Lets talk about Gout

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#1194798 10-Dec-2014 12:35

gchiu: Very unusual for first presentation of gout to be knee swelling.
Needs confirmation with some fluid taken from your knee and examined under polarised light microscopy.
For most people, the reason they get gout is that their kidney function deteriorates with time, and they under excrete uric acid so that it accumulates in the body.

Id been getting knee pain for about 2 years prior, no swelling....suspect it was early signs of it "gout".

Kidney function in my tests was fine, I'm picking it was diet that needed attention and my body saying hey I cant get rid of all these purines you are loading me up on. I went though a period last year where I was consuming about 3-4 bottles of white wine per week.

MikeB4

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#1194799 10-Dec-2014 12:36

If you are getting recurrent bouts and the Uric Acid is persistently high you should talk to your Doctor about Allopurinol it removes Uric Acid from the blood and eases the build up in joints

Here is a crazy notion, lets give peace a chance.

gchiu

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#1194869 10-Dec-2014 13:52

Dratsab: I had a flare up in my foot a few months back which the doc suspected was gout. Turned out it wasn't and an xray revealed osteoarthritis. Didn't enjoy being off the Saturday morning liver/kidney breakfast fry-ups (done Thai style) while waiting for the test results.

An x-ray showing osteoarthritis does not disprove the presence of gout. The two occur independently.

Still, you may not have enjoyed it, but it may have saved at least one Thai from being harvested for their liver and kidneys for your breakfast!

gchiu

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#1194870 10-Dec-2014 13:54

dipkiwi: I recently have been experiencing some sharp pains in the knuckles of my right hand an hour or so after eating a decent meal. I was wondering if it was gout related. I had a uric acid blood test yesterday and it came out at 0.40 mmol/L. Reference range for the lab was 0.20 to 0.42, so I think mine is a bit on the high side. Reading this article here I am going to try severely limiting fruit and honey for the next couple of weeks (I already eat very little sugary products) and see if the discomfort subsides.

Worth a shot anyhow.

You'd be better off severely limiting your decent meals than cutting back on fruit.

gchiu

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#1194877 10-Dec-2014 13:59

During a gout attack (ie you have the pain and swelling) your acid levels will be normal as the uric acid has crystalised out of your blood.

Only happens like that in some people. Not all.

gchiu

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#1194880 10-Dec-2014 14:01

KiwiNZ: If you are getting recurrent bouts and the Uric Acid is persistently high you should talk to your Doctor about Allopurinol it removes Uric Acid from the blood and eases the build up in joints

Or cutting back on your intake of animal protein, shell fish, beer and other sources of purines as well as maintaining an adequate fluid intake.

Allopurinol is for life, so other options should be tried first if appropriate.

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gchiu

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#1194884 10-Dec-2014 14:08

One of my worst trigger was cauliflower, but many "good" foods are included.

http://www.whfoods.com/genpage.php?tname=george&dbid=51

Interesting. Studies have generally suggested plant sources of purines do not normally cause gout.

geekiegeek

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#1194928 10-Dec-2014 14:50

I have had severe gout since the age of 16 (I'm now 44).

What I mean by severe is acute attacks in my feet, ankles, knees and elbows, sometimes in multiple places at once. I remember once having it in both feet and ankles and couldn't walk for a few days.

I avoided going on Allopurinol for many years and then finally gave in when I was informed that my joints would deteriorate over time from the damage. Took Allopurinol for about 6 years until 2 years ago when I increased my exercise and changed my diet to Paleo. Haven't had an attack since.

For me it wasn't beer or red meat, my main trigger was legumes so baked beans etc. If you clean up your diet, i.e. eat whole foods and cut out sugar along with getting plenty of exercise i.e. something that makes you breath heavily and sweat a lot for 30-60 minutes 3-4 times a week. I think you can manage it without Allopurinol.

dipkiwi

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#1194974 10-Dec-2014 15:44

gchiu: You'd be better off severely limiting your decent meals than cutting back on fruit.

Going to try cutting back on fruit for a start and see what happens. I had recently upped my fruit intake with big servings of berries or grapes after lunch or dinner and having a banana or two for breakfast in the morning. Then soon after I started noticing the pain in my knuckles. If I banged my hand even slightly while doing the dishes after a meal, it was quite painful. Right on the point of a knuckle.

I suppose it makes sense from a Paleo diet/evolution point of view. We probably only has access to sweet fruits for a short time of the year... rather than having international air freight and supermarkets supplying us fruit all year round.

Goes back to that old advice of eat locally what's in season.

MikeB4

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#1194986 10-Dec-2014 15:47

gchiu:
KiwiNZ: If you are getting recurrent bouts and the Uric Acid is persistently high you should talk to your Doctor about Allopurinol it removes Uric Acid from the blood and eases the build up in joints

Or cutting back on your intake of animal protein, shell fish, beer and other sources of purines as well as maintaining an adequate fluid intake.

Allopurinol is for life, so other options should be tried first if appropriate.

absolutely, but if that does not work then medical intervention will be required with medication like Allopurinol.

People joke about Gout but there are some serious complication with Gout and it is very painful .

Here is a crazy notion, lets give peace a chance.

dipkiwi

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#1197254 14-Dec-2014 15:56

A few days now of eating less fruit and I reckon I am experiencing less tenderness in my knuckle joints.

I still have some bananas and grapes and strawberries that I brought last week that I am slowly picking away at, but once they're gone I won't be buying any more fruit at all for a couple weeks at least and see how it goes. But so far the results from cutting back seems encouraging.

I'll get another uric acid blood tests done after that and see if my level has come down.

A lot of the reading I have done on this says the usual... "the kidneys cannot process purines so cut down on foods high in purine"

But now the new line of thought and research is... "what's stopping the kidneys from processing purine..???"

One possible answer... The level of purine in foods mightn't make that much difference to hyperuricemia but high fructose consumption with its complex metabolic process has a close correlation to hyperuricemia.

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JimmyH

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#1197338 14-Dec-2014 18:08

It's painful - I have two relatives who suffer from it.

While this conversation is good, I wouldn't rely on GZ for serious medical advice. Advice on my WiFi yes, but not my health. Also, I note you have seen your doctor - but in the experience of my relatives GPs don't often know that much about gout.

Given that it's a very painful and debilitating condition that may be with you for life, I recommend spending some money up front to see a specialist. And doing so as soon as possible. That will ensure that all the needed tests are properly done, and you will get the best advice possible on what you should be doing lifestyle wise, and also on what medication you may (or may not) require.

Your GP should be able to organise a referral.

gchiu

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#1197454 14-Dec-2014 21:54

dipkiwi: A few days now of eating less fruit and I reckon I am experiencing less tenderness in my knuckle joints.

Experiment of n=1. Good luck.

I happened once to sit with a world expert in gout at dinner, and not once was reducing fruit consumption mentioned as a way of controlling gout. Some fruits ( cherries, blueberries and others high in vitamin C ) also act to lower uric acid by increasing renal excretion.

MikeB4

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#1197457 14-Dec-2014 22:02

Mayo Clinic info of diet and Gout in particular Purine and Fructose

http://www.mayoclinic.org/healthy-living/nutrition-and-healthy-eating/in-depth/gout-diet/art-20048524

Here is a crazy notion, lets give peace a chance.

dipkiwi

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Master Geek
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#1198048 15-Dec-2014 20:10

Have a read of this, this and this.

And then this.

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