Gout Query

[Magicmarker28]

Hi there,

i have been having some trouble with gout, and wonder if i could get some assistance, as my doctor seems about as useful as a chocolate teapot..

I have gout for about 4 weeks, it comes and goes, but remains painful at all times, 15 days straight without a good nights sleep is telling..

I've read about foods with high purine content, and high oxilade content and avoid those, bicarb of soda and apple cyder vinegar with water, i drink a lot of water, little if any alcohol. Some would say i am very very fit, i like to run, helps clear my head, but i can't at the moment.

I also took colchicine 500mcg for 3 days, which had no effect at all

So my diet is very very limited, i am coeliac, and dairy intolerant also, so all processed foods are out, apart from a little bread. Nearly all veg is organic, i eat very little meat.

But gout still remains, any other assistance would be gratefully received ...

thanks in advance,

Mark

[Researchfan]

Hi,

Sympathies, gout is extremely painful!

I would recommend to keep a food diary and assess your fructose consumption.

Even if you don’t eat added sugar, whole foods of Fruit and vegetables can be quite high in fructose.

Excess fructose can be the root cause of gout.

The metabolism of fructose raises uric acid levels. High uric acid can lead to gout. Excess fructose either from the food or from the body making it from high glycaemic and refined starchy carbohydrates is a cause of gout.

Also as a handy ref guide is to use the Monash University Fodmaps app and diet info for which fruit and veg contain fructose and fructans. Apples and oranges are high for example. Tomatoes and green peas are high for example.

The more I research and read the more I realise vegetables are not all they’re cracked up to be re health. Especially in people with sensitive guts.

Dr Robert Lustig is a main man when it comes to learning about fructose metabolism, if you’ve not already come across him.

You’re right about avoiding oxalates too. I’m just reading Sally K Norton book “Toxic Superfoods”.

Hope that’s helpful info!

[Magicmarker28 in reply to Researchfan]

thanks, i don't eat much fruit now (apples / oranges etc), tomatoes are out, peas i don't eat... so very minimalist !! Thanks for the information though, i shall research the fodmaps more, and i'll look this book up...

[Researchfan in reply to Magicmarker28]

you’re welcome. Hope you get relief soon. If not keep going back to your dr. Check your kidneys etc. keep drinking plain water that’s good. You say you keep fit and run otherwise? I’m an Exercise Scientist by training and it might be noteworthy that muscle break-down and repair as is normal following workouts could potentially raise purines. Like proteins in seafood, meat and mushrooms are high, the breakdown of muscle can be. It’s also why anyone that goes through sudden weight loss or heavy exercise can end up with uric acid crystals in joints/gout if accumulation of uric acid exceeds excretion. It’s a balance the body deals with as normal everyday. Sounds like you’ve got a bad case and it takes time to clear the crystals so hang in there. If no improvement definitely return to dr!

[Researchfan in reply to Researchfan]

A reference for you.

“Purine metabolism…muscular exercise”

sciencedirect.com/science/a...

[Heilung18-Gesund]

Mark, I am sorry about your troubles.

Have you tried taking allopurinol to lower UA levels? Colchicine just lowers inflammation in the affected joint.

Also, make sure you take no meds, like thiazide diuretics, that might increase UA levels.

I don’t know your history, but if you have any diabetic, cardiac, or renal issues, the SGLT-2 inhibitors, such as empa/dapaglifozin, lower UA levels as well.

Hope you’ll feel better soon. TB

[Magicmarker28 in reply to Heilung18-Gesund]

thanks, i have no issues apart from coeliac / dairy intolerance, and seemingly a great deal of intolerance to many (normal / natural) foods. I take a great deal of care mostly of what i eat / drink, so to have this happen as well, well... typical i suppose!

I was hoping to understand how to lower levels without having to go down the meds route, if at all possible, but understand pain and the need to resolve this may overtake that desire. Good to note the colchicine information though, thank you for that. it had no effect anyway!! Thanks for your reply.

[Researchfan]

Just to add to reply. From Monash low fodmap diet app: the alphabetical list of vegetables high in fructose, (may or may not be helpful).

Alfalfa, Jerusalem Artichokes, Asparagus, Black garlic, Broccoli, Broccolini, bell peppers red orange and yellow ones, not green peppers but they have fructans,

Chilli peppers, cucumbers, tomato, butterhead lettuce, spring onions, sugar snap peas, yellow squash.

Also if you eat a lot of gluten free carbohydrates such as rice, corn, and potatoes or starches any excess glucose not used for energy can get converted to fructose and go down the same metabolic pathway of increasing uric acid.

Is your everyday diet an anti-inflammatory one? i.e. Low in seed oils, low sugar and low glycaemic.

Also be sure you’re getting Enough quality protein (at least 1g per kg ideal body weight recommended. More if you exercise heavy.)

[Magicmarker28]

So it turns out the main contributor appears to have been bacon, ham and things of that nature!!! Crazy, but there you go! I am clear of gout for months which is great, thankfully!!