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It’s hardly perplexing. Indeed it was quite predictable.
Unless you used to consume raw oil and/or sugar, it would be extremely challenging to reduce caloric intake without reducing your intake of other things as well.
I don’t know what’s going on but yes, it looks like weight loss might inherently involve increased uric acid production though I would always suspect excess protein consumption, hunger, inadequate mineral intake and dehydration even when people claim they’re eating right, drinking enough and so forth.I guess another problem could also be that your system is unable to metabolize fat efficiently enough, especially if you used to consume little fat and reduced your caloric intake brutally instead of progressively. In that case, you might be burning your muscles rather than fat which would definitely involve the production of lots of uric acid. And that particular problem should improve quickly, else you’d end up in the ER before long.
People who have untreated gout should avoid consuming animal flesh, especially when losing weight.
Also mind the amount of fructose in these fruits.Hi!
Yes, diets triggering gout is a commonly-discussed phenomenon. Your body will not somehow adapt to dehydration or to an otherwise dangerous diet. The main problem may not be the caloric reduction as such but I do not know of a safe way to reduce calories drastically, other than treating one’s gout properly.
That said, there are better and worse ways to reduce calories of course. In particular and assuming you have no cholesterol or other problem requiring you to be careful about the fats you consume, you shouldn’t overeat protein and you should get most of your protein from dairy or possibly eggs. If you don’t have an insulin problem (or indeed full-blown diabetes), you should also be eating a moderate amount of grains which you need to take into account in your protein budget. And of course you should always make sure your fluid intake is adequate! Eating less typically requires one to drink more and some people overlook this, to damaging effect.You can not control gout by abstaining from beer or any other trigger.
If you keep avoiding treatment, your condition will likely get worse over time, possibly resulting in debilitating bone disease or other incurable joint problems.
But right now, you need to stop the inflammation which is causing faster damage than the excess of uric acid you were likely suffering from on a daily basis. I strongly recommend you consult with a doctor if you don’t know how to stop inflammation fast.Assuming you don’t have a disease such as a kidney problem which would make the following recommendation dangerous, the main thing you need isn’t actually a food but lots of water. So I suppose foods containing lots of water would be advisable but you might as well eat whatever and make sure you drink plenty of the stuff.
The most important thing when it comes to food is to avoid sweeteners and diuretics and since the main ones in many (most?) diets are drinks and additives, I would recommend sticking to water, produce and products made only with basic ingredients you understand (ingredients should be printed on the box or can but if you’re not baking/cooking for yourself, you’ll have to ask the cook/baker).
Otherwise the basics of diet are: no corpses, yeast or single-celled algea. Some shrooms are OK but you should know your shrooms or stick to plants. The ideal protein source is dairy (ideally relatively low-fat products such as skimmed milk or cheeses which aren’t made with cream).
I must again stress the above isn’t suitable to everyone and the diet you should follow depends more on your other medical issues (including ones you aren’t aware of) than on the notion that you might have gout. Even if you know for a fact you have gout, what you eat is typically not what drives the evolution of the disease (it matters, but not as much as people often assume).How frequently you should get your blood tested depends on your medical history but the average might be around 3 weeks after you started allopurinol. If there’s no red flag in that next test, the subsequent ones needn’t be so frequent as long as no major dose adjustments are required.
0.43 what per litre? If I’m guessing right, the number doesn’t show anything on its own. In combination with information you didn’t share such as precise symptoms and the results of older tests, it might at best suggest you could have had an attack. But of course you might be talking about something else than my guess…
Hi!
There are lots of things people do. So it would be time consuming to get into all of them… care to be more specific?
The most important things in your situation are to take enough Naproxen that it gets rid of the inflammation in less than a day (that’s not always possible but it usually is that simple) and to make sure these drugs aren’t going to harm you. And how do you do that? You make sure you are scheduled for a blood test, that you understand your past blood tests and that you have discussed how to dose your drugs with a doctor (or possibly pharmacist) who has a clue (change doctors if need be)… and finally, you pay attention to how various parts of your body feel.
Also, make sure your doctor wasn’t negligent when they suggested paracetamol (some people shouldn’t take that because of the side effects, and in my experience most doctors don’t care).Yes, many have had experience with longer attacks than 13 days.
