I was diagnosed with gout in February at the age of 37 which has shaken me up somewhat. After the second flare up GP has prescribed me Alliproinol which I have refused to take for several reasons (which i will not go in to). I thought that i might be able to control it through diet.
This is where the problem starts - There is some conflicting information out there which advises for or against certain foods but no definitive list has been compiled from what i can find on the Internet and my GP gave me a general guide line but not enough information which is disappointing.
I have taken up gout fight with the following actions (which are not recommended or endorsed by my GP):
1, Dried cherries (Brand Urban Fruit) I have a handful a day
2, Drinking 2-3 cups of black coffee a day
3, Drinking plenty of water
When I feel the first signs of 'goutyness' in my foot i take 2 ibuprofen and a sachet of Dioralyte and maybe some more cherries which seems to hold the flare up and stop it in it's tracks.
I have on top of all this cut down dramatically on Alcohol & oily fish red meat.
My questions to the community are:
1, Does anyone else trying to control gout flares without using prescribed medication?
2, Does anyone have a definitive comprehensive list on high/low purine foods?
Written by
MushroomDave
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I too have had gout on and off for several years.I have kidney impairment which seems to wander in and out of stage 3 and 4 and this is what is believed to be the major factor for mine.
When it first raised its ugly head I was given indomethacin tablets.Even if I had a really painful attack when I couldnt put my feet to the ground it would be a lot better the next day and coupled with colchicine tablets a couple of days later I would be up and running again.
After a couple of years I was told I couldn't have indomethacin any longer as it was affecting my diabetes and at that point I was told to move to allopurinol.
I also did not want to start these as when you initially start them they cause a massive flare up of gout and then when started on them you can't really stop because the same thing will happen.I was also told I couldn't have an alcoholic drink.I don't drink a huge amount but I really enjoy a glass or two of wine and there are occasions when I want to go out and celebrate so this wasn't going to fit in with my lifestyle.
I haven't had an attack for over 12 months now but I still have my supply of colchicine.If I feel what I think is an attack coming on I take the usual dose for about 2 days and it seems to ward it off.Now whether that's coincidence and it wasn't an oncoming attack or the fact that the colchicine has done its job I don't know.
With regards the Foodstuffs there is a lot of conflicting info out there.
Personally I go for the cherries but I use the fresh ones not the dried ( however they may be just as effective).I also drink cherry juice.These can be quite expensive and not always too easy to find out of season.I have also found that a small continued use of these is better than an odd dose every week or every few days.They seem to work better as a daily dose where you build up enough in your system to prevent an attack happening.
I don't like coffee particularly esp black coffee so I haven't tried this one and I don't suppose I ever would so I can't comment on its effectiveness.
Yes,the water is good as it helps to dilute the Uric acid in your body,and cutting down on alcohol and red meat is also a good move.
You will find that any offal meat such as liver or kidneys are bad for gout- things which you think of as reasonably healthy.
Some veggies too can bring on attack.I find if I used to go a bundle on mushrooms and cauliflower it could start it off.
The other thing I was told by a doctor was that if you are going to eat meat, white meat is better than red meat ,but even some white meats can trigger an attack.If you are eating chicken its best to stick to the breast meat. Apparently the legs or wings ( which are the tastiest bits in my opinion) can trigger an attack.The thought behind this is the harder a body part has had to work in life the harder it is to digest when cooked.And this applies to all meats red or white. I have seen no medical evidence to corroborate this theory but as it came from a doc I have believed it.
I used to have a list which I obtained from my renal unit and I have tried to find it this afternoon but without success,but your gp should be able to provide you with some info on this.I will have another look for this info and let you know if I find it.I must admit I haven't used it for some time as I have got to know what triggers it for me and so I avoid them where possible.I also think that the same foodstuffs do not affect everyone in the same way as with migraines we each know our trigger points.
Sorry for the long rambling reply but I hope there is some info in here that is helpful.
First of all, thank you very much for your reply if you could find that list that would be fantastic - If not, I am at the hospital next month (for an unrelated matter) and will see if I can obtain one from the renal unit.
Interestingly I had spent about 2 years on a high protein diet. The weekend of my first flare up was a case of over indulgence lots of steak/strong cheese/wine & ale and the week after once it had died down i thought i'd lay off the meat and had Mushrooms/asparagus/king prawns instead which set me off again. Do you know if there was anything which set off your first flare up?
My GP has not been that supportive which is annoying and has a very cavalier attitude - his answer is "take drugs ask no questions" as a result I am actually changing GPs.
I was taking colchicine until about 2 weeks ago and now nothing. I am always thinking about my foot as I am scared of another flare up.
Gout is a horrible thing. It's amazing that the affected joints cannot be "cleaned" of the crystals using surgery. The only way to describe the pain is like toothache in the foot. I find over the shelf anti inflammatory do not help with the pain and that I have had to reach for a supply of Codeine Phosphate just to get through the day.
Until you've had that pain you dont know what it's like.There were times when I used to have it I the past that I couldn't even stand the sheets touching my foot in bed.It was excruciating.I will have another look for the list again over the weekend.
