Anyone else here suffer from gout?

I just had my first gout attack this week. Monday night, I got home from work and noticed my right big toe was hurting like a banshee. I figured I must have broken it at work (I have broken both of my big toes in the past), but I couldn't recall how. Went back to work on Tuesday, and it got worse. By Wednesday, it was even still worse. Thursday morning, my whole foot was inflamed, and I left work after just an hour, barely able to hobble.

Our family doc got me in right away, and after a blood draw and a couple of x-rays, it was confirmed as gout.

So I am looking at diet in conjunction with meds and exercise. I was wondering if anyone else here has experience with gout, and if they have found any particular foods that tend to exacerbate it.

This is the list I am operating off of:
http://www.gout.com/causes-triggers...iQ#/treating-gout-pain/healthy-lifestyle

Some of the foods that are high in purine are beef and lamb, beer, spinach, oatmeal, and certain fish like trout. My question is (and my doc couldn't answer this), caribou is a red meat, and we have been eating a lot it after I just recently shot two out on Adak Island. Is it high in purine? or other wild game for that matter? And salmon, while a "red meat" fish, is a relative of trout, which is on the list. Does smoked salmon (I have it 2x a day, at least 5 days a week) have high purine levels also?

And are there other foods not on the list that people have found to cause flare ups?

I don't have a family history of gout, and so this is all very new to me. I appreciate any help that you guys would be able to offer.

Thanks,

Jake

I'm new to it too but have it so bad right now I can barely walk. It sure has [bleep] up my hunting season this year.

Damn guys, sorry to hear this, dont know what triggers it, but an old Bud has it, and he drinks the hell outta cranberry juice, says it kills flareups fast.

Gunner

Having broken both of my big toes, I can tell you that I would have preferred breaking my toe to gout. It is not fun.

I am on codeine right now for pain management (which I never used for either of my toes, dental implant, or other uncomfortable surgeries I have had), and the colchicine hasn't done much for reducing the inflamation yet.

thanks, I will try the cranberry juice.

I don't know about cranberry juice but I do know that cherry juice or dried cherries (eat the whole bag) works. When I first thought the pain/swelling/inflamation might be gout I went to the grocer and bought/consumed a bag of dried cherries. Within 25 minutes 80% of the pain/swelling/ inflamation were gone. Still works for me. Stay away from shellfish and beef, especially cured or with nitrates. Other meats seem to be okay.

Good luck UJ.

Gunner

Jake,

I've had it a couple times....brought on by beer and shellfish [shrimp].....I eat lots of moose meat and have no problem there. My Doc has it also and he advised his remedy and it seems to work:,,,,,when you feel it coming on, take 4 Ibuprofen and eat cherries.....

Damned painful stuff!

Curses this bastard called gout!!!! I have had it since my late 20's and would almost not wish it on Obumbles. Damn bright sunshine on my toe in an attack is enough to cause some serious pain it seems.

+1 on the Cranberry juice and also Black Cherry juice or black cherry pills. You can get them at Walmart or any place that carries vitamins etc.

See a Dr. and get on Allopurinal and it will keep the attacks from happening. I also got some type of anti-inflamatory meds from my doc to take in the case of a flare up. They are liver toxic so you are supposed to use them sparingly.

All in all I am making it through and I hope you find relief soon I feel for you.

Sorry to hear of your suffering. I jammed my big toe when I was just a kid by kicking a football barefooted. It's bothered me off and on my whole life. Several Dr's have told me it's better to break a toe than jam one.

DMc

Vern,
I am glad to hear that moose meat doesn't affect your gout. From the little "research" I have done on the i'net, supposedly wild game (moose/elk/caribou/etc) is high in purine. But that information is not from what I would consider legitimate sources. Hence, why I am seeking out first hand information from people who live a similar lifestyle to mine. Out of curiosity, what size of meat portions do you typically have? I really love that Adak caribou, and would hate to have to let my kids eat all of it....

Unfortunately, due to a kidney condition, Ibuprofen and similar anti-inflammatory drugs are off limits.

Mack,
I actually started taking Allopurinal about a month ago, as my kidney specialist noticed that my Uric Acid levels were running high (10.6). I just wasn't even thinking about gout on Monday when it hit. Once the flare up is gone, I will be doubling my dosage (per the doc's instructions).

