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Personally, I prefer this coverage of the vegetables and gout research, but I'm biased
That was, one of my first gouty discoveries and the reason I decided to try and explode a few Internet Gout Myths. That page, and the associated research are long overdue for a makeover, but it is a shame that so little specific research has been done on the benefits of diet since that report.
Other than the pointers that dairy products (statistically) appear to help gout, and vegetables are not the villains that they were once thought to be, there is little research into gout and diet – no money in it I guess
Just start it now.
There are no medical reasons for the delay. Many doctors delay the uric acid lowering treatment because they believe that the patient is less likely to continue with it if they associate it with continuing, or temporarily worsening, pain. I believe a proper explanation would be more effective.
Prophylactic colchicine is a standard treatment during the first few weeks of allopurinol treatment to minimize associated gout flares in New York, and the rest of the world.
It doesn't make sense to take it in this preventative way if you are not on allopurinol (or other uric acid lowering treatment).
I usually get the first signs at night before I go to bed. So I take an Indomethacin pill before I go to sleep. Ya.. the feeling I get is like a sharp kink in the toe joint.
cjeezy said:
GoutPal said:
You've mentioned “healthy diet” a couple of times recently in a way that suggests that you feel it is not good for you. What do you mean by healthy diet?
I just meant that certain healthy foods like spinach, legumes, etc are bad for gout sufferers but otherwise would typically be healthy for the average Joe.
No they are not bad.
Many people get confused about purines (including myself
). Yes, uric acid comes from the breakdown of purines in the presence of xanthine oxidase, but there is no evidence to suggest that this happens to vegetable purines, and some evidence to suggest that it doesn't.When your allopurinol stops the xanthine oxidase being produced, it's irrelevant anyway – as it is for all food. Though this does beg the question “can food increase xanthine oxidase production?”
I'm looking into this, but not getting far at the moment. I have found one reference answering the opposite question – flavonoids inhibit xanthine oxidase reduction.
If anyone has any info on food (or anything else) that increases production of xanthine oxidase, I'd love to see it.
Mark said:
Went to the quacks and started a course of Allopurinol. 100mg per day (hoowever I must admit i sometimes forget to take the bloody meds).
If you wanted to design a course of action with the best chance of inducing a gout flare, that would be it.
Allopurinol is intended to lower uric acid. Mis-use it, and you will almost certainly suffer the consequences.
hey guys,
Just my 2 pence worth..
I've been suffering for a couple of years, 3-4 attacks a year. Very painful. Started in big toe (left foot), then to the other foot, then ankle blah blah..
Went to the quacks and started a course of Allopurinol. 100mg per day (hoowever I must admit i sometimes forget to take the bloody meds).
Anyway, my point is that after a couple of weeks of taking them, I had a huge flare-up in my left knee!!
So beware and brace yourself if you do start on this course of action.
‘This is a lifetime drug. Once you are on it, you’re on it for life’ is a generalization.
Like all generalizations, there are always exceptions (except this one of mine).
Allopurinol has one function – to lower uric acid to a safe level (below 6mg/dL). If something else happens that achieves this (e.g. withdrawal of one or more contributory factors), then allopurinol is no longer necessary. For most gout sufferers, nothing else can be done. For some others a change in diuretic usage, iron intake, weight etc can allow phasing out of allopurinol.
Statistically, the odds are against you. Medically, it absolutely depends on your circumstances and statistics are completely irrelevant.
Gout patients on uric acid lowering treatment fall into two groups. Those who maintain uric acid below 6mg/dL (.35mmol/L) and those who are wasting their time, effort and money.
Those who are not getting any treatment, or who are not treated adequately, will definitely experience gout attacks at some point in time. They will get more widespread, more frequent, and more painful.
Those who are maintaining uric acid levels safely below 6 (a safety margin is needed to cover those natural fluctuations) might experience some gout flares. They will get less widespread, less frequent and less painful.
Nice idea funandsmile1,
A good place for this information is in your profile. That is a good place to put any information about ourself that helps people answer your questions better. But keep it brief, or people won't read it.
Mine now reads:
Managing gout pain: Ibuprofen as required
Managing uric acid: Considering allopurinol
Gout first diagnosed: 2001 (ish)
Also, I've amended my signature so that anyone viewing my message can see that there is information in my profile.
