Gout and taking responsibility. confusing facts

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Hi all, Im 37 and had my first attack 6 years ago. I ran up the stairs and stubbed my toe on the way up. the following morning i was in agony, thought id broken it and went to A&E. Blood test and high uric acid was detected. I was perscrobed a course of colchicine and sent home. After about a week it was resolved. 

I did some research at the time as to what causes it and id been on a stag do a few days prior and put it down to that. 

Fast forward 6 years and my second attack followed the first bank holiday in April this year. Id been out drinking with firends then on the follwong day a boozy afternoon and rich meal and cheese board with the family at a nice pub. the next morning agony. I knew what it was. 

After about a week of trying to elliveiate the pain with anti inflamatories i went to the doctors who didnt want to do a blood test and just visually confimed it was gout. talked to me a little about it and suggested initially colchicine as that worked before followed by allopurinol for the rest of my days. Natuarly i didnt want to be talking tablets for the rest of my life and asked if it was possible that a change in lifesyle could prevent it. To which the doctor confirmed it was.

I also talked about my inability to drink water. At work im tea and coffe and tend to go out with friends for a dinks once a month. With the occiasional lunctime pint on the last day of the month with work colleauges. But simply it is totaly alien to go to the tap and get a galss of water. looking at 2 litres a day seems impossible... however something i need to address. 

So to take responsibility, knowing what food groups can cause it and trying to avoid or in moderation and secondlt making sure im hydrated and not dehydrated.  

Since reading more and more about gout ive come to the conclusion from various articles that once you have high uric acid levels then you must have medication to keep them low regardless of diet and other lifestyle changes that you have done to take responsibiluty for yourself. Is this ture? 

It was my understanding that high uric acid causes crystals to form in joints and thus you get the gout pain. If a lifestyle change to reduce this level of uric acid prevents an attact then does this not do the same as allopurinol? 

Lets take for example my hydration. If im dehydrated then the uric acid is less soluble in my blood and harder for your body to process it out. If i drink more warter i help my body to remove it and as such my uric acid level is lower and perhaps in check. the same as what allopurinol does. 

What ive read is that this is not the case and you would still need allopurinol. Its quite confusing. All i want to do is to take some responsibility for myself and underdstand. If i can do this i can perhaps limit my attacks or potentially stop them and also reduce my risk of other associated and pretty scary health risks if nothing is done.

Thanks for the help and pointers.

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  • Posted

    Hi Alex, I've lived with gout all my life since I was a kid, therefore,  I can attest to the lifestyle changes making a huge difference, but on this same token, I also drink a lot of water. I had to cut out drinks with high fructose as this causes an immediate reaction in my joints, as well as wheat, e.g wheat bread, wheat crackers, cream of wheat, etc.

    Yes, you're correct that the urine expels the crystals, but this doesn't mean you get rid of them all. Some actually stay lodged within the joints when you're not taking anything for it.  

    I saw they removed your test strips comment and if you're wondering why it's because you mentioned the name of the product and where you bought it. 

    How are they working out? 

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    • Posted

      "Yes, you're correct that the urine expels the crystals, but this doesn't mean you get rid of them all. Some actually stay lodged within the joints when you're not taking anything for it."  - isnt this the case with any person then. do the crystals only form during an attack.. they cant always be there? 

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  • Posted

    Having been on here a while I'd say treatment seems very variable depending on your doctor. I've never taken Allopurinol although I know a guy who does but still gets gout. Colchisine works for me too so I rely on it for bad attacks. I didn't used to like drinking water either (although I now do) so drank decaff most of the time, its just flavoured water. I don't like tablets much so I concentrate on my diet and hydration. You get used to it after a while. I've had 5 attacks over 6 years now so I don't consider myself such a serious case as some. You probably need a couple more for it to sink in and start taking it seriously. ANYWAY - welcome to the club! FUN isn't it??

    PS it's funny how often it's triggered by an injury.

    PPS We're all different, you get to know what personal things to avoid and even when it's about to happen. People will recommend all sorts of things, lemon juice, cherries and the much more exotic. Some might work for you.

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    • Posted

      Ive only had it twice in 6 years and just recovering from the second. My toe is still read and a little bit swollen but the pain has gone mostly and ive been walking normally for a week. My Colchisine prescription finishes today. Ive been complimenting that with an ice pack on and evening and training myself to drink more water. 

