Long-lasting gradually intensifying toe joint pain
Posted , 6 users are following.
Hello community -
I started to get a twinge of discomfort in that big toe joint about 2-3 weeks ago. Kind of blocked it out and carried on as normal. It gradually intensified and got a bit more swollen and stiff so it hurts to push off on that toe and ball of my foot while walking or running now. It's been at the same level now for about 10-days. Now this isn't the classic gout flare up of intense pain that I hear about from gout sufferers - but it is located right in that classic joint that gout goes after.
I've had a handful of what I think might be mild gout flares in the last couple of years. Not had a formal diagnosis. The flares have been in my toe, ankle and elbow and separate times and all dissipated fairly quickly with only mediocre pain intensity compared to what I hear gout can be like.
X-rays of joints have all been clear. UA blood levels were up around 9mg/dL a year ago and then after diet and lifestyle adjustments have been between 7-8 mg/dL the last few months. I'm in my mid-30s and very active so even though this pain is mild it is not allowing me to walk and run and do much of the sports activities I typically do.
Any ideas on this? Does this sound gout related or something else? I have started taking some ibuprofen and got some turmeric and some tart cherry and celery seed extract supplements to try and get down the inflammation and further reduce the urate. I'll be going to see my GP this week so we will see what the docs have to say if anything... I feel like they tent to treat acute symptoms and send you on your way and if you aren't totally crippled with pain and disability they don't take you seriously enough!
0 likes, 24 replies
jx41870 JohnS15
Posted
And how about your diet?
Those UA readings are a bit high, as you know.
Funny thing is, I've just been going through a similar thing - one big toe was hurting very much like a gout attack but just a little, not a lot. Is it even gout? I cut out meat for a couple of days, wasn't really anything else in my diet on the high purine list. I took some extra celery seed. A couple of days later it had cleared up.
A good doctor will take your high UA readings seriously, even without/before painful symptoms.
How are your other lipids - cholesterol, triglycerides?
Remember in your diet, to cut back on sugar, especially fructose.
JohnS15 jx41870
Posted
Thanks for your comment. My diet is reasonable - mostly plants and grains, some chicken and dairy - occasionally some red meat or pork (couple times a month maybe). The only thing I recently had that might have triggered something was some shrimp and scallops (which I hardly ever eat) during a meal out with work. I'm definitely being extra vigilant now and I do try and avoid sugary and high fructose food and drink. I've also cut out alcohol completely for now - I am fond of a drink so that likely plays a role.
Just had the lipid panel done as well and everything was bang in normal range.
My high UA is genetic for sure - just trying to see how much I can control it without going on full time medication. I'm not totally opposed to allopurinol though and will talk over options with the doc.
jx41870 JohnS15
Posted
There's a lot of variation between people on this, but I've been able to trace any attacks I've ever had to specific dietary mistakes, including something as innocent as hummus - in fairly large quantities, was having it every day. A couple of fresh trout in the same month, oops. Just one meal shouldn't do it, but you never know.
I've had good luck with diet and celery seed, just a 500mg capsule once a day, keeps my UA under 7, though not by much. But a number of my lipids are right up on the border, have to watch them all. With a number that high you might try at least twice that much celery seed - and/or a lot of fresh celery, too, it is tasty enough after all, though it takes about five big stalks to equal one little capsule.
rustygecko jx41870
Posted
The thing is though that a person who is healthy can eat what they like and not have a problem. i suspect your celery seed extract could well help the gout. But, the underlying disease - high blood urate is still doing its damage to the veins. It is this damage which causes the heart attacks and is the reason that mortality rates are so high with gout sufferers.
jx41870 rustygecko
Posted
The celery seed active ingredient is supposed to block the conversion of purines to uric acid. Whether this is exactly the same thing allopurinol does or not, I do not know.
Guest jx41870
Posted
I though celery seed helped me for a while and have been taking for 2yrs - but by now they don't seem effective. This combined with cherry juice and capsules too. So allopurinol it is. My diet hasn't changed but I was almost in constant gout by now, with the odd massive flare that incapacitated me - maybe for a few hours maybe for 2 days. I think its a condition that builds up in you and just gets worse all the time.
I need to start a thread about diet as I refuse to not have red wine and steak on a Friday! Order my box if I have to live like a teetotal vegan!
rustygecko Guest
Posted
I am afraid that even vegetarians and vegans get gout. most of the "meat" you consume each day, is your body recycling your own dead cells. Gout is a metabolic disease, not one of life style.
You could go to the NICE site and see their recommendations both for doctors and for patients, its all there in black and white.
JohnS15 Guest
Posted
Abso-bloody-lutley!!
jx41870 rustygecko
Posted
It can be both, it has a long reputation as life-style, and I can certainly trigger an attack in short order by having a couple of bad meals.
Of course some vegetables are still high on purines, but I fully concede, even with a perfect diet, not everyone is going to avoid high blood urate levels and gout problems.
But for anyone like me, diet is a critical item, and there's just no getting around that.
rustygecko jx41870
Posted
°You° can trigger a gout attack by what you eat for two reasons:
1 You have an underlying metabolic illness; when you were (younger) and healthy you couldn't trigger gout;
2. You don't have your blood urate controlled and therefore easily upset an unstable equilibrium. In my case for example, a tin of sardines was sure to trigger gout. Today, my blood urate is very low and whatever i eat doesn't trigger gout.
Guest rustygecko
Posted
Thats interesting as my diet hasn't really changed over the years. I am heavier, and heavier people produce more purines dont they - there must be a link here? Is it also that the kidneys get less effective at getting rid of urate as you get older? Have tried washing them out with some Rioja to help 😉 Seriously though its just something that has crept up as I turned 50 - nothing much else changed, other than the weight.
Guest JohnS15
Posted
9 seems quite high! I've had horrendous attacks at 6.
I'm currently not so sure how much diet and natural supplements reaehelp. Have had to give up and go on allopurinol as I think gout gets worse over time from your first attack - whatever you do. And sounds like you are young and fit so it's genetic.
Allopurinol is going fine for me so far (only 2 weeks mind) but joints and worries over functionality are better; good for the mind...
JohnS15 Guest
Posted
Yeah it's genetic for me - my male family members have high UA and dealing with gout with varying degrees of severity. Which is why it's always on my mind as soon as a joint issue crops up. Thanks for your response - I'm definitely not opposed to allopurinol if that is the best option for me -- I don't underestimate the value to easing the worry over hight UA and gout attacks!
rustygecko JohnS15
Posted
Sounds like gout.
you dont need to get your urate down a little - you need it down a lot - to under 3, or youre looking at a heart attack before youre into middle age.
In other countries you would be sent to a cardiologist to check your heart out. On the NHS you won't. you should however see a rheumatologist.
jx41870 rustygecko
Posted
Hey @rustygecko, it just strikes me - rheumatologist, for what is really a metabolic problem? I know "gout" says "joints" says "rheumatologist", but ... I guess I'm not sure what other specialty might be better, now that you mention it. Endocrinologist, maybe?
rustygecko jx41870
Posted
I agree that gout a metabolic disease but its the rheumatolgists that specialise in its treatment. i suspect the reason is they are better equipped to distinguish between gout and other disorders causing swelling in joints.
its not just in the UK where rheumatolgy takes care of gout. There are several diseases that fit into two camps - probably loads, but one i know of personally is lymphoma which may be treated by blood specialists or oncologists.