Gout and taking responsibility. confusing facts

Posted , 6 users are following.

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

    Just thought I'd update this is I received my testing kit yesterday.

    I tested at about 5pm when I got home and was 7.3. I was in training that day and managed to drink a litre of water as a couple of mugs of coffe. Cheese sandwich for lunch.

    I've just woke up with the kids and done another test befor eating breakfast and it's 11.3. I expected it to be higher in the morning and I understand the importance of testing at the same time each day but just wanted to show som early results.

    • Posted

      Are you in any gout pain by any chance or feeling pain in the toe or burning? 

      I'm asking because these numbers seem high. I'm not sure how they're measuring the numbers but still they seem quite high. Is this like a ph strip? Is it a urine test? 

    • Posted

      It's a blood test like a diabetic digital meter and pin prick.

      I'm recovering from an attack in my toe about a month ago. I'm totally walking again and the pain is gone but my foot is still a little red and slightly swollen.

    • Posted

      Thanks!  Had no idea they've come this far. Amazing how advance science has become. Drink plenty of water, cherry juice, eat cherries, and avoid all the bad stuff. 

    • Posted

      Thanks soch

      It's been an amazing hot day today and I've drunk several pints of water while been in the garden all day. My wife was worried that I'd not urinated once but I remember from the army you can literally just sweat it out even if you're drinking lots. I tested 11mg this morning and 11mg at lunch.

      I'm going to try you suggestion of cherry juice and also vitamin c supplements after my week of normal testing and compare with the cherry/vit c.

      If I can't lowere with my diet all go back to the docs. I've not had an attack since April even though my reading is high.

  • Posted

    What you are saying is pretty spot on. You won't be able to lower blood urate to the level that is needed by someone with gout because the problem is your kidneys not taking enough urate out of the blood. a)it's probably a genetic predisposition b) welcome to middle-age: you are getting the welcome party earlier than most. As a gout sufferer you need to get your blood urate down low - to about 3, not just down to under 7 to stop attacks. The reason is that high blood urate long term (a decade) leads to damage to the arteries which leads to heart attack. Most of your blood urate comes from purines produced by your body, those from your diet is only 15%, so even a vegetarian can only reduce their urate level by 1 - 2 points max.

    You should seriously consider allopurinol, which, for most sufferers is a non-issue. It will save your heart as well as your joints. As a free give away, allopurinol also has the side effect of reducing cholesterol.

    Good luck n good health.

    PS a blood urate test must be done at least 2 weeks after gout attack, with no food or liquid taken within 4 hours.

    • Posted

      Not far of that decade. my first attack was 6 years ago. 
    • Posted

      When I was diagnosed (abroad), the first thing they did was send me to a cardiologist to see if any damage had been done. The NHS won't do that (probably). However you can protect your heart by getting down to under 25 BMI and buying a bike (and using it), or running or some kind of cardiac sport. Cycling has the advantage that you can do it till you drop in 50 years time.

    • Posted

      Just like to comment that I had to give up cycling three years ago due to cartilege damage in both knees, although I'm still OK going downhill!

    • Posted

      The solution may be an electric assist bike. On the flat you do almost 100%. As soon as there's any incline it takes more and more of the strain. Keep it in a very easy gear.

  • Posted

    I'm currently seeing a chiropractor every few months and. My last appointment he asked me to get an ECG from the doctors as I had a tight chest and wanted to rule out a heart condition before treating the biomechanical issue. ECG came back fine.

    Ironically I'd started running about 6 months ago for 30 mins every other night on a treadmill to stay in shape but with the gout I've had to stop. Catch 22.

    • Posted

      I'm certainly not burying my head in the sand. In doctors waiting area as I type this smile

  • Posted

    Nice doctor. Has talked to me about alpurinol, wants a blood test first. She said that really if I've only had 2 atacks in 6 years then I should first make lifestyle changes as they normally only prescribe for people having more than 5 attacks a year. she checked my bmi. I'm 31. I'm 6ft1 and 16.5 stone. So have a doctor set target of at least one stone to lose but ideally 2.

    My blood test is booked for next Tuesday at 12:30 which she says is not a fasting one which I was a little confused about.

    I'll keep testing myself, improve my water intake, address my diet and update. I'll be interested to know feedback on this from everyone

  • Posted

    Hi. Ive had my bloods back and they are 0.44mmol/L. The doctor said 0.43 is the top end of normal. the blood was taken at 8:30am which when ive done my own tests are the highest of the day. 

    she said that i could be asymptomatic. considering my BMI etc shes asked me to lose the agreed weight and watch my diet. Drink lots of water. etc and come back in a few months for a retest. 

    Does this sound logical. 

    • Posted

      This goes against the advice of the NICE in the UK., who recommend that someone suffering from gout should have a much lower level than the top level normal for a non gout sufferer.

      The objective of gout treatment should not be to simply stop gout attacks - it's to stop heart attacks which requires a very much more aggressive approach than your (female?) doctor is suggesting.

      Gout is not treated seriously because a) it's a male problem

      b) the heart attacks come a decade after ignoring gout specialists advice.

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