prolong gout attack

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I have been experiencing what it seems multiple gout attacks for the past 5 weeks. It all started on the back of my right foot where the aquilles meets the heel and my GP thougth at first it was a tendonitis. A couple of days later it moved to the outer ankle, same foot. Two days later, to the big toe but on my left foot, a week later the external section of the sole (left foot). Just when I thougth I was getting better it came back somewhere else or same place as the days before. Obviously it wasn't tendonitis and I knew that a few years ago I had my uric acid levels up (9+) however, the recent test done during these attacks showed my Uric Acid as 7.1mg/dl which is on the high end but within the normal limits. I am not a meat eater or drinker so I can't say it is 100% associated with poor diet eventhough my diet isn't perfect. I blamed these attacks on a rapid weight loss I have had due to lots of excercise (12+ lbs in a couple of months) and carb diet, I am back to what I believe is my normal weight. I have read that weight loss can trigger attacks due to the concentration of Uric Acid. I have read all the comments of many people on their gout experiences and I feel for all of you, it is a very painful illness. During these last multi attacks I really thought it was going to be over in a few days but it has been 5 weeks and just now I can walk 'almost' normal. I still feel pain on the sole of my left foot and my left toe is still stiff with minor redness but inflammation is almost gone. Does any one have any idea how longer is this going to take to be over?. The lessons I have learned throughout this ordeal come from medical articles I have been reading and other gout sufferers comments. I can tell you that for everyone the trigger is different, that gout diet is not really as well understood as we think, I have read several professional opinions on food, some say tomatos are bad, beans are bad, spinach is bad, tuna is bad, salmon is bad, etc. and of course the usual suspects (red meat and alcohol) and then I find articles where they say the opposite or point out the lack of proof that some of these food are the cause. In fact I read and article/study where they say diet contributes only 12% to gout issues (?). A doctor friend of mine found a study performed by a US University where they find no correlation between red meat and gout (?), I have not gotten a hold of this paper but when I do I will share the details. Anyway I hope sharing my limited experience with gout can generate some feedback on why a gout attack can last so long.

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  • Posted

    Juan from what you're describing it doesn't sound like gout. It sounds to me like you have some sort of autoimmune type of arthritis or rheumatoid arthritis.

    I, too, loss weight about 40 pds., yet, although I felt a bit of gout pain in my foot, rather than get worse, it got better. And I never got any type of attack after losing the weight.

    The foods you're referring to are called night shades, these contain something called lectins and their levels are high such that they're the culprits for arthritis pain. These include; tomatoes, potatoes, bell peppers, eggplant, cayenne chilli and beans.

    I eat meat, occasionally but it doesn't give me gout. But if I eat or drink any of the night shades it won't take long before I start feeling arthritic pain, and inflammation in my Achilles heel, my ankles, and my hands.

    The internet has so much information that lay people really shouldn't rely on it unless the source is coming from a reputable, in this case, medical website.

    I worked in medical research, and as a nurse, such that I use only medical website's? and I follow a few doctors to source my information. I hope this information helps you.

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    • Posted

      Thanks Sochima, Yes I have thought about the possibility of something else other than gout but my GP hasn't mentioned it. I am planning to see a Rheumatologist as I mentioned in my other reply to someone else. I am not really sure my gout symptoms were trigger by any sort of food, i eat all sort of vegetables usually without any issue so can't really think of one single item I ate in excess before my gout attack. I would appreciate if you can point me to a good medical website so I can inform myself better. Have you been diagnosed with gout or any other type or arthritis, just curious?

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    • Posted

      Well, I can't post websites here since they don't allow it but if you type, in your famous search engine, gout organization, you'll see an arthritis organization for which gout is considered a form of arthritis and another one with a medical reference name. Those two should help. 

      If you ate spinach, cauliflower or kale, or wheat (especially brown) consecutively for a few days expect a flare up. These vegetables and grains are not to be consummed often if you're a gout sufferer. 

      I was diagnosed with gout when I was 14 yrs old. I was put in a cast for 3 months. Everything was good until I started taking aspirin when I was about 40 yrs old. Almost a guaranteed bet that if you're a gouty & take an aspirin daily you'll get a gout attack, as well as eating high purine foods, not sure if wheat bread is on the list, but brown wheat bread gives gout. 

      The only way to combat any type of arthritis/gout is to warm up with stretch exercises before starting your workout, and exercise with low to moderate intensity. I only work out for about with 30-40 mins max with most of it in warm ups.  Ellipticals and bikes are good way to warm up.  

      Last, there is a website that lists all the foods high in purines. Search for it, it's pretty to find. Hope this helps. 

