How soon would you start to feel "something's wrong" after eating high purine foods?

That's very interesting Sochima

What level are your blood urates?

No idea. One day I'll get them checked.

But recall I had my blood levels checked in March, and nothing was abnormal. Next time I see my doctor I'll ask what it was.

The issue is this: most doctors (I guess as I have only seen a few and asked another few who are friends), are unaware that the norms (under 6) are correct for those •who are not suffering from gout•. For those who are gout sufferers the level needs to be lower, to not only protect against gout, but to protect against other nasties like kidney and heart issues.

Duly noted. I will ask. But I recall my doctor saying once that I was too young to go on Allopurinol.  Friends who also have gout are on colchicine. As long as I keep myself healthy, purine free and don't have any health issues I think I'm fine without it. I get an attack only once every 10-15 years or longer.  I've only had 3 real attacks my whole life with an occasional tinge when I've eaten too much wheat. Then again I take Bromelain and Turmeric. Nonetheless, I'll talk to my doctor about my urate level. Thanks.

Frankly an attack every decade, I'm not sure if that counts as a gout sufferer! :-D

You don't have to worry at all I think.

The only difference between those who get it young (under 30) is a lot are over producers of urate (liver), whereas most of us under excrete (kidney).

Well, I guess I am one of the younger group? I'm a 27 female (161CM/44KG).

To be honest, I am still not very sure if this is my first gout attack. May I have your advice, please? Thank you!

About the possible gout attack -- 

I did hurt my left big toe 2-3 weeks ago by jumping/dancing barefoot on hard floor for several days until I could barely walk without pain.

There was no swollen or redness at that time, it was just as though I sprained my toe very bad. I had been using Salonpas patch on my left toe, it was better after a week but never fully recovered. I am currently traveling so I had been walking more than usual in flip-flops. 

Last Wed., I started to feel sore on my left toe in the afternoon, and it started to get a bit red and swollen later that night. When I got up the next day, it was not as bad. I didn't feel sore as long as I don't bend my big toe back. So I put on casual shoes, went to a mall and walked around even more. My left big toe and joint became more swollen and red at night. I took 400mg ibuprofen still woke up with swollen/red/sore toe. I couldn't walk that morning. It went down later the day so I went to an internist. The doctor was pressing around my foot and said it looked like stress fracture until I told him about my history of high urate. He said it's possible gout. I was prescribed with Naprosyn (500mg), the redness/swollen went down after 2 days and continued to improve little by little everyday but I still feel minor pain when I bend my toe and the joint is still dark/red. 

My urate history -- 

My urate level was high (8.9) two years ago because I never drank water unless I felt like I was thirst to death, and I only drank 500-600ml at most. 

After that blood test, I forced myself to drink some water and I started to eat healthy since I was not on any medication. I have been making smoothie every morning with 5+ fruits, flax seeds and greek yogurt. I have been juicing at night at least 5 a week with 12 veggies and fruits. Many of the ingredients are anti-inflammatory (flaxseeds, tomato, bitter melon, ginger, pineapple, celery, etc). 

I did a thorough health checkup 2 months ago, the urate level was down a bit (7+) and no findings on kidneys or other organs. Other than the urate level, I was generally healthy.

What make me unsure of if I am currently suffering from gout is, I didn't feel that much painful except for the next day after walking around in the mall. My toe was only sore when I bent it back, which is true before/after the naprosyn. Also, I started to see see very minor bruise on my left joint since the swollen went down few days ago. I can't be sure if it is bruise, but it definitely is darker than the other joint of my right big toe. 

On the other hand, if the redness and swollen is due to the injury, why it affected me this much 2 weeks later...

May I hear what you think, please.

Thanks again.

It does sound like gout to me from what you're describing. It does take a long time to bring down gout pain in my experience. It took about 2 months for the swelling and pain to subside completely after taking medication. Also, you need shoes that are soft and comfortable but yet supportive. I've had shoes that make me feel as if my gout will come back, especially when stepping on rocks or uneven pavement. With gout make sure you don't over exert the toe. Doing so doesn't allow to it heal as it takes time for the urate crystals to dissolve where ever they cause the pain. Hope this helps.

The pain you describeAmy pretty much describes my initial experience of untreated gout: a toe pain which isn't too bad unless you try to flex the joint. I found the only shoe in which I could walk was a proper mountain boot which has a flat sole that is so solid that flexing it (thus the toe) was impossible. The pain untreated could last 2-3 weeks. The other indication are the high urate levels. My money I'm afraid is - gout!

You might try drinking water as a cure. Drink it copiously - I reckon •at least• 2 litres a day if you are in a temperate climate. More if you eat salty food or a warmer climate. Drink!

In the meantime to get this attack under control try to get hold of colchesine or something else which reduces the immune system attack. Ibufren is a good pain killer and anti inflammatory - you're on the right track there. Avoid any form of aspirin.

I would then ~ after the attack is over ~ get your blood urate tested again.

One last thing Amy - you really are very slender (161cmm/44kg). Are you Caucasian? it is really unusual for someone to have gout so slim and so young. I assume that apart from your toe you are in perfect health?

Sorry rusty, but again you're wrong. I got my first got attack at 14, and weighed less than 44 kg.  Apparently, height and weight have nothing to do with urate levels being high.

Neither does age, btw.

I am afraid I'm not wrong. MOST people with high blood urate have high BMI and MOST are over 40. There is a difference in the two groups. MOST in the over 40 overweight group are under excreters; MOST of the younger group are over producers.