Allopurinol will probably not help with this attack but you should keep taking it anyway. If you want opinions about whether allopurinol was right for you, you’ll have to disclose a lot more information.
There are of course unsweetened drinks you can buy. Or you could simply make them yourself.
Hope is poitnless and “high level” is meaningless. Every product (or cultivar) is different. Either you have a number or you don’t. If you don’t, best abstain.In any case… at home (or wherever you wouldn’t be bothering anyone doing so) you should be eating whole fruits and drinking water, plain or flavored with herbs and/or lemon rather than sweetened. Fizzying that up is of course harmless.
But if you want glucose on the move, the right fruit juice is a decent option as long as you understand it’s not a replacement for a meal or some kind of comfort drink but a fuel that should be consumed in amounts proportionate to the energy you’re expending.Some citrus fruits do not have much fructose. It depends on the amount you consume, what else you eat and your metabolism but lemons, clementines and the like would probably be more likely to your SUA. Mangoes are more likely to be a problem (depending on the amount). But in most cases, the impact will be minimal anyway. What you’d be eating or drinking instead probably matters more.
If you’re concerned about fructose, you should be looking at actual numbers and quit generalizing. And I’d be much more concerned about how fructose impacts your uric acid indirectly (through both caloric intake and liver function) rather than whatever it might turn into since fructose doesn’t contain any nitrogen.Anything can trigger gout, especially if you go crazy with it.
Citrus fruits would however be very low indeed in the list of likely culprits… and if they happen to trigger you for some reason, that’s a sign you need better UA control which you will never achieve by changing the amount of citrus fruits you consume one way or the other.People who tolerate allopurinol well could simply take a bit more to counteract the effect of a drug which increases uric acid… assuming of course the drug combination has been validated by the doctor(s) in charge, that its effects are monitored and so forth.
I recommend you consider the balance of risks and avoid generalizations.
If you ended up in the ER because of a dose that’s too low or because of the side effects, you would be a lot more likely to catch a virus than if you got your blood drawn.
Obviously you don’t want to sit for half an hour in a poorly-ventilated waiting room or something but a lab might have set up a process that involves patients spending minimal time indoors for instance. So do consider the measures which have been deployed before ruling out a blood test.
The virus isn’t that contagious. Most people are being irresponsible, is all.I’ve naturally had shoulder pain linked to wrist pain before I took a UA-lowering drug. So far as I know, it’s pretty common to develop shoulder pain when you have a wrist issue. And you can definitely get gout in the hands.
Whether actual gout in the shoulder is plausible considering these UA values is another matter. But during the initial phase of treatment, UA crystals are known to wander so I don’t think the notion can totally be ruled out even though there are more plausible explanations.
If this shoulder problem is indeed secondary to the wrist issue, anything that relieves muscle stress might help (as well as very mild exercise). If it’s bad enough, seeing a physical therapist might be advisable (though if it seems very bad one should of course first rule out serious problems).
Also note that topical anti-inflammatories might be somewhat effective for hand inflammation and should be much less prone to causing stomach issues than pills. Even if the hand isn’t painful anymore, mild inflammation there could still be causing arm and shoulder stress.I hope the liver and kidney function values are as good as the uric acid values! Ideally you would want to stick to the 100mg but if it’s too much for your husband’s system, it looks like a slightly lower dose might still be effective (if further blood tests keep returning such low UA values, that is). During the initial phase of the treatment, it makes sense to use a dose that’s a bit too high anyway.
I wasn’t talking about triggers but about uric acid control. Lentils do tend to trigger me for instance but it isn’t much of an issue since I’m on a XOI (I probably wouldn’t be eating any otherwise). Some people simply take a large XOI dose and eat whatever they like but my liver would object so my diet is part of a balancing act between minor joint inflammation and slight elevation of liver function values.
I’m not gaining weight now. If you’re prone to weight gain, perhaps pick low-fat or at least high-protein dairy products over butter and the chesses made with lots of cream. I would normally use vegetable oils in order to add fats to a dish.I’ve been eating a low-purine diet for a very long time and even gained weight on it so I have to dissent on the starving thing. But I for instance was (and am still) eating some legumes and cauliflower, mind you. It’s all about the total numbers so lots of not-great foods are OK in moderation. Some salt is fine as well (not eating any might actually be dangerous). I fail to see the benefit of corn syrup, actual sugar or other sweeteners so I would normally abstain but I’ve been eating lots of relatively low-fructose fruits even though they can be very sweet.