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  • Posted

    One last thing I forgot to mention, drink tons of water. And stay away from fruit drinks or Gatorade or anything with high fructose, corn syrup, or diet drinks. Crucial to stay away from diet drinks and hfc's. These three drinks also cause arthritic pain and gout.

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  • Posted

    Ok

    Firstly, the fact that your doctor did a Utica acid test during a gout attack shows that

    a) he/she was asleep on the afternoon the studied gout

    b) doesn't bother to read the NICE instructions they are given.

    My advice: change GP.

    Blood urate levels fall to normal during a gout attack. The GPs instructions are to take a blood test 4-6 weeks after the attack.

    Weight loss will not "cause" the attack, but it will trigger it.

    To end the attack your doctor should have given you the following advice and medication: drink loads of water, put the foot up when possible, put it in very hot and or very cold water (whichever you find best), drink loads more water, stop drinking alcohol, keep up the exercise, drink loads more water, and assuming you have no other comorbidity - take colchicine.

    As for red meat - vegans get gout. On a 100 kilo man catabolism (your body destroying its own tissues as a part of replacing them) produces enough primes that to get the same through meat you'd have to eat 1.5 to 2 kg of meat. Unless you have the diet of a Begal Tiger your diet isn't the problem. The problem is probably: genes, age, kidneys not as they were, and probably overweight and fatty liver (but not always).

    The solution long term is wait till a few weeks after the attack ends and see if your blood urate is higher than say 6.0. If it isn't then look for another cause.

    If it is, then take allopurinol in high enough dose to flush out the stores of monosodium urate.

    Note: long term high blood urate leads to blood vessel damage, kidney damage and heart attack. Gout causes damage to joints.

    There is no good reason to control purine intake based on the research, but nobody wants to hear that. When I asked several researchers why this advice is still given the answer was a) tradition b) some foods trigger attacks in some people c) it gives the patient a sense that they can control it.

    Good luck and good health.

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  • Posted

    My attack lasted over 60 days. My highest uric acid test was 12.2 must and I tried to adjust by diet at first. We could lower the level into the 8s. That's when testing began. After a 24hr urine test and some blood testing it was found that I was over producing uric acid. Only thing I could do is go on meds. I now have my life back.

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    • Posted

      Thats very interesting as that is less than 10% who are over producers. IN reality I think that for most of us, the only solution is allopurinol.

      What is your normal level of uric acid now?

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    • Posted

      Thanks for the feedback, it is helpful. I am new to these gout issues, I am 46 yo and from your input and what I have read so far I am starting to believe that diet eventhough important to one's health it is not the solution to gout as many put it. I excercise 5-6 days a week, I do not drink, my red meat intake is low, fairly decent diet, not overweight and I have gout. If we pay attention to the list of food we cannot eat to avoid gout we basically would have very few options left to eat. I am still under what my doctor think is a gout attack (5 weeks on now) and he has not ordered another Uric Acid test so I do not know my current levels. When he first ordered the test about 4 weeks ago it was 7.1 mg/dl. I can walk now, but still have pain (foot sole) and stiffness (big toe). This has been very frustating for me, never thought a gout attack can last so long and disrupt your life like this, if this is indeed gout (the symptoms point to it). I will see my GP next week and I will ask for a referral to a Rheumatologist as I would like to discard the possibility of something else.

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    • Posted

      Juan

      I'd just reiterate one point. The long term objective is to not simply stop your foot hurting, but is the long term management of the underlying hyperuricemia, which given time substantially increases mortality, heart attacks, vein problems, strokes and kidney issues.

      My experience is that the rheumatologist are more conscious of this than GPs.

      Good health.

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    • Posted

      Febuxostat - advantage of allopurinol is that it is well understood, well tolerated and dirt cheap. Do not take it if you are Han Chinese Korean or Thai.

      The reason most people give up on it is that for the first year it causes gout as the monosodium urate crystals in your body are removed. For this I have 100 at a time colchicine: first sign of a twinge I take one. Some doctors give them out six at a time as if they're morphine.

      The only problem I had with allopurinol - for first few weeks made me sleep like a baby. After couple of months it affected my stomach so used to hide it in a bit of banana. That lasted a month. Now it's no problem at all. The normal dose to flush you out is about 300 mg. Work up to it. Get regular blood tests to check blood urate. Ideally get it down to 3.

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  • Posted

    Hello juan. I was wondering if you ever found out of you were having something other than goit and if you ever got better? I am having very similar problem. I have a history of what i was told was gout but never just had it in the big toe joint. Usually side or middle of foot or whole foot or knee. This lastest on is both feet one knee and an elbow. Its been two months now and im having a very hard time getting up and moving. Seems to start to get better but then gets worse again. I too am ganna get a doc to send me to an RA doc.
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