One of the concerns I have now is what would happen if I had a flare up while doing a back packing hunt. I think I would have to just hunker down and wait it out, as walking is out of the question.

Dimebox,

while I know nitrates are bad, I don't know exactly what they are. Would they be in smoked meat, like salmon or caribou that I prepared myself?

I very rarely eat "store bought" red meat. My diet is mostly salmon that I catch myself in the summers and smoke, and then venison when I am lucky to get it. This is supplemented with whole chicken that is store bought.

36 years old and had my first bout of gout this year. The flare up lasted a solid 3 or 4 weeks and at one point I could barely walk. The pain is no fun. My two big ties still aren't quite right.

I ate and drank a steady diet of wild game, beef, pork, homebrew/beer, sushi, and just about everything else that is bad for gout. Needless to say the potential lifestyle changes are no fun to consider, but a healthier lifestyle is probably overdue for me anyway so its a blessing in disguise.

My attack calmed down and I ended up at the doc for blood tests. Yep, elevated uric acid. So, I ended up on Allopurinol.

It's done well managing my gout and I have not had a major flare up since but have had one or two instances where my toe(s) barked a bit because of something I ate or drank in excess. A lot of beer and an excess of wild game will set it off a bit, but in moderation I can eat just about anything.

Sipping a homebrew IPA right now and New York strip is tomorrow's dinner

Gout is a precipitation of uric acid crystals in a joint, many times the big toe...it was once called the rich man's disease....Allopurinol will work well but you must take it every day....for acute flare ups, colchicine or indomethacin are usually given....btw, under a microscope, uric acid crystals look like sand spurs....

Cochicine -- or colchrys -- knocks my flareups out almost immediately and they do not return soon either. Its been over a year... Wonderful stuff. Worht its weight in gold.

1B

Black cherry juice is what you need, not cranberry.

I've been dealing with gout for several years, to say it sucks is to put it mildly. Allipurinol has gotten mine under control, I rarely have a flareup now. While some foods do exacerbate it, at it's heart it's really a dehydration problem. Keeping well hydrated will do more than anything else to keep it at bay, you've got to really push the water to keep your kidneys flushing the uric acid out of your bloodstream. Winter cold with the dry air it brings is really bad for keeping hydrated, especially in a place like Alaska. Colchicine and Indomethacin do good to knock it out, but they take time to work. Colchicine is hard on your stomach in tablet form, a few hourly doses of that stuff will give you new appreciation for the atomic squirts.

If you're already on the allipurinol then once you get to the full 300 mg daily dose it should dramatically lower the chance of reoccurance. In the short term colchicine, indomethacin, black cherry juice and LOTS of water will rid you of it the quickest.

A tsp of baking soda and apple cider vinegar in 16 oz of H20 3 times a day.

Plus cherry juice or dried cherries and alleve ( naproxium sodium)

Try it

Thanks everyone for the replies. I was taking Colchicine last night (2 tablets to start, 1 every hour) and it didn't really help that much. After talking to my doc today, I had my prescription refilled and will continue taking it through the weekend.

Not a fun experience....

If it was me, I'd cut out everything on the list except the beer. Seriously, I hope you get a handle on it and are able to prevent further misery. Ken

Arthritis is somewhat related to gout (uric acid crystals involved) - hydration helps. Drink plenty of water.
My Doc told me that after a gout attack - said "I know you raise beef, and like your beer - you're not gonna give up either - so at least drink a beer, drink water, repeat."
Haven't had an attack in 3 years.

Mark

Indomethacin also works well, but is a very strong prescription Motrin. Must be taken with food.

I just had my first attack a few weeks ago, as I was rolling into hunting camp. My left toe was so swollen and painful, I could hardly push the clutch in my truck. I didn't sleep a wink that night.

The next morning I knew that tree stands were out of the question and I just went to a patch of woods in the middle of a big alfalfa field. Fortunately the deer were cooperative and I got an 8-point whitetail right off the bat.

The next day I went to a clinic and I got some colchicine, but the doctor told me that it would give me diarrhea if I took too much of it. The following morning I was feeling good enough for the 2-day drive home.