NB the important qualifier is MOST.

Okay, that would make sense since weight is a factor in a lot of gout sufferers. But take into account that genetics plays a bigger roll.

Of course, if you get gout at a young age, it really means you're not eating well, by eating lots of junk food, and soda and need it's a wake up call to change your diet.

Genetics plays an essential role and from memory there are two alleles which predispose the carrier to gout.

I'm not sure why the young can get gout; but I do know they tend to be over producers, which •might• be an indication of a genetic predisposition caused by the liver. If you think about all the millions that live on a very poor diet, with high junk food, it is remarkable how few younger people get gout.

I forgot to mention the other predisposer to gout is sex: pre menopause women •rarely• get it.

"Women develop gout at an older age than men and have twice the prevalence of hypertension, renal insufficiency and exposure to diuretics. The onset of gout before age 30 in men or before menopause in women is atypical and raises concern about an associated inherited (liver) enzyme defect or renal disease."

"More than 150,000 Britons - mainly men over 40 - suffer from gout. On average, a doctor with 2,000 patients will have 17 male and three female sufferers."

I was reading on a gout site that the young and teenagers with a predisposition to genetics get gout when their diet consist of soda & junk food. I recall in my teen years leading to 14, I use to drink 3 cans of coke a day. When I got gout I was told to cut down on soda & sweet drinks. So I guess they knew back then that sugar caused gout. But they were stumped at the fact that I was super skinny, young and had gout . Definitely not the norm but the number of teenagers getting gout nowadays seems to rising.

One of the things recommended to avoid is high sugar drinks. Obesity among teenagers, rare before the turn of the century, is now common. Gout may well be on the rise among the young.

Hello rustygecko,

I am Asian.

Yes, I would say I'm in good health in general. My left foot has always been a problem for me. Perhaps because I have pigeon toe on that one, and I tend to squeeze the side of my left foot when I walk. I often feel sore on my toe, but never swollen like this

The internist I saw said, too, if this were gout, it would've been a very rare case.

In terms of genetics, my mom does't really drink water either, she doesn't have gout. The only person I know in my family has gout is my uncle on my mom's side. However, he is the typical gout patient -- obese, high-protein diet, no water, beer consumer, hyperglycemia, hyperlipidemia and hypertension. 

Bingo, your uncle has it, which means you won the gout lottery allele.

the internist said that I shouldn't be on Colchesine if I plan to get pregnant. He recommended that I lower my urate by diet. I will definitely do what you suggested. In fact, I have been drinking more than 2L of water since the attack. I also ordered nutrition supplements to control my urate level, hopefully they will help, too.

My toe is almost good now, I'm only sore on other soft tissues since I had been walking funny.

One more question for both Rustygecko and Sochima822--  during the gout attack while I am on anti-inflammatory med, would it make no difference if I happened to eat mid to high purine food or it will make the attack worse? I had been eating protein and some seafood, it doesn't seem to affect me at all as my toe keeps improving...so I was wondering if this could be regarded as the "free diet time" while I'm on anti-inflammatory med? or it was just a wishful thinking...?

Amy, it really depends on what you're eating that is creating more uric acid. While NSAID's are working to keep inflammation down, the purines could be accumulating and bring on another attack after your stop the medication. I am living proof of this because I thought the same after my last gout attack. Two weeks later after the inflammation and pain were down I got another gout attack but it was milder. So try to keep purines down. There is no "free diet time" with gout unfortunately. It all accumulates in your liver or kidney.

It would be best if you can you think of some food that you ate within 24-48 hours that you rarely eat, that may have caused you the gout attack? By doing so you can avoid another gout attack. It could be salmon if you ate seafood or ate sweetbreads. There is a purine table you can refer to if you google Purine table. It will show a list of foods that are high in purines that you can either avoid or eat less of them. 

For me eating Herring, a white fish, throw my body into a full gout attack. So I suggest you try to find what food may have triggered the gout attack so that you keep that food away from your diet. Rusty may have more suggestions but I hope this helps.

I have thought about it and I can't remember reading anything about this question as to whether you can eat anything during an attack. All I know about this is that sardines are an almost sure trigger for my gout, but only 90%. I never noticed any other pattern.

I wonder if your attack is not improving due to simply increased water intake?

As for getting pregnant - you have a BMI of under 17, which is associated with lower fertility. Ideally you should be 4 kg heavier (BMI 18.5).

I was 30 when I got gout attack 12-13 stone and I've had loads bad,bad attacks in bed for week to ten days, but I do like a drink, witch is the worst thing for gout.😞

I suspected you might be from east Asia!

Knowing that I'd make the following comments:

a) What is a normal BMI for Chinese would be too low for Europeans. This means my previous comment about fertility may be wrong, but you are at the low end rather than below the limit for optimum fertility.

b) if you are treated for gout and a doctor offers allopurinol - point out your race - as a deadly skin reaction is relatively common among Chinese, Thais and Koreans.

To come back to - is this gout. A damaged toe would help gout develop in a person who had high blood urate. I would see if you get more episodes (or take a sample to test of your sinovial fluid). However, not drinking enough water isn't good for our health in general and makes us feel tired and causes headache. Therefore for your general wellbeing and to protect against gout ... drink more water!

Genetics is the key Amy. I have one branch of the family - cousins - they all have it. I had a BMI of 27, but pretty fit. No alcohol. Good diet. But the gene got me in the end.

I have the gene coming from both sides of the family. So I have to be extra careful.