First bout of gout

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I am at the trailing end of my first bout of gout. I have read heaps and understand the mechanism i.e. purines being broken down to uric acid, uric acid not being removed by kidneys efficiently which then precipitate as crystals in your joints and tissues. Body then having an inflammatory response.

The day prior to the gout bout I sweated profusely all day, drank very little, ate sugary junk food for all meals and finished it all off with a bottle of wine and a few beers. I was very active on my feet from 4am to 8pm and believe I sprained my toes. Not my usual day. My foot was sore the next day. I believe the gout struck after another day had passed.

I have two questions:

  1. Could this extreme day on its own have cause my uric acid levels to spike and resulted in the bout?
  2. When uric acid levels return to normal do the offending crystals dissolve?

Thanks

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11 Replies

  • Posted

    Hi John,

    Certainly your diet may not have helped. From my past experience a gout attack always used to follow a period of self abuse.

    I have maintained certain diets and have ceased drinking alcohol for months and gout attacks have still blighted my life.

    Trying to find out if a certain diet can stop these attacks has not been successful. Hopefully if it is your first attack it should be shortish. My attacks have grown longer and more painful over a period of years. A good healthy diet and drinking water on a regular basis can only help. As for the crystals disappearing, unfortunately in some cases you will be left with visible tophi.

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  • Posted

    Q1 Yes!

    Q2 - how long is a piece of string? If you get some colchecine it will certainly help.

    You need to get your blood urate tested - not now - it will be low (the urate crystalises into the joints reducing the blood urate), but in a month or so. I assume this is your first attack? Gout and hyperuricemia are strongly associated with (long term) with substantially increased risk of heart attack stroke and cancer. You should get the blood urate level down to under 3, not the under 6 which is acceptable to those without gout.

    Go to the N.I.C.E website and you can see the latest advice they give to GPs on gout / hyperuricemia management.

    Good health!

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  • Posted

    My one and only attack was at the end of a week when I'd had marmite, shell fish and mushrooms a-plenty all of which I later found should be avoided. I've had shell fish since but kept clear of the others. No idea how significant this is but I'll take a chance on it being no more than coincidence.

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    • Posted

      Now you mention it I had half a loaf of toast with Vegemite the next morning!!! my hangover remedy. Seems this time it may have moved the hangover to my right toe and extended it by a week.

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    • Posted

      I never isolated anything in diet myself - ever.

      I never touch most of the 'trigger foods' like sea food and beer and mushrooms...

      I had an immediate attack of gout in my KNEE in summer after 2 beers. That's a first - knee attack and me drinking beer. Mythos with fresh lime as you ask! I was also on 300mg Allopurionol so the beer trigger may be STRONG. Nothing since in months...

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  • Posted

    1. Sugary junk food can cause a spike in urates, fructose, half of common sugar or appearing on its own, can increase uric acid just like high purine foods.
    2. It may be that diet only triggers problems if you were already borderline.

    I've had a couple of gout attacks that were certainly triggered by relatively minor dietary indiscretions, that did clear within a week or so, though some soreness remains for weeks longer. However, there are no guarantees.

    Getting tested and treated for chronic high uric acid is an excellent idea. As is watching your diet if you are borderline and susceptible like this.

    Meanwhile look into celery and celery seed, it really has helped me. It may be better at preventing gout symptoms than lowering your uric acid, but it helps with both.

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  • Posted

    Thanks for all the responses. It has been about a week and my foot has almost returned to normal. There is lingering pain and stiffness in the big toe. Is this normal? Is it the result of damage to the joint that needs to heal.

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