Obviously, only do this if you feel comfortabl with revealing information about your health.
I missed the smiley on my experiment comment
I'm not seriously suggesting that you monitor food / drink against uric acid levels. There are simply too many factors for a one person experiment. A group average of 20 or more might show something.
There is certainly no need for you to worry anymore. Allopurinol is clearly keeping you in a safe place.
You've mentioned “healthy diet” a couple of times recently in a way that suggests that you feel it is not good for you. What do you mean by healthy diet?
Great points, cjeezy.
The occasional lower uric acid reading after a few beers doesn’t surprise me. Alcohol has several effects, one of which is that it promotes uric acid excretion. Beer also promotes uric acid production thus counteracting that effect, but if you are on allopurinol the second effect will be very much reduced.
It might even be possible to arrive at the optimum beer intake to maximise uric acid reduction, but very difficult to rule out other factors. Much better experiment than many I’ve thought of recently.
Fascinating stuff, metamorph.
This points to a uric acid reducing benefit of Black Bean Broth, as well as an anti-inflammatory benefit.
I don't suppose anyone has before and after measurements? I might have to do a little experimenting on myself.
Dr Buff said:
I'm still convinced that their must be a better way to clear out problem joints faster and without invasive surgeries.
There is a well proven way, which is to lower blood uric acid. It must be below 6mg/dL, but lower is better. Get it down to 3, and the uric acid will be gone from your joints in a few months.
Thanks for the response. I have problems with many joints, I was mis-diagnosed for not having gout for about 15 years; It got to the point I could not use my right arm and was developing lumps of uric acid on my arm before a doctor would believe I even had gout. I tried Allopurinol for two months and saw no improvement in my arm, actually it got worse. I then tried probenecid and in two weeks I felt and saw an improvement. I'm on a gram a day, 500mg twice daily; everytime I try and bump it up even by a 1/4 tab (125mg) I have problems with my knees, which would prevent me from doing my job and put me in pain for a week or two. I did colchicine for the first 7 months for the pain but stopped due to my hair falling out. I will have to go in and get my levels checked now after being on the meds for this long. Honestly, I am annoyed by doctors at this point from being in pain for this long… I actually put myself on Probencid; after doing much research on the net. Also, I replaced my colchicine with Lemon/Lime juice a few times a day. I read that this helps kick the acid out of the body and alkalizes the body, although it is acidic. It seems to be helping with the pain/burning.
My pain is not only from having immune reactions but from joint obstruction. I still cannot fully extend my arm without some crackle and then maybe a pop and then pain. My knees and one ankle are the same.
I'm still convinced that their must be a better way to clear out problem joints faster and without invasive surgeries. I will continue to look. thanks and regards.
Though the pain of a gout attack is often localized in one or two joints, uric acid affects all joints, and other body tissues. It is only when you get an immune system reaction to these urate deposits that uric acid causes gout pain. All gout sufferers have an abundance of uric acid crystals all over the body, but not all are causing pain (yet).
Uric acid is carried all around the body, and will crystallize where it can. Hence tophi in the ears are common. New technology shows us how crystals, though concentrated in joints, are spread throughout the body (use the search box above to find DECT images here, or “dect gout images” in the blue Internet search box at the foot of each page).
So to stop new crystals forming and dissolve old ones, the only answer is to lower blood uric acid levels and treat the whole body via the bloodstream. Allopurinol is one drug that can be administered by injection. The new genetically engineered uricase treatments must be delivered by injection. However, none of these are site specific, because they do not need to be. They also involve trips to medical facilities that pills do not.
As for neutralizing uric acid, the chemistry is somewhat beyond me. My basic knowledge suggests to me that even if a specific agent could be found to react with uric acid alone, this would inevitably produce deposits of the resulting salts. I can only assume that such a reaction would be fatal. Maybe someone with a better grasp of chemistry will be along soon to comment.
Finally, if you are only peeing a small amount of uric acid, is probenecid the right treatment? It is not a good choice for under excreters. Have you had a 24 hour urine test? Are your uric acid levels measured regularly?
Urate lowering therapies are currently the best they have ever been, with recent new drugs, and more under development. However, they are only any use if uric acid levels are properly monitored and managed. Not much point in looking for new treatments, if the existing ones are not applied correctly.