Next week I'm going to my regular doctor to see about getting a standing prescription for either alpurinol or indomethacin.

As for over-the-counter medicines, Advil seemed to help kill the pain better than Tylenol or Alieve.

I went to a P.A. at my regular clinic because my doc wasn't in. He said to take Naproxin (alleve) and by golly it worked. The trick is catching it early on. I know it hurts like a son of a gun and I feel for you.
I watch what I eat and haven't had an attack for several years now.

Bacon and asparagus seem to be triggers for me. I cut them out, still drink homebrew and have oatmeal every day. So far so good (knock on wood).

I've had gout attacks over the last 30 years. Started in my big toe but know occur in my foot or knee. They are rare, haven't had one in 3 yrs now but are painful when they occur. I've kept track of when they occur and for me there is no correlation to anything I'm eating or anything stressful in my life. They appear to be random flareups. I can generally tell that it is going to happen and take indomethicin immediately, this controls it very successfully and within hours or a day the pain is gone or greatly diminished. I NEVER go on a trip without having the indomethicin available and make sure I have a current prescription on hand at home. I've tried all the popular home cures, cherry juice etc and that didn't do squat for me.

It hit me after a couple days eating a lot of seafood. Never had it before or since, had my blood checked after a couple months on appurinol any uric acid was normal, quit the meds and checked it again in about six months and it was still normal. Was one of the worst pains I have had. Went up into my knee before it went away, I didn't understand it could do that I thought I was gona have to have a knee surgery. No more seafood binges for me.

It can also be caused by diuretics. If you ake tooo stro ng a dose it can dry out your kidneys and then they won't process trhough the acids that form the crystals in your joints. The efct of medications wil also increase becaue your body will ot eliminate the excess at the expected rate. Watch the kidney function through blood tests if you are on diuretics.

1B

I had gout for 20 years or more. Eventually I found that Black Cherry juice helped keep my uric accid under control and that helped. A year ago I went on a low carbohydrate diet to loose weight. Within weeks it was obvious the gout was better. After a month on the diet I never had a gout attack again. I can eat seafood and all the things that seemed to turn on me. I lost 40 pounds on the diet but the real payoff was lower blood preasure and getting rid of my gout problem........

Sorry to hear you have gout. I have a friend who has it and I've witnessed his flare ups...Damned awful stuff.

he tells me one of the worst triggers for him is shrimp, He suffers for weeks after eating the stuff.

I've been fighting it for years. You just have to figure out what triggers it in you, different for everyone. Pinto beans set it off in me like a bomb. Once you're on the allopurinol, don't miss a dose or the attacks can come back with a vengeance. Restarting allopurinol can cause an attack also. Colcrys will knock it out quickly if you get on it as soon as you feel the first twinges of an attack. As said, it is toxic, so stop taking it when you get the squirts, and you will. Doesn't work as well once you're in the middle of a full blown flare. I feel for you, it is an unbelievable pain.

Drink 10 glasses of water a day,it works to flush out your system,my Mother told mt that years back,and don't eat liver.Good Luck.,

for those that get these symptoms keep in mind that there is such a thing as pseudogout.....feels the same, acts the same but its a different crystal causing the pain so you need different meds as regular gout meds dont work....my dad went through hell till they figured out he had pseudogout and not the normal gout...

In my humble opinion (I am not a doctor but have been a gout sufferer), there is something missing in your treatment: you need also a real anti-inflammatory, like Ibuprofen or indometacin, because Colchicine is not anti-inflammatory.

Don't eat anything high in purines. Don't let yourself get dehydrated. Cherry juice and Indocin when you feel it coming on.

Deersmeller~

I have IgA Nephropathy, so anti-inflammatories that are processed through the kidneys are out of the question. I really wish I could.....

A diet change, as usual, will likely change your outcome. My brother had issues and with his diet adjusted and made them go away. Medication, as always, is the last resort IMO.

I understand.

Best wishes in dealing with your gout, I know by experience how painful and incapacitating it can be.

