Healthy young man with high blood uric acid and probable gout

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Gentlemen (and the occasional post-menopausal lady I guess!),

First of all thank you to all that post and provide information to this forum - I've found it an incredible resource for learning about these conditions.

I'm a 36 year old man living in California, 5'11" tall and weighing 190lbs (13.5stone). I am in decent shape, exercise regularly and eat a healthy diet (rarely any of these high purine foods). I do drink a fair amount of alcohol (until recently) - a couple of beers, maybe a glass of wine or two and a whiskey night cap most everyday. I do eat marmite on toast every morning which I've shockingly just found is one of the foods to avoid (thank you UK factsheets!) I gained a fondness for Vegemite after spending some time in Australia! I'm super active and played competitive sports until pretty recently. I'm an avid swimmer, runner, hiker, biker etc.

About 2.5 years ago I woke up after sleeping with my foot in a weird position to excruciating pain in my ankle. Believed it was a weird tendon irritation from sleeping in a weird position. Doctor suggested gout but I totally blew it off as something that only happens to corpulent middle aged men. Nothing came up on X-ray. The pain went away in a few days and I didn't think much else of it.

A little over a year later I had a very similar thing happen in my other ankle. Then about 6-months ago I woke up with a very similar thing in my elbow - again nothing on X-rays and physical therapist I visited thinking it was a tendonitis issue was baffled. The elbow pain lasted a couple of weeks and was especially painful at night. But then with NSAIDs and rest went away and has been totally fine since.

Currently I have a similar issue going on in my left big toe which at first I thought was an injury as I did roll over on my toe joint playing sport. The pain in this area though is what led me back to thinking it's possibly gout. The joint pain seems to be instigated by some sort of minor injury each time. As I'm so active I've just sort of believed up until now that it's aches and pains of getting older after some kind of sporting activity I've been doing. The pain has been quite bad but nothing compared to more severe gout flare ups I've been reading about.

My brother (2-years younger) has similarly had some strange joint pains the last couple of years and was recently tested high for uric acid - he suggested I get my levels checked. So in between this elbow flare up and this toe flare up I did get tested about 3 months ago. Uric acid level was 8.9 mg/dL. Which I didn't really understand at the time but now I looked up these results I understand that it is well into hyperuricemia (high blood uric acid greater than ~6mg/dL) territory. And the genetic link here seems pretty obvious.

So not sure I really have any specific questions but just wanted to hear any thoughts the community may have on my situation. I am working on drinking plenty of water each day. Doctor has suggested some dietary changes and reduced alcohol and test again in a couple of months time to see if it's a continued high level. Will then discuss plan for the future. Allopurinol (for long-term uric acid reduction) and colchicine (for flare ups) will be discussed. I am hesitant to sign up for a lifetime medication unless absolutely necessary. The thought of long term joint damage, not being able to be physically active, chronic joint pain, and the cardiovascular risks from hyperuricemia scare the crap out of me. I feel like I'm way too young and healthy to be having these types of conditions....so really just trying to make sense of it all.

Thank you all for your time.

0 likes, 12 replies

12 Replies

  • Posted

    You sound very similar to me. I'm 36, 6'2" and 190lbs.

    I'm very active and watch what I eat. I cycle and run and compete in other sports.

    I've had a gout flare up once (18 months ago) and it was agony. I ended up unable to walk. Mine was in my ankle and I also had injured it about 6 months before.

    I've ensured I've eaten healthily etc. However my last uric acid test had a result of 11.4mg so I'm seeing the doctor next week and will probably end up on the medication for life.

    Research I've read suggested that endurance exercise (like my long runs and cycle rides) are bad for gout as they regularly cause a bit of dehydration.

    I've tried further diet restrictions and they made no difference and I've also been on an all inclusive holiday which tested the other extreme and didn't trigger anything.

    • Posted

      Thanks. Yeah I followed your thread a little bit. It's comforting to know there are others in a similar place trying to work out the best path forward.

      From what I've read... if the high uric acid blood levels are predominantly due to some genetic factor that means the kidneys are much less efficient at getting rid of it rather than from ingesting an overabundance of high purine containing food and drink... then there's not much that can be done other than to reduce the uric acid levels other than to take something that can increase it's excretion from the body or block its formation in the first place.

      It looks like that is the case for you and I'm pretty sure its gonna be that way for me too. Whether we end up on the drug allopurinol for life or trying to figure out a supplement of some kind that can do it will be a matter of choice and trial and error I guess. It is heartening to hear from people that have had great success with the drugs and have managed the condition fairly well. Fingers crossed we don't end up with side effects!

