Gout? what the fuck??

[vinzclortho]

Oddly enough I had a dream I was limping around this morning....anyways, woke up and my right foot was killing me. After about 20 minutes I got up out of bed and could barely walk. I forced it, as I'm prone to doing, and came to work having taken 2 Alleve but the pain persisted. So now I have gone to the doctor's office and gotten anti-gout medication as well as oxycodones for the pain.

This really has taken me by surprise but I guess that's the nature of this beast.

Anybody ever have this shit? What can I expect? I started doing some research but I know that you dentists are my first line of defense. Do I really have to stop drinking and eating shellfish? I love drinking and eating shellfish.

And how am I supposed to take these hydrocodones without booze?


F'n hurts like a bastard though.

[BobMc]

Welcome to my world, it sucks. I was getting attacks about every three months, started in my feet and then I started getting them in my hands. I've since given up beer 100% and stopped eating a bag of beef jerky in a sitting. Now I only get them every once in a while.

My doctor prescribed me Indomethacin, whenever I feel an attack (usually feel a twinge in my toes or fingers) coming on I take two pills in a 24 hour period and it takes it right away.

Good luck man, it ain't fun.

[Tye 1on]

Coincidentally, first small flare in a few months kicked in yesterday, ankle. Couple colchicine at 7am, another at noon, holding it at bay. FYI colchicine's pricing went thru the roof a few months back cuz of typical corporate bullshit. My doc says they can hook me up thru Canada if i ever need a refill, good to know. Lots of good info in this thread.

good luck mang.

[vinzclortho]

thanks for pointing me to that thread Ty. Good info in there.

So no beers, or no alcohol at all?

This is really sinking in that two of my favorite things; booze and seafood, are now a no-no. fucking pissed!

I'm trying to find out if this is related in anyway to thyroid conditions....any insight on that anybody?

[Dantheman]

Maybe try PMing DeutschBag, I recall reading that he had some major gout issues that he has had good success getting under control.

I haven't heard of shellfish being an issue, but you definitely need to eliminate alcohol and fructose intake as much as possible.

[Tye 1on]

If you have untreated hypothyroid, i dunno, maybe.

I've got mine narrowed down to booze. I can drink Natty Light til the cows come home, but if i have a bunch of IPA's, over 1.5 bottles of red wine or over 3-4 gin/tonics, i'm asking for trouble. BobMc had to drop kick the beer too, so ymmv.

[DeathVan]

A couple of friends suffer, one is the brewer here in town (he still drinks everyday), the other has given up red meat entirely.

Get on the meds, I know they work.

as to a relation to a thyroid condition: I found these articles that do point to a relationship


http://www.ncbi.nlm.nih.gov/pubmed/11791637
CONCLUSIONS:
Ourfindings confirm the data in the literature concerning the high prevalence of hyperuricemia and gout in hypothyroidism. It shows that hyperthyroidism can cause a significant increase in serum uric acid, as well, although lower than the hyperuricemia due to thyroid hormone deficiency.


http://adam.about.net/reports/000093_4.htm
Thyroid Dysfunction. Some studies have reported a higher prevalence of gout in people with hypothyroidism (low levels of thyroid hormone). Hypothyroidism may even trigger gout. There is also some evidence to suggest that hyperthyroidism (high levels of thyroid hormone) can increase uric acid levels, although not to the degree that low thyroid hormones levels do.

Interesting correlations

Best Luck

[Harry]

Gout sucks.

I was having about two flareups per month, became a vegatarian, and then a vegan, plus stopped drinking booze. No effect on my gout whatsoever. Still multiple flareups every month. After a year as a vegan, still with horrible gout, and craving beef, I went back to being a carnivore.

So at least in my case, diet has no effect on my gout.

Allepurinall (sp?) worked good in my case, take one every day for the rest of your life. Did that for several years, with 1 or 2 small flareups every six months or so.

Then the voters of Montana legalized medical marijuana. I got my card using gout as the reason, mainly just because I wanted to get high. To my surprise I was able to go 4 years with zero gout without taking any drugs or change in my diet. So medical marijuana definately works for gout. A few months back the Tea Party here in Montana, with campaign donations from the private prison industry and big pharma, overruled the vote of the people and clamped down on medical marijuana. When my card ran out, I stopped smoking and 45 days later had a huge flareup, the first in over 4 years.

I am back on prescription allepurinall. Glaxo Smith Kline got a good return on their lobbying investment...

[Tye 1on]

A couple of friends suffer, one is the brewer here in town (he still drinks everyday), the other has given up red meat entirely.

