, there is another affliction, they call pseudo gout, that lookslike gout and is in fact a deposition of calcium phospate in exactlythe same place and the same way that sodium urate percipitates orcrystallizes.

Thus I am theorizing that calcium, and perhaps a calcium phospatepercipitate is the original stimulation that gets the uratepercipitation started. Calcium urate is also a probable culprit butif it is in the literature I sure cannot find it.

By the way, one of the oldest known remedies from both Mesopataniaand from ancient Greece for gout, and one that has been shownrecently to be relatively effective, is to put the patient on a milkintensive diet. The Greeks and the Mesopatanians perscribed goatsmilk. The amount of milk recommended in these ancient remedies wouldraise your calcium levels well above normal limits and recentclinical studies have shown that that the milk diet does in factreduce the frequency, the intensity and the duration of gout attacks.The researchers also point out however, that the average patient onthe skim milk diet lost an average of more than 15 pounds over 3 to 6months and perhaps the weight loss alone caused the reduction ingout. “When all you can eat is milk, you end up losing your apetite.”

The real issue is this. Should we take calcuim, extra calcium, in ourdiet or not? I don’t know and I believe it is very important to findout the answer to that question.