    • Posted

      Hey Matt16522

      Sorry to hear about your condition. I am also an acute gout sufferer. Why don't you take medicine only for the duration of bringing your values down . Once they are in normal ranges stop taking medicines and avoid any high purine diet.

  • Posted

    Hey dude, sorry to hear all this. Gotta say I’m pretty healthy too and was diagnosed the same at 30 I’m 34 now. Exact same symptoms. 

    Not being able to walk really sucks and as an Aussie not being able to eat vegemite sucks twice as hard. But I’m now currently on allopurinol. And life is much better. I’ve tried to come off it by they say diet is only .5 or a uric difference if your body just wants to produce it, it will produce it. If you are constantly getting flares I’d suggest to get on it. But that’s just me. Lifetime drug is nothing to take lightly but quality of life is so much better. Keep to a low Purine diet and cut back on the beers.

    • Posted

      Thank you for the reply. It's nice to hear from the younger blokes that are in a similar spot in life! An Aussie that can't eat vegemite and can't drink beer?! Are you shunned by society?!

      Glad to hear the drugs have worked well for you. I agree that if it's a choice between a lifetime drug and constant flare ups with potential joint damage then there's not much competition there as long as the side effects aren't too severe.

      Gonna monitor the uric acid levels for a bit and see how they do before I sign up for the meds. I figure over the course of the next few months with some diet changes and whatnot I'll be able to determnie if I can get a low enough uric acid level to reduce the risk of flare ups. If I can't I'll definitely be sorting out a dose on the allopurinol.

  • Posted

    My symptoms went away when I went on celery seed extract, 75 mg., 85 % 3nB, two times a day.  There is actually some sound science behind this; two studies on humans, one a small pilot study and the other a larger study with 75 people.  Pain from gout was reduced by 68 % in the pilot study on average, and even more on the second larger study. The chance that this was due to the placebo effect was 1 in 1,000.

    The extract works the best and the dosage matters as well as the 3nB (abbreviated name for the compound that gives celery its unique taste and smell and also works on gout).  You need 85 % 3nB.  I haven't had an attack since I started taking this stuff a few months ago.  I was having them like clockwork every month.

    • Posted

      Interesting. I will definitely do some research on this.

      Other supplements that I've heard having a beneficial effect are bromelain (from pineapple stems) especially in combination with quercetin (a bioflavinoid). Of course turmeric which many swear by for anything inflammation related and especially chronic conditions. Also vitamin C.

      Anyone tried a massive cocktail of the lot?? It seems that bromelain, quercetin, vitamin C, and turmeric can often be found in the same supplement formula.

  • Posted

    Hi,

    Just to reassure you, gout can happen to anyone. My 22yr old, rugby mad, health nut, almost teetotal nephew was diagnosed with gout last year. I have also heard of vegetarians getting gout too. My partner has just been diagnosed too after 3 bouts in the last 6 weeks. He has been given allopurinol and after reading up about the repercussions of not treating gout has decided to go ahead with the treatment. He is only 2 weeks in so we will wait and see.

    Good luck.

    • Posted

      Thanks. Yes the old stereotype of too rich a living doesn't seem to hold true for many cases. I'm learning a lot about all this so will post with some updates of information over the coming months with what I'm finding.

  • Posted

    Mainly for flareups in combination with colchicine.  Bromelain does temporarily lower blood urate.
  • Posted

    im in the same boat. im 38 year healthy male.. ocassionally drink alchohol, eat no red meat and workout regularly. i had my first gout attack in 2015 and since then i got 3 . in my recent bloodwork the uric acid levels were around 9 and for the life of me unable to figure what i do causes those seemingly random attacks.

    I eat lemon juice daily and turmeric few times a week but not sure what else to do to avoid being on lifetime on allupurinol.

  • Posted

    I thought I'd posted an update to this thread but I guess I hadn't. I started daily allopurinol maybe 2.5 years ago. Doesn't seem to give me any side effects and just part of a daily routine where parts of the year I take a daily hay fever pill also. The only time I had a flare-up interestingly was when I bumped up to 200mg from 100mg about 6-months into taking allopurinol. Got the same ankle attack. Other than that I've had no issues and my UA levels are hovering around 6mg/dL down from 9+mg/dL. Diet and supplements alone could only get me so far and it was so restricting I just couldn't keep it up. I understand the fear of being locked into a medication for life... but just wanted to say that it hasn't been a massive hardship for me and has reduced the fear and disabling pain that come with gout flare-ups.

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