Get on the meds, I know they work.

as to a relation to a thyroid condition: I found these articles that do point to a relationship


http://www.ncbi.nlm.nih.gov/pubmed/11791637
CONCLUSIONS:
Ourfindings confirm the data in the literature concerning the high prevalence of hyperuricemia and gout in hypothyroidism. It shows that hyperthyroidism can cause a significant increase in serum uric acid, as well, although lower than the hyperuricemia due to thyroid hormone deficiency.


http://adam.about.net/reports/000093_4.htm
Thyroid Dysfunction. Some studies have reported a higher prevalence of gout in people with hypothyroidism (low levels of thyroid hormone). Hypothyroidism may even trigger gout. There is also some evidence to suggest that hyperthyroidism (high levels of thyroid hormone) can increase uric acid levels, although not to the degree that low thyroid hormones levels do.

Interesting correlations

Best Luck

thanks for that, interesting.

Gout sucks.

I was having about two flareups per month, became a vegatarian, and then a vegan, plus stopped drinking booze. No effect on my gout whatsoever. Still multiple flareups every month. After a year as a vegan, still with horrible gout, and craving beef, I went back to being a carnivore.

So at least in my case, diet has no effect on my gout.

Allepurinall (sp?) worked good in my case, take one every day for the rest of your life. Did that for several years, with 1 or 2 small flareups every six months or so.

Then the voters of Montana legalized medical marijuana. I got my card using gout as the reason, mainly just because I wanted to get high. To my surprise I was able to go 4 years with zero gout without taking any drugs or change in my diet. So medical marijuana definately works for gout. A few months back the Tea Party here in Montana, with campaign donations from the private prison industry and big pharma, overruled the vote of the people and clamped down on medical marijuana. When my card ran out, I stopped smoking and 45 days later had a huge flareup, the first in over 4 years.

I am back on prescription allepurinall. Glaxo Smith Kline got a good return on their lobbying investment...

Seems like the biggest constant about treatment across individuals is that it is very individualized.
Good to hear of the results of that medi-mari stuff...sort of an interesting coincidence...

[skinnyskier]

Allopurinol is cheaper than pot. I doubt pot gets your uric acid below 6, but hey, who knows?

[Tye 1on]

Allopurinol is cheaper than pot. I doubt pot gets your uric acid below 6, but hey, who knows?

I don't think it's a straight 'over 6=flares' equation. Most w/flares are over 6, but not all that are over feel the pain...

If it's any consolation, if you choose to 'just deal with the pain' it changes over time [and i'm NOT recommending this approach!]. Goes from smaller into bigger joints, more dull/overall compared to the early 9 out of 10 superpiercing 'don't even talk to my big toe' pain...

[Spats]

Important update: DeutschBag hasn't had a single gout attack since going paleo. See this post:

http://www.tetongravity.com/forums/s...ut#post3434714

Here's the post I made which started him on the journey. It includes several links to peer-reviewed studies, and most importantly, what the REAL dietary problems are for gout sufferers (hint: not meat or purines, though alcohol is indeed bad).
http://www.tetongravity.com/forums/s...ut#post3170413

The bad news is that gout sucks. The good news is that it's usually possible to keep it in remission with diet (I won't use the word "cure" because its causes are complex and multifactorial.)

Harry: it's not surprising that going vegan/vegetarian had no effect, because (as noted in the posts I linked) purines aren't the problem. As the scientific literature clearly states, "90% of hyperuricemia is due to underexcretion, not overproduction."

[doughboyshredder]

Allopurinol has been a godsend for me. After years of just dealing with the pain, it moved up to my foot from my toe. Worst pain ever. Dietary changes had no effect at all. As long as I take my pills everything is fine.

Sent from my PantechP8000 using TGR Forums

[skinnyskier]

I don't think it's a straight 'over 6=flares' equation. Most w/flares are over 6, but not all that are over feel the pain...

If it's any consolation, if you choose to 'just deal with the pain' it changes over time [and i'm NOT recommending this approach!]. Goes from smaller into bigger joints, more dull/overall compared to the early 9 out of 10 superpiercing 'don't even talk to my big toe' pain...

< 6 is the usual goal for uric acid. Some docs don't increase allpurinol so as to get below 6 in order to prevent recurrent gout. That's not to say everyone with a uric acid above 6 will have a flair.

Also, I think I more or less agree with Spats. OMG. Some evidence suggests that gout sufferers should get their protein from low fat dairy not meat and fish, but I agree with the avoiding refined carbs and not trying to severely restrict purines part. Patients can push their uric acid down by more than 1.5 mg/dl with such a diet.

[Harry]

Allopurinol is cheaper than pot.

True.

But look what Big Pharma did to the price of Colchicine. $5 per pill ? I used to get a whole bottle for less than that. Who's to say those asshats won't do the same to the price of Allopurinol ?

I doubt pot gets your uric acid below 6, but hey, who knows?

Yeah, I don't know.