      Ive not been given a repeat perscriptuon or advices to keep Colchisine close should i feel one start. i preseume because its only happened twice? 

      I was really concirned last night reading that the crystals can eventually end up in organs and cause failure / heart desease etc. 

       

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    • Posted

      I just came across this article: What HFCS does to your body.

      Creation of Uric Acid

      Uric acid is a normal waste product found in your blood. The metabolic processes involved in the breakdown of fructose can lead to a buildup of uric acid.

      Uric acid is an inflammatory factor that increases free radical stress throughout the body. It depletes nitric oxide levels which leads to chronic tension and contraction in the arterial smooth muscle cells. These sorts of changes do not occur with normal starch or glucose consumption.

      High uric acid levels are associated with gout, high blood pressure, kidney disease, and being overweight.

      They forgot to add diabetes.

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    • Posted

      The crystals form in the joints only and I've never heard of them migrating (they're not in your blood). Colchisine is quite toxic and they won't give you a repeat prescription for it. It kills your kidneys and liver. It is from a plant commonly called the Autumn Crocus and in the 18th and 19th centuries when people first came across it for treating gout and ate it it generally killed them. Gout does go on its own if you 'go clean' during an attack but takes longer. You're going to have to come to terms with the fact that there is no cure for this and the best you can do is try to avoid the attacks by limiting the causes. Every time you get crystals in your joints it will cause damage to the joint. I'm 62 now so it's less important than you a relative youngster. So far it doesn't sound as if you get it too easily so you should be able to have a reasonably normal life as long as you bear it in mind. I drink wine now which seems to be less trouble than other alcohol but I have Coeliac disease as well which means staying away from Gluten and Malt.

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    • Posted

      Philip do you take anything for your gout?

      I've never been given Coleshine much less allopurinol. I cure my gout with cherries or the juice. Seems to work for me at least. In the past, when it was severe I was given indomethacin.

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    • Posted

      Thanks for the advice Philip. Id read on another site that over time the crystals can migrate and cause liver, kidney and heart desease. Perhaps it can cause theses things but not in the way the article suggested? I concluded from this that taking responsibility to prevent an attack is keeping my own Uric acid level low and thus not forming any crystals. Since the crystals cause the pain, no pain no crystals no complications? Perhaps im just dreaming.

      The trouble with the internet is that you can access a wealth of information that is conflicting. Youre not sure whats accurate and whats bogus.

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    • Posted

      Not in natural unprocessed wholesome real food. HFCS always gives me gout, so I know for a fact that for me it is the culprit of my pain. I avoided like the plague. I also avoid, wheat as well and a few other foods my body can't seem process. 

      Certain vegetables as well are off limits for me as well, like Kale, spinach and cauliflower. 

      You need to find what's causing your gout and avoid consuming it. Fairly simple. Secondly, find a way to drink more water. I found that I love drinking cold water. So putting ice in my water makes me drink it more. 

       

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    • Posted

      Soch, I've had two severe attacks (couldn't sleep for the first 3 nights) and three lesser attacks which allowed me some sleep every night. For the severe ones I went to the doctor for Colchisine and the others I just let them run their course avoiding anything dodgy at all and hydrating. I take Ibuprofen two at a time throughout. They say Colchisine only works for 30% of people anyway, don't know why.

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    • Posted

      I've never heard of that but high Uric acid levels can cause a host of other problems apart from gout. There's a guy on here Rustygecko who's like our professor of gout who, if he comments, will fill you in on a lot more than I know.

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    • Posted

      Thanks Soch. Both times were excessive alchohol consumption and eating out. 6 years apart. i cant say there was anything particular during the two episodes i woudnt have normally eaten between the 6 years. It was more the excess qty and lack of water. 
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    • Posted

      This information is not correct. They will give a repeat prescription for colchicine, but the doctor has to make a decision as to whether the patient will use it sensibly. 

      The croucus from which colchecine was originally extracted was not found in the 18th century. It was known at least as early as the Ancient Egyptians and dated to 1500 BC. It did not generally kill the patient as it will generally give you awful diarreahea before it kills you. 

      Colchesine has both the disadvantage and advantage that it causes reduction in clotting. In small doses it is not toxic as long as you have a properly funcitoning kidney, and you drink reasonable amounts of water. 

      Colchesine is not hepatoxic, and is used as a medicine to treat certain liver problems.  

      Coclchesine should not be used for those taking Statins.

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