Don’t forget my golden rule of being wary about the last result. The next one might show this up as a bit of a rogue.
Also, there are many other factors that could cause a blip in uric acid results. A burst of exercise, a reaction to a germ or virus, some old uric acid crystals dissolving. It is a long list, and so I urge you not to be disheartened over one result. There are a lot of people round here who are relying on you to show that dietary control can work. Let’s hope you’ll look back on this in a few weeks, and see it as one of those occasional high readings that just happens.
Excellent topic title – you know where the Add new topic is (and I'm more than happy to close or delete this one, if asked).
I think your doctor has responsibility to act as professionally as possible. The very fact that some fall short means that we also have responsibility to learn about our own health.
For sure, when you are lying crippled, you can blame the doctors. Far better to take some responsibility back, and check some of the basics yourself (I got flamed for saying something like this earlier, but can't remember the details. This is my general opinion, not aimed at anyone in particular)
The adage “Doctors bury their mistakes” is old enough to suggest that at least the responsibility for selecting a good doctor must always remain with the patient.
No, I do not get fed up with people who have to self diagnose. As long as respect is shown, and people are asking gouty questions, then that is what this entire forum is all about. And if it's not gout related, there is the general section.
I have long thought of a protocol along the lines that you suggest. Trouble is, people arrive here from many, many different avenues, and it would get too complicated methinks. There might be some mileage in a few different “protocols” – e.g. one for new to gout over 40, one for had gout for over 10 years, but never done anything about it.
Trouble is, there ends up being too many things, so I've settled for a simple “What is your uric acid level? OK let's do something to lower it approach”
I do, however think a doctor-patient protocol would be a good idea. Covering the key points of diagnosis, initial care and ongoing support, it might help make it clear that gout management is a lifelong commitment by both the gout patient and his/her medical team.
Back to the starter question of making me fed up.
Posting in the wrong forum is a bit annoying, but easy to move if I catch it early. If I do not, and people have started replying to the post, then there is not much I can do about it. But if people are happy to discuss something in the “wrong” topic, then who am I to argue. I often think the forum divisions are a bit meaningless – maybe we should just have one big forum where anyone can say what they want. Anyway, this “please help my gout” place is a good place for the undecided. Not sure where to post? Just stick it in here.
Next up on the annoying list is overuse of abbreviations and acronyms. It must be a nightmare sometimes for people who are new to the forum. Whatever happened to the rules that were drilled into me at school. Only use abbreviations where they are commonplace, and introduce them properly at the first use (so if there is only one instance, they remain pointless distractions). I deal with this by trying to use everyday language when replying to posts in the hope that it will clarify the original to other readers. I am not a General Practitioner.
Next is wandering off topic. Not too bad if all outstanding points have been well and truly covered, but if someone is still waiting for an answer then it must be annoying for them. It's annoying for me, but I deal with it by shrugging my shoulders.
Final thing that gets me fed up (unless I think of another whilst typing) is people who write entire posts in CAPITALS. I thought I'd got over this by having a sleep, but no.
Oh, I thought there'd be another. The thing that really truly is beginning to get the better of me (and may account for some temperamental outbursts) is this slooooow computer of mine. I simply cannot work out what is wrong with it. The good news is that Mrs GoutPal is dropping serious hints that Santa Claus may soon be coming to my rescue. Ho Ho Ho
Happy at last.It is generally advised to wait until a gout flare has finished before starting on allopurinol.
Everything I have read points to this being a psychological benefit rather than a medical one. Allopurinol might prolong the attack. If you wait until it is over, it might start another attack (though also, it might not – I will try and find some percentages). Doctors believe that you will not take your allopurinol if you link it to failing to cure pain, but I cannot understand the logic behind this.
I believe the reason why so many people fail to continue with allopurinol is lack of understanding about what it is actually doing. It’s benefits suggest to me that the sooner you start taking it, the better.
As for Dan’s point about disagreement amongst doctors – that is because many of them have not been trained how to deal with gout. Send them to zip2play for some lessons.
dandz said:
Sorry if this isn't referencing your question, but I've tried everything and can't figure out where in hell to post a new question !!
I'm not ususually too bothered where you post, but I managed to move this to a new topic in time (once people start answering, then I can't move a “off-topic” discussion).