A doctor friend of mine sent me some links this morning, suggesting that black coffee can help prevent gout attacks:

http://www.johnshopkinshealthalerts...sHopkinsArthritisHealthAlert_2895-1.html

http://arthritis.webmd.com/news/20070525/coffee-lowers-gout-risk

http://www.mayoclinic.com/health/gout/DS00090/DSECTION=alternative-medicine

I find these studies confusing, as coffee is a natural diuretic, which is recommended that you avoid for gout flare-ups. But, as you can see, these come from fairly reputable web sites. So at least I don't have to give up everything I like!

I almost hesitate to mention it, but your recently going on allopurinol is likely what caused your gout attack. Allopurinol works by breaking down the coating on uric acid crystals. By the time you have a gout attack you've likely had elevated uric acid levels for years. It's in your muscle tissue all over your body, but the only place it really affects is your joints. When you start on allopurinol it breaks down the protein coating on the uric acid and your tissue starts releasing it into your bloodstream where it gets filtered out by your kidneys. For the first month or so on allopurinol you actually have elevated uric acid levels in your blood as your body purges it and because of that some ends up in your joints and causes a gout flare up. That's the reason they start you out on a low dosage, if they started you out on the full dose you'd get a bunch more uric acid in your bloodstream and REALLY have a bad case of it.

Don't stop taking the allopurinol, just realize what's happening and that it will get better when your body finally gets rid of the stored uric acid. It took about a month on allopurinol for me before it evened out. Hang in there and drink as much water as you can. Every time you piss you're getting rid of more uric acid and you're that much closer to getting it under control.

Don't eat rhubarb, either.

yeah, per the docs instructions, I am actually off of the Allopurinal for right now. It could have had something to do with it, but it usually happens sooner than a month (most of the time, sorta according to the specialist). What we think set it off was a couple nights prior, the wife and went out to dinner, and I had a big prime rib with a lot of wine that night.

* * * * *

Interesting to hear about the rhubarb.... another thing I love.

I have gout on my right hand between the knuckles of my index and middle finger. Can't make a fist. Went to a orthopedic specialist and he wanted me to eat pills for the rest of my life.
I said nah and changed my diet and hit the gym. Stayed away from rich and fatty foods. Lost 27 pounds, still can't make a fist, no Big Pharma hands in my pocket, can squeeze a trigger, and there is no pain.

100% pure cherry juice everyday will cure gout and make it go away...remember it has to be 100%pure,good luck!

Beer,and organ meat is no good,plus red meat it has to be cooked thou,no rare steak,tomato's anything with acid,I had it since early 80s,flarups are no fun I've been doing good for 15 or so years,I don't want it to come back,worst pain I ever had.

I have it, dad has it, he can't eat cabbage. I have about 1-2 flare ups in my big toe a year. Some years none. It do suck.

I work with a Indian fellow in his 40's . He has been suffering from Gout for years and when he has the attacks it is real bad. He is a strict vegetarian and never eats any sort of Fish,Chicken or Beef . He is thin and is not carrying any extra weight. He never has the attacks when he is back in India visiting only when he is here.

I have had arthritis since I was 18 and gout since about 30. I am currently 78+ and rarely have a gout attack (it is a type of arthritis caused by excess uric acid production). I have taken allopurinol for over 40 years and it works perfectly for me. I have actually never had a single Dr caution me about eating anything which is probably unusual but true. Mine actually affects only my left foot and ankle when it ever does flare up. But one allopurinol a day has seemed to keep it at bay for these many years.

All I know is the frickin pain is unbearable. I thought many times that it would have felt better to just cut the damn toe off.

that seems to be a common thought my dad swears the pressure of a fan blowing across his foot hurt like hell during a flare up

I stopped the doses of ColBenemid (probenecid and colchicine) before spinal cord surgery in 2007 because one of the interactions listed was with general anesthetics, it can intensify and prolong the effect. My big toe became so sore that I couldn't walk, so the physician injected it with cortisone. I also had stopped taking Naprosyn because it thins the blood, sort of a double whammy. During recovery the hospital doc saw my swollen foot and leg causing him to freak, embolism or something was his concern. I explained about the gout meds, he immediately ordered ColBenemid and Naprosyn, being that I wouldn't bleed after surgery and the anesthetic had worn off. I felt better right away.

I was diagnosed with gout as a teenager, apparently it's hereditary.