One potential nutritional pitfall with a vegetarian diet is the lack of omega 3 fats if you’re not using the right oils (or grounding the right seeds). People afflicted with particular conditions might have more serious troubles with a vegetarian diet and of course a vegan diet has extra issues but so far as I know that is the most serious general issue.I’d like to know how “Uloric has been shown to damage the heart”. I don’t care if some doctor said so because I can’t count how many doctors have bullshited me. What’s the evidence?
It’s easier to take a small allopurinol dose anyway because pills containing reasonable doses are commonly available (unlike Uloric which is a monopoly).
Be sure to mention to your doctor that you want to try a small and therefore fairly safe dose to see what it does to your liver. If your liver has trouble processing the drug, a smaller dose would probably be sufficient anyway. A drug you take every day can build up in your system if it’s not eliminated quickly.
I’m being insistent about this point because there are doctors out there who do not follow guidelines and tell their patients to take potentially dangerous doses…What could “normal living in a modern world” possibly mean? Probably things like alcohol consumption which people with sensitive livers shouldn’t do, and which have nothing to do with modernity.
Yes, allo and Uloric are XOIs. The point is to prevent the damage gout causes rather than to address only the pain while the underlying condition worsens. But of course when you’re in pain you’re going to want quick relief and not a long-term solution.
My cardiologist also recommended I quit Uloric. But it’s basically the same issue as with my rheuma: speculation based on a very different dose than mine. I’ve not seen any evidence of heart trouble with my dose (which is common in some countries where the drug is sold in smaller amounts with a different brand name).
And based on the blood tests, my liver seems healthier now that I’m not taking anti-inflammatories anymore. Herbs can harm the liver too by the way.The forum rejected my post earlier and I’m not going to re-type but basically, a very low XOI dose is effective in some cases. A rheuma also thought I couldn’t take a XOI but it turned out she was surprisingly ignorant about the drugs she works with.
Anti-inflammatories aren’t a solution, herbal or not.This UA drop must be confirmed by further testing but is a good sign.
A higher allopurinol dose might help (especially considering this kidney problem) but we don’t know how fast its metabolites are eliminated in this case so increasing the dose could conceivably do more harm than good. It looks like 100mg might be a sufficient dose (combined with a reasonable diet) if not the dose that allows for the fastest recovery. Someone who understands both the parmacokinetics and this kidney disease might be able to venture a guess or reference relevant studies…
The main thing he apparently needs is drugs targeting inflammation or pain anyway. Surely the bleeding concern is an issue with COX inhibitors, not all drugs. Taking lots of acetaminophen without testing liver values is dangerous by the way.With a name that sounds like yours, I wouldn’t lead with the military stuff on an international forum. Anyway…
1) the easiest guide we have for the evolution of gout is the amount of uric acid in the blood, a value you haven’t posted so we’re totally in the dark
2) considering steroids would apparently be ill-advised… higher doses of regular anti-inflamatories such as ibuprofen (though a slightly different drug might be advisable if your stomach is sensitive), drugs which target gouty inflammation more specifically such as colchicine, real painkillers (beware Tylenol’s liver toxicity)
3) it’s not a given but certainly possible, depending on how (and how long) you walk
4) other than drugs which are much more effective than the following and of course adequate hydration (drink plenty of water), you could try icing gently (low joint temperature can trigger or worsen gout) as well as stimulating blood flow to the affected joint with hot water or vigorous exercise involving other parts of the body
bottom line: your main objective isn’t to stop this flare quickly (indeed, improving your diet could actually make your gout worse for a few months/years) but to stop having flares in the future, and cardio or weight loss will probably not the trick. Quitting alcohol and adopting a better diet (I wouldn’t recommend salmon or chicken to someone who isn’t on a uric acid drug!) might help but most people require a drug such as allopurinol to cure their gout. If your doctor isn’t serious about treating this condition, consider getting another.
I was hoping Keith (or a deputy of his) would delete this but in the meantime…
There is evidence that many vegans have high uric acid which increases their risk of gout in the long run. Low-fat diets are likewise dangerous even if they might lower the risk of attacks in the short run.
Do not use quack videos as a substitute for medical research or expert opinion, people!