For future questions, and to any other newcomers reading this, Each forum has a “New Topic” button and link. There are also “Start New Discussion” links in the Forum Guidelines, which I strongly recommend reading before you post. If this sounds a bit draconian, I don't mean it to be. I simply want everyone to get the most out of the forum, and like any forum, a little preparation, planning and targeting will always get you the best responses.
I will be back to answer your question more fully soon, but the short answer is: body pH, measured either by urine or saliva, has almost nothing to do with uric acid. Alkalizing the urine will make uric acid more soluble and help avoid kidney stones but it will do little else for gout management.
You must, absolutely must, and at the risk of repetition, definitely must, measure your uric acid number. Depending on that value, and your gout history, you might be able to control your uric acid through diet and lifestyle.
Report back with your uric acid number, and we can help you better.
But if you use Google Scholar or Pubmed, you will find very little, which leads me to believe that the other stuff is marketing bollocks.
As ever, I would love to be proved wrong. Can anyone explain to me what a lymphatic workout is? (science not hype please – I've had enough of that in other threads).
I am not saying that rebounding is wrong – sounds like a great gout exercise to me. I'm just concerned that people use these thing for the right reasons.
I didn't mean to sound harsh about the home-made aspect, but I remain concerned that people are careful about safety. Even the bought ones should be checked regularly.
Excellent news, nokka.
I would think that your greatest risk would come from cold (6.8 is saturation point at normal body temperatures)
Keep warm, and keep us posted.
Wizza, If you are being treated for gout by someone who thinks .43 is normal, you are being treated by a sadist.
Irrespective of your injury, you need to control your uric acid properly.
Fractures usually heal eventually. Untreated gout will just cause you increasing musculo-skeletal problems as you get older.
Home kits are OK, but what you really need is a doctor who knows gout – or at least train yours to keep your uric acid under .35 mmol. To clear your uric acid crystal buildup, you need to aim much lower than .35 for at least 6 months.
As well as the Uric Acid Levels page I just referred to, you and your doctor also need to read the related page from the Reference menu above – Uric Acid Levels – which explains scale conversions and decries “normal”.
Darren, I hate to be harsh to a newcomer, but you need to wake up!
If you have had gout since your twenties, you have a serious medical condition that will not be fixed by pissing about with diet.
The allopurinol risk for kidney stones is lower than the risk without allopurinol, and is no risk at all with adequate hydration and alkaline urine (best practice for all gout sufferers).
If you were half-blind, would you stop wearing glasses because of a myth that it might lower your chances with the ladies? (seriously not true!
)You've got 20 years of urate buildup that will cripple you in your 50's or 60's unless you get your uric acid levels under control.
Please get back on the allopurinol and get your uric acid sorted.
If you Google rebounding you will see amazing benefits from rebounding for a slew of conditions(as well as testimonials). Of course, most of these web sites sell rebounders. If infact rebounding is the best way of activating the Lymphatic system, maybe it would also have benefits for gout. Was wondering if anybody had tried it. As to the rebounder I made, it was not to save money. It gives a very slow and less harsh bounce than 4ft rebounders. Toes usually stay on the board with just the heels raising. Easy to talk and do breathing exercises while bouncing. After 5 minutes of bouncing it leaves me a little light headed. I dont need the hand rail, but my friend “Tiny” uses the handrail. Can you picture a 550lb man on a 4ft rebounder? Ha!
Thank you for your quick response. I am currently looking into state medical assistance so I can treat this properly. I just have a question on when to start taking allopurinol. I thought I remember reading that you should take it after a flair up and not during. Could you adivse? Should I start on it right away? Thanks again for this wonderful resource.
– Jared
I can’t recommend changing dosage without consulting your doctor.
It takes 2 or 3 days for allopurinol dose change to affect your uric acid production. How this affects you personally is unknown until you try it.
Colchicine can be used as a low dose preventative at .6mg twice a day. There is an unofficial guide to colchicine for acute gout attacks splattered around here.
The lymphatic effect of exercise, as far as I can tell, is not proved. If it does exist, it is certainly not exclusive to mini-trampolines.
Trampoline exercise is preferred over similar floor based exercise, e.g. rope work, as stress to the joints is reduced.
Be very, very careful on home made equipment. I would have thought the efforts of testing to ensure safety would not be worth the cost saving.
