In the summer of 2013, I had my first occurrence of gout. A doctor visit and bloodwork confirmed that I had gout. I was given a list of things to avoid, but it turns out they are all my favorite food/drink. Rather than give up beer, mussels, anchovies, liver, etc I have instead relied on drinking huge volumes of water in an attempt to diurese.
A little over a year went by, then I had a second flare up. I also had a small flare up from trauma, when I kicked a wall out of anger/frustration.
But here is where things get interesting. In the past four years I have not had any more flare-ups. I try to drink plenty of water, but I haven’t modified my diet at all. Out of curiosity I have been specifically enjoying foods from the NO!! list just to see what would happen. Nothing. Last week I had braunschweiger & egg sandwiches for breakfast every morning, organ meats for lunches, and steak for dinner every night. Plus I’ve washed it all down with beer. I even cut down my water intake to more reasonable levels.
I’ve had basically the same experience. First time I thought I broke a bone in my foot. I had to take a couple days off work because I couldn’t walk. That was probably 8 years ago. Since then I’ve had a couple times where I thought I felt an attack coming on but it never flared up bad. I haven’t eliminated any of the trigger foods either. It’s been 5 years since I’ve had even a remotely sensation that an attack was coming.
That and not all gout is created equal. Mine is a serious issue due to the various heart meds and stuff and without a regular control Rx it slams me about every month or two at the most; even eating and living right. Now my one buddy has had an attack once every 3-6 years for about 50 years; it hits him and colchrys for a week and then he is fine again for years. Its just one of those conditions with a lot of YMMV.
My Daddy never could get rid of it until his gastro doctor insisted he modified his diet to combat diverticulitis. Gout never bothered him again. He drank beer everyday.
I never had gout until I was in my early 40s. It was always something my dad got, not me!
Anyway, we don’t seem to start out with the issue, but I suppose something happens along the way with aging that changes how we process purines or other chemicals. I guess it’s called “getting older.”
Anyway, yes, dietary changes can work, such as what you are doing. For me, dehydration seems like a gateway for problems such as gout, so I am always careful to drink plenty of water each day, and be wary of gout triggers. I have not eliminated anything from my diet, but I have cut way back on animal protein in general. I am also more selective when I do have a steak, for example, it must be a fine steak - if I am going to risk a gout attack, it better be worth it. I am not going to risk it on some crappy fast food item. Also, for me, plenty of exercise and being active also helps ward it off.
But no, once you start having it you will always have the risk. That first one is a bitch, tho.
Are there studies on the number needed to treat (NNT) to prevent gout flareups with diet alone? I’d be interested to hear what they are. colchicine has a NNT of 5, which is pretty good. But I can’t find info on diet alone.
If you are prone to gout, watching what you eat and drink is extremely important, mostly on the drink plenty of water front. Or so my ex insisted on learning the hard way. Keep drinking water. Cherries are good and so is a magnesium supplement.
No idea – but I will pick on the article a little from the standpoint of my experience.
Colchicine as I originally took it is no longer sold on the US; our version is colcrys. My doctor explained it all in detail when the FDA put its foot down but basically all it did was give me a headache trying to follow the logic and minute differences. The drawback to it is that “early in the attack” and “low vs high dose”. If an attack starts the best course for me has been 0.6mg every two hours until you shoot shit like a rocket and then go twice a day until 3-4 days after the symptoms go away.
Now as a preventative I have had fantastic luck with allopurinol alone; my last real attack was 2013. I actually started with in it combination with probenecid and it was a total fail. As a side effect, with me, either or the combination caused significant hair loss – which never recovered. I don’t mind; I hated my hair. But I know a few other people who have had the same issue. Its well down the list of “could be’s” but -------- its a long list.
So if it wasn’t a serious risk of outbreaks for me I would try the freak out of diet and other options before going the daily dose like I do.
As I understand, colchicine has been known for centuries to treat gout, but it was never FDA approved. FDA came along with this program to get unapproved drugs tested and approved like modern drugs. A nice pharma company enters the picture and sees that the drug is tested, confirming what centuries of use already indicated, and then gets an exclusivity deal to market Colcrys (at inflated rates, of course).
Oral colchicine had been used for many years as an unapproved drug with no FDA-approved prescribing information, dosage recommendations, or drug interaction warnings. On July 30, 2009 the FDA approved colchicine as a monotherapy for the treatment of three different indications (familial Mediterranean fever, acute gout flares, and for the prophylaxis of gout flares), and gave URL Pharma a three-year marketing exclusivity agreement in exchange for URL Pharma doing 17 new studies and investing $100 million into the product, of which $45 million went to the FDA for the application fee. URL Pharma raised the price from $0.09 per tablet to $4.85, and the FDA removed the older unapproved colchicine from the market…
My gout took 5 years to become regular. I got it, then an entire year went by before I got it again. then 9 months went by before i got it again. Then 6 months. Then 3 months. Then I started getting it anytime I had more than 2 beers or some sardines.
Allopurinol to the rescue. I haven’t had an attack for over 10 years and I eat/drink whatever I want.
I’ve never taken any medication other than ibuprofen for pain during an outbreak. I’ve never avoided “gout foods” and recently I’ve purposely gorged on purines. Yesterday no gout.
Since I started taking allopurinol, my gout has pretty much disappeared, but at rare intervals I seem to get slight flareups of it. I keep indomethacin on hand for that.
So the answer (at least for me) is – almost
I believe that I had a several-day bout of gout once during the summer of 2014. Never went to the doctor or got bloodwork done, so it was a self-diagnosis based on how other people describe the symptoms. It didn’t go away on its own – I had to take 800 mg of ibuprofen a few times over the course of two days.
Kayaker and others, look into the drug ALLOPURINOL. It removes excess uric acid from the blood.
You will need to get it prescribed by a doc.
I know gout. Have had it in my big toe. Oh, it comes and goes, and flare ups can be medicated. Sucks like… well gout sufferers know just how bad it sucks (just had a hip replaced, almost hurt as bad as gout in my big toe)
I had always had a bit of a ‘twinge’ after the gout in my big toe. And it was pretty much immobile. Now, I can actually move it and have zero pain.
Allopurinol. One pill a day. My gout issues are gone after about 6 months.
My Dr offered me allopurinol, but also mentioned potential unpleasant side effects, and also suggested I might try to manage things thru changes in diet and getting more exercise first (which are good for you in general). I have been successful in managing it this way.
For those that chose allopurinol, any issues with side effects?
Just the hair loss I already mentioned and my GP/GS and I could never decide if it was it or the combination. Because of the other medications I am on for heart and BP she expected some blips in liver or kidney function but other than my usual December small liver blip ------ nothing.
I am careful to stay current on it though. The two times I did go off and then back on I got a couple really severe attacks; the second being the last attack I had. If you do decide to take it talk it over with your doc and be prepared with something like the colcrys; you may need it for a few days.