A few years ago it inflamed my entire right foot (my symptoms usually involve the lumbar spine), it happened that I was seeing an acupuncturist, so I scheduled an appointment. I could barely hobble into her office. Worse pain I ever had, worse than when a horse spooked and jumped on my foot with both hooves! When I stood up after a forty minute treatment, half the pain was gone. Two more treatments and there was no pain whatever, and it never returned. Sure my toe bothers me now and then, but that excruciating pain involving the entire foot was gone. What relief.

My wife keeps telling me to eat a half cup of blueberries every morning, she mixes them in with oatmeal, but they are supposed to reduce uric acid naturally. They are tasty, and preferable to the brain fog I am feeling from a 10 mg dose of hydrocordone I took two hours ago for arthritis pain in my neck where they took apart the vertebrae to remove the tumor. Pain that is keeping me awake, but drugs are faster than blueberries. Maybe I can get some sleep now. Good luck guys, and don't suffer with chronic pain, see a pain specialist.

Great explanation, thanks!

Had several flareups a few years back. Biggest issue with me is hydration. Drink lots of water and watch the rich foods (all that are high in purines).

Yep, that's what I will get around my left ankle. In the midst of a flareup I had lab work done, and two different tests both came back negative for excess uric acid. They gave me the Indomethacin anyway, and it fixed it. After I moved back here I had another bout, and hobbled into a doc and asked for Indo. He gave me the script, but then told me about pseudogout.

Mine seems to be triggered by stress on the joint, like say I step off the bed of my pickup, and drop to the ground. I don't do dat no mo.

Resurrecting an old thread here with some new info. So after switching to Miller beer and other lower end stuff, had no issues with gout for years. Recently developed a taste for Ranger IPA. Now laid up with gout attack in right big toe.

Googled IPA and sure enough, significantly more purines than normal beer. Gotta let this attack get over and going back to my cheap stuff. If you are a gout sufferer, I'd avoid the IPA types of brews. No where near as bad as kidney stones but this kind of pain would make a hunt about impossible right now.

Sitting here on the couch reading this with my left foot up on a cushion. I hate this crap. Need to seriously change my lifestyle. Two nights ago big, juicy ribeye and we went thru two bottles of Pinot noir. Today GOUT

Flipping hate it

I didn't read this whole thread, so if it's already been mentioned, I apologize.

There are more foods ON the list than not!
You have to figure out what triggers your flare ups.
Beer...is usually a biggie.
For me...it was iced tea. Which is a HUGE drag cuz I love iced tea!
I still drink a glass occasionally, and I can always feel it in my feet.

If you drink tea...give it a rest and see what happens.
Something else that will flare it up is extreme weight loss.
If I get on a hot job in the summer where I'll sweat off 5 or 10 pounds rather quickly, I'll get a flare up.
But...in the end, you have to find your trigger.
(but try the no tea thing)

Red wines and seafood like shrimp trigger gout for me, and mushrooms............ luckily, I haven't had a bout in about five years, due to 400 mg. of allupurinol every day. I'd rather do without my BP pill than the allupurinol........

I had it chronic for about a year, then changed my diet and it went away completely. No more problems at all and no more meds. I had been eating sardines and grapefruit for breakfast every single morning. Once I stopped those two foods, no more problems.

Gout hit me again Tuesday, still too swollen to wear my boot or shoes this morning. Spent the last three days sitting in a chair alternating between the right foot on the ottoman or in a tub of cold water.

I was taking Sodium Naproxen every 4-6 hours and Friday night decided to take aspirin before bed, huge mistake, I never went to sleep and by 3:30 I had the filet knife and was ready to amputate my foot.

The internet indicates high purine foods cause the buildup of uric acid and naturally, being on a low carb, high protein, low calorie plan for the last 15 years, I question if this is really the cause in my case.

On the other hand, I know I was dehydrated after being about 3 lbs lower than normal for several days straight. I also recall being dehydrated the few days before a kidney stone, maybe three times in the last seven years. It seems logical, if the kidneys normally filter out uric acid along with the other waste products, and I don't drink and piss enough, and my eating plan leads to dehydration, and the coffee and diet sodas lead to dehydration.

I was asked me how bad it hurt, I said it's like hitting your thumb with a hammer...

...and repeating every few minutes.