For the life of me I really can't remember what caused my first attack.At the time I had no idea it was gout I thought I had broken my toe (big toe on right foot- a classic joint often the first to be affected) so I hadn't really taken much heed of what I had eaten.
We were away on holiday in Devon at the time and as it was good weather. We were having steaks on the bbq every night so I suspect red meat coupled with a few glasses of wine and we were heading right for a gout attack.( yes we did have good summers once upon a time !)
Over the counter meds don't come anywhere close to touching the pain,so it's a waste of time and money.Thankfully I have not had an attack for over 12 months but when I did,along with indomethacin or colchicine I would take cocodamol 30/500 which are very good painkillers.I also wonder if some of my RA meds have helped to control mine or whether it's just coincidence.
The attitude displayed by your gp is not what you would expect .I thought they were supposed to help ? Having said that a number of people are quite ignorant about gout.I remember going into work one morning after an attack.loads of people fell about laughing,saying it was an old mans disease and more or less suggested I was an overindulgent alcoholic.I was most put out.I am diabetic so can't and don't overindulge on alcohol,although I do have a glass of wine regularly.I am also in stage 3 kidney failure so I am careful with what I eat (renal diabetic diet) but occasionally stray from the hallowed path,and also have RA ..Gout is not always to do with excessive drinking/ overindulgence as a lot of people assume but can give you an attack.I know of people who are teetotal and have it and it is mainly due to eating high purine foods.Some of these foods you would also put in the healthy group so you can be stumped before you start.
I hope that you can manage to control these attacks and I will seek out list for you.
I have had another really good search for this sheet today, again with no success but I have googled "high purine foods and gout"
Brought up a number of sites which I Looked at .To be fair these are probably now more comprehensive and up to date than the list I had, after all it was some years back.
The ones I found which looked particularly good and informative were.-
Purine health N1Health
Acumecico purine table
Mayo clinic gout diet what you can eat and what you can't,
The tables on here were very similar to what I got but there are more up to date options than the old list I had.These list the foods and supply the purine value so you can see which have the highest purine content and most likely to cause an attack.- so avoid or use in moderation!!
I hope these will be of some help to you,sorry I Cant find my original list but I have printed these off this afternoon as I think I will now use these to refer to.
hank you for including the links regarding diet etc. It pretty much backed up what I have found triggers an attack for me.
Since January I have lost three stones and eaten a healthy balanced diet and also stopped taking allopurinol too.
My recent attack was the first since I stopped taking the meds and followed eating a rather large mixed grill and 3 pints of beer! I had been restricting my portions of meat to around 75-100gms and then mostly chicken but on Sunday had about that size portion of steak, gammon, chicken and a sausage! Monday morning the dreaded gout arrived!
Back on allopurinol and anti inflams and the pain subsided and then last night I had liver and sausages and it flared up again.
So it seems for me to keep things under control I should restrict my red meat intake and keep portions of meat or fish to under 100gms a day. Cut out beer, I suspected before this gave me joint pains, and watch my intake of pulses.
Glad you found the links of some help.Like I said to Dave I use these now as the original list I had from my renal unit was a few years ago and these lists are more up to date and more foodstuffs on them.I haven't used my original list for a long time because I now know what my trigger foods are .
Congratulations on your excellent weight loss - that is certainly an achievement to be proud of.I could really do with losing a shed load of weight myself but from being fit and active cycling 80-100 miles per wk in 2010 the severe immobility which RA has brought me,along with steroid medication and I am really struggling.
Quite an achievement getting off the allopurinol too.The dr discussed it with me but I never had to take it in the end.I understand it has a number of side effects and very difficult to come off it.
I have a tablet called colchicine if I need gout meds, as I can no longer take indomethacin and I must admit if I fancy a foodstuff that I know will trigger an attack I take a few of these and it seems to ward off any attack.Not sure if I should be using them like that but it works for me.
Mushrooms and salmon seem to get me if I overindulge on them.I have an occasional beer but I am rather partial to a glass of wine and that's a sure trigger,so I just have to keep tabs on how much I have.The one big thing for me is liver.I really love liver and onions but have had to stop this completely as it used to lay me up for days.
I try to follow a reasonably healthy diet but as some days with RA I don't cook I often use ready meals so although I have good intentions it doesn't always happen that way.
Good luck with your continued weight loss and it seems like you know how to control your gout sensibly.
I used to have acute episodes of gout every 2-3 months affecting my feet or ankles mostly. After 2-3 years, a friend recommended vitamin C. Published evidence on the effectiveness of vitamin C does not really exist, and as a doctor, I am not easily swayed by personal anecdotes. However, it is generally safe to take vitamin C in high dose (excess is simply excreted through the kidneys), so I started to take vitamin C 1000 milligrams every day.
I have not suffered an episode of gout since beginning the vitamin C. I was already taking statins, low-dose aspirin, beta-blocker for angina and an ACE inhibitor for high blood pressure - nothing else had changed. I have had no further joint pains or angina episodes in the last 2 years and am now able to increase my activity and am losing weight. I think it is certainly worth trying high dose vitamin C (1000 to 1500 milligrams) daily before taking other medicines with more potent effects (and side-effects).
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CHANGE OF BIOLOGIC TREATMENT 
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