Gout Diet Blog

I was golfing yesterday and ended up playing with a man who also hasgout. We kind of compared stories (though he’s been suffering for20 years) and when I told him I had just recently had my secondattack; he asked me if I was on allopurinol. I told him that mydoctor told me that if I had more than one outbreak a year, she toldme I should get on it. His advice, though, was that I should be onit as “…I was just waiting on another attack to occur…”.

Granted he’s not a doctor, but he has more of a knowledge of thewhole thing. Any ideas as to what I should do?

He also told me that seafood (oysters, etc.) really set it off andwhen I thought about it, I had raw oysters a few days before my last

I recently suffered my worst attack ever. First, for the past fewmonths my feet have been experiencing a numbness and also the toeshad been throbbing and keeping me awake. Then about 2 months ago myright wrist and foot swelled up. After 3 unsuccessful 12 day suppliesof prednisone I ended up unable to walk for 3 weeks it seemed as ifall of the bones and muscles in both feet and legs up to the kneethrobbed. I could not put any weight on my legs.

I have been to three Doctors, an Orthopedic surgeon who said It isfrom both gout and osteoarthritis, a Rheumatologist whose firstthought is it is just a bad case of gout. (Never had one like thisbefore) and my own Primary care Doctor seems to think it may beperipheral Neuropathy and is now trying to see what is causing it.

I have been on alpurinol 100mg for years was first diagnosed withGout at age 26 am now 54. The rheumatologist has since increased thedosage to 200 mg and also I must take one colchicine each day. WhileI am now able to walk without a walker (only a cane to steady now) Istill have that numbness in the bottom of my feet. Was wondering ifanyone else had experienced this from gout.

Ofcourse, it may be totally unrelated to theallopurinol. Or it might be a kidney stone of anon-calcium variety. Or you may have a viral infectionwhich has been exacerbated by allopurinol, such asEBV, CMV, or HH6. Such viral infections often induce ahypersensitivity to allopurinol.

Anyone else ever heard of this?I am on maintenancecolchicine..2/dy..been for a few years..OH I needed it..and nothingelse worked..I am also on allopurinol..in the hope that in 1-3 yrs(another 1 1/2) will rid me of uric acid deposits in my feet. Then..the gout came back..no.. abolutely not one thingchanged..nothing..just that the gout came back.. Somehow it dawnwed on me that my feet felt fine UNTIL about anhour after I took the colchicine..so one day I didn’t take it..andfelt fine..AND then EVERY single time I took it..gouttwinges..discomfort.. Hunh?..it appears that my loyal old friend..colchicine..hasturned against me..what’s this all about?..I sure tried this theoryenough times..that’s enough of that..I’m not exactly going to golooking for gout..SOoooo..I just stopped taking it..and feel fine.. I am VERY lucky in that I can see a specialist,chiropodist,and mygp with practically no notice..I see them plus my rheumatologist inDec.so I think I’ll let this one slide..I’m pretty sure they’d justsay to stop taking it..and I did. Gout is a stupid disease..there I was again with it..caused bywhat used to cure it.. Always fit,low uric acid(down from average),almost perfect diet.. Oh well..hey I feel good..fingers crossed..

I had my first attack 2 years ago which was controlled withVoltaren and Allopurinol.After 6 months my doctor reccommended with an adequate diet i couldcut out Allo……..so i did and was fine until 2 months ago when ihad an attack.I am currently experiencing an attack where the gout hasspread from my big toe to the next one along. This makes itimpossible to walk at all. The big toe attack came 1 week ago. Itried Gout cure pills which were a waste of time and for 2 days havebeen on Colchisine (3 a day). But the swelling has not gone down 1bit in either joint. How long would one reasonably expect Colchisineto take effect before going back to the doctor and should i betaking it still if it hasn’t worked yet?

Alright I know beer is bad. Yes I know I should not drink it. But IF one was to drink a beer is any kind better or worse than another? Brand name or brew type, i.e. Bud vs. Becks, or Ale vs. Stout.

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.

It turns out I might have Psoriatic Arthritis and not Gout after all.I still need to see my doctor to confirm my suspicions. Upon studyingthese conditions I found out that PA is sometimes mistakenlydiagnosed as Gout because with PA you also have high uric acidlevels. You can generally tell if it’s PA rather than Gout if youalready have Psoriasis of the skin and also what is known as “sausagedigits” in toes or fingers have a sausage like appearance. AlsoArthritis of other joints is another telling sign of PA. I can’tfully straighten out my right arm or make a fist. I always wonderedwhy I never had the classic Big Toe attack of Gout. Thank you newfootfor the insight….about PA. I finally put the puzzle together.

i am a regular cannabis user and i have found, throughmany months and years of research, that cannabis willnot actually bring on an attack on its own, but if youare suffering an attack, it can make the pain worse.whether this is due to foreign bodies in the bloodstream or due to a heightened sensory level because ofthe effects, i do not know.

my advice would be to puff away until you get anattack, then stop till it clears up.

one more point. there are two basic types of cannabis,there is the solid block (usually called “hash”) thatyou can get, or the dried leaves (usually called”weed”). the hash, i have found, has worse negativeeffects than the weed.

and it was nice to see that everybody completelyblanked me on the “work and gout” issue i raised lastweek. has no-one had a job lost or career ruinedthrough continuous gout attacks? damn.

I spoke to Dr. Raymond Enzenauer, the chief of Rheumatology at theUniversity of Tennesee Medical Center. He has never met me but wasrecommended as someone knowledgable in gout. I came out of theconversation with a few points that I think are important.

First as to a recent post by Newfoot, Dr. Enzenauer also says thatonly 10-15% of your uric acid load comes from diet, as was posted,but, he points out, if your renal system is able to manage 100% ofwhat it makes and cannot handle any more, a 10% overload, every dayof your life, ends up being a lot of extra Uric acid.

The biggest culprit for gout sufferers in his experience is beer.Beer is a double problem for us because it shuts down renal excretionwhile increasing, substantially, the purene load on the system. Hesays that his office knows that Monday after the super bole, therewill be a stream of gout complaints. According to Dr. Enzenaauer,alcohol consumption is a much bigger culprit in triggering goutattacks than diet.

Men and women act very differently when they have gout. Men are morethan 4 times as likely and get gout much younger than wemen. Almostall of the women he has treated are older, 60 and above, and theirgout is related to impaired kidney function. He stresses that hedoesn’t really know but it seems like the attacks in women areentirely different than they are in men.

I need to summarize the conversation more consicely and will do so ina future post.

For now though, I need to go to my exercise. Ond day on the treadmilland I am so much better that I wonder why I waited so long.My attack has almost entirely resolved and I now walk normally.