All I know is what worked with me and what did not work for me. I have never had my Uric Acid level tested. I have had the needle jammed into my toe to confirm the existence of crystals.

Becoming a vegatarian/vegan did nothing, but lighting up solved everything.

Two months ago, when I was blazing nightly, I was training for a marathon. But right now I can barely walk the length of my living room.

Hard to believe our society says it is wrong to use an herb from nature that God created, but that I should take a synthetic chemical created by man into my body every day for the rest of my life...

[Tye 1on]

< 6 is the usual goal for uric acid. Some docs don't increase allpurinol so as to get below 6 in order to prevent recurrent gout. That's not to say everyone with a uric acid above 6 will have a flair.

My last labs came back w/uric at just over 10. Two very minor flares in six months, one took 3 colchicine, other 2, pain only 3/10. I'm probably the exception to the rule and wouldn't advocate my program, just pointing out how individualized it is...

Good to hear on the refined carbs. Six weeks ago the doc suggested cutting out all yeasted breads, unfortunately including pizza. Easier than i thought. Pretty interesting doc, last night listened in on a webinar he did for docs on 'Integrative Cardiology: Identification and Nutraceutical Management of Emerging Cardiovascular Risk Factors'. Understood maybe half of it...

[Spats]

In case it wasn't clear from the links I posted above, here's the executive summary:

-The kidneys deliberately hold onto about 90% of the uric acid we produce. Therefore, the question isn't "how to produce less UA", it's "how do we get our body to excrete it instead of holding onto it?"

-UA is a strong antioxidant, which is why our body keeps so much of it around.

-The two substances that cause our bodies to raise serum UA levels the most are alcohol and...FRUCTOSE.
-Yes, that's right, fructose. It's extremely reactive in vivo, which is likely why our body holds onto UA when we ingest it.

-The oxidative stress of exercise also causes our body to raise its serum UA levels.
-Inflammation also causes our body to increase sUA production and provides sites for the crystals to grow (AFAIK).

Therefore:

-Don't drink alcohol. But you knew that already.

-Cut out ALL sweet drinks from your diet, INCLUDING FRUIT JUICE. Large, fast spikes of fructose tend to overload your liver's ability to clear it from the circulation. Result: raised sUA.
-NO SUGARY ENERGY SHIT, ESPECIALLY WHILE YOU'RE EXERCISING. This is a double whammy on your sUA levels.
-White sugar is half fructose, so you need to cut WAY down on anything containing sugar.
-Cut your fruit intake, especially fructose bombs like apples, grapes, and oranges. (An occasional handful of berries won't kill you.)

-If you desperately need energy sugar during exercise, make your own Gatorade from Kool-Aid, salt, and pure dextrose. Homebrewing stores sell bags of dextrose.

-Simple carbohydrates aren't the problem so long as they're starch, not sugar. White rice and potatoes are fine in moderation: there are other reasons not to overdo them.
-Meat, protein, and purines aren't the problem. Your body is regulating its sUA because of oxidative stress: if you ingest more purines your body just excretes them.

-Eat an anti-inflammatory diet to decrease systemic inflammation. Stop consuming "vegetable oils": replace them with coconut oil, tallow, butter, and occasional olive oil. Cut out grains, especially gluten grains (white rice is usually OK). Eat some fatty fish or take fish oil supplements.

Given all this, it shouldn't be surprising that eating a paleo diet helps many people with their gout symptoms:
http://www.gnolls.org/1141/eat-like-...ational-guide/

I hope this helps!

[Tye 1on]

^^^that is a great summary and tracks spot on w/my meager research.

My only slight different take is on the DIY energy drinks. For better or worse, i'm a big believer in Hammer Nutrition products. My only century ride and a bunch of 60-90 mile training rides were liquid only/pure hammer fueled. Never bonked or got hungry. They talk about staying away from all of the -ose sugars here and talk about osmolality or the biochem of fuels absorption here.

[vinzclortho]

Well, the foot is back to normal as of Saturday night and I was able to go to the gym yesterday morning finally.

Gonna see a nutritionist about weight loss/gout prevention. As fun as the oxycodene + port wine was saturday night while watching Temple Of Doom with my father-in-law, I would prefer to avoid the whole intense-pain-in-the-foot thing again.

I'll let y'all know what the nutritionist has to say.

[joetron]

^^^that is a great summary and tracks spot on w/my meager research.

My only slight different take is on the DIY energy drinks. For better or worse, i'm a big believer in Hammer Nutrition products. My only century ride and a bunch of 60-90 mile training rides were liquid only/pure hammer fueled. Never bonked or got hungry. They talk about staying away from all of the -ose sugars here and talk about osmolality or the biochem of fuels absorption here.

YES! Hammer Products are incredible.

[Spats]

Well, the foot is back to normal as of Saturday night and I was able to go to the gym yesterday morning finally.

Gonna see a nutritionist about weight loss/gout prevention. As fun as the oxycodene + port wine was saturday night while watching Temple Of Doom with my father-in-law, I would prefer to avoid the whole intense-pain-in-the-foot thing again.

I'll let y'all know what the nutritionist has to say.

If they tell you anything half as correct or helpful as what I've already told you, I'll be stunned. Most doctors and nutritionists are stuck in the 1950s idea that meat causes gout. And I haven't seen a single one mention the fructose issue.

The science is very straightforward, and I can send you all the citations you like...it's just taking decades for the GPs and nutritionists to catch up. The reason? Once allopurinol was discovered, all gout research basically stopped until rates started climbing again (i.e. allopurinol wasn't enough). "OK, we've got a drug that cures it now, no need for further investigation."

They talk about staying away from all of the -ose sugars here and talk about osmolality or the biochem of fuels absorption here.

Hammer stuff is solid, but it's a lot of money for a very incremental performance improvement...and the idea that exercise makes you magically not absorb dextrose is, well, silly. Fructose would indeed be stupid because it can only be used by the liver, and sucrose requires sucrase in addition to being half fructose, so I agree with them there. However:

"Complex carbohydrates, however, absorb at about three times the rate as simple sugars."

Um, have we heard of the glycemic index? That's a measurement of how quickly sugars are absorbed. Pure dextrose has a GI of 100 BY DEFINITION...it's the measurement standard. Any "complex carb" will, by definition, have a lower GI than dextrose.

So they're right about mainstream "sports drinks" being suboptimal because they usually use HFCS or sucrose, but I don't see how dextrose can possibly be absorbed slower than (say) maltodextrins. Complex sugars are just a bunch of dextrose strung together in chains!

[DeutschBag]

vinzclortho - save yourself the time, money, and frustration and listen to spats! It is very likely that the nutritionist will be dolling out typical standard american diet advice, much of which is horrible for gouties and non-gouties alike.

I am still completely gout free, nary a twinge, since I started eating Paleo. In our house, we just refer to it as eating clean. I will be forever in debt to Spats and the information he has shared on TGR. It has literally changed mine and my wife's life. We feel we are so much better prepared to raise our twin daughters now because of how much better we feel, how much more energy we have, and just having a better mental outlook on life. Yeah, I would have chimed in earlier on this thread, but I haven't had much time since the birth of our daughters 5 months ago.

I'm dead tired, but will try to re-visit this thread in the next couple of days and read through it more carefully. It was linked above, but I did fairly thoroughly outline my experiences with gout and what I did to get it under control in this thread

Here are a few brief thoughts from a quick perusal of the thread:

- The gout food lists are pretty much bunk. I don't believe there are 'good' or 'bad' gout foods or foods that act as triggers. It's a person's overall diet that must be looked at. I am convinced of this now. I went against all conventional gout wisdom, went from being a near vegetarian, and began consuming only quality meats, eggs, vegetables, and fruits and have not suffered from an attack since. I can not find one other single person who has been able to completely eliminate gout attacks from their lives, be it via drugs, giving up meat and seafood, going vegan, eating pounds of cherries or drinking black bean broth or other homeopathic remedies. I'm the only one I know of - no attacks, no flares, no twinges since going paleo (I haven't taken allopurinol now for six months either).

(shit, that wasn't brief at all)

- If you have unbearable gout and still drink alcohol, stop.

- Mary Jane is wonderful for gout (and many other things). It won't lower your uric acid, it won't help with inflammation, it won't cure any of the physical aspects of gout at all. What it will do is help you relax and take your mind off of the pain. For a while, I was eating Percocet like it was candy. My gout was so bad that the docs kept giving it to me. Talk about messing with your system..... Thankfully, living where I do, I can get to Holland quite easily for medicine when I need it. In fact, I just vaped my last bit of Leiden goodies an hour ago to help with my newly diagnosed torn meniscus and dislocated big toe.

Dang, must go to bed. I'm not good at brevity.

Spats - I'm going to keep saying it - thank you, thank you, thank you! I just saw the post on Free the Animal and will watch the interview tomorrow. It's actually what led me back to TGR to see if you'd been active on here lately. Ordered your book tonight too Didn't know you had completed it! Congratulations! Again, I've been out of the loop the last six months with the back surgery and then the twins being born. Glad I checked Richard's site tonight! Stoked for you man, and can't wait to read the book!

-

[panchosdad]

Bumping this as I've had a swollen big toe now for 5 days. Any body with any updated advice?

[SJG]

a lot of folks have success quickly with tart cherry juice. I have a couple friends who used it and it worked.

[BobMc]

Indomethacin for the short term get it gone effects. I now drink red wine as my primary alcohol and haven't had a flareup in years.