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dcdude said:
In searching for “clean” protein sources, it's hard to overlook beans and cheese. However, there seems to be some conflict in terms of which are safe to eat.
Beans are relatively high on the purine list (127/128) but their Ph is relatively low (-.1)
Cheddar cheese is one of the lowest on the purine list (6) but it's higher than many meats when it comes to Ph (18.98)?!
It seems like the Ph rating might be more important, if you had to go by one, but why is there a conflict with these?
I'm probably in the minority, but I don't pay any attention to the purine content of food, especially vegetables.? If you avoid meat, and try to avoid purine rich vegetables, well.. there is little left to eat.
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Here's a study that showed that purine rich vegetables like beans do not cause gout:
[edit – poor quality resource replaced: Food High In Uric Acid: The Mythical Beast That Still Haunts Gouties.]
There could well be something to pH, but the information is so confusing and conflicting that I don't bother with that, either.? I'd advise to eat a healthy diet, mostly plants, avoid red meat and alcohol, drink plenty of water.? Monitor your SUA closely and take medication if necessary to keep it under 6 mg/dL.?
Beans?? Good source of protein.
If it were made clear that file sharing sites besides dropbox were acceptable it might reduce some of the confusion.
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Sometimes people just want an image to appear with their posts, and won't want to sign up for yet another file sharing service.
hansinnm said:
Trying to copy charts of SUA readings. Keith had left some instructions but I haven't been able to decipher them, yet.
I couldn't figure those instructions out either.? When I recently wanted to post a picture, I uploaded it to a free picture sharing site called tinypic.com, then copied the url, pressed the insert picture icon here on gout-pal, and pasted the url where it said “Image url”.? It worked fine.? There a a lot more picture hosting sites than tinypic.? I just like to use that because there is no registration and it always seems to work.
I'm 51 and have suffered from gout for about 9 years.? I finally (hopefully) have it under control with allopurinol.? I test my serum uric acid (SUA) frequently.
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I don't like going to the doctor much either.? My last doctor visit I presented her a graph of my uric acid and insisted on a year's prescriptions for colchicine, allopurinol 300mg. and a prescription for prednisone in case of emergency.? She gave me all the scripts.
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I always have colchicine with me and take a pill at the first sign of gout pain.? I haven't taken a pill in a week, but in the past month there was a day when I took 4 x 0.5mg colchicine tablets, and a bunch more when I took one or two.
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I haven't had an attack that made me need a cane since November, but I still get little flares, and colchicine stops them dead in their tracks.? I have never stopped taking allopurinol, but I adjust the dose over time based on my SUA.
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Colchicine is great.? I have several year's supply stockpiled.
I'd never heard of that place, but since you pointed it out, I just registered there.? It seems very slow.. both in terms of bandwidth and activity.
I'll keep an eye on that place, though.
Tramadol is an opioid similar to codeine.? I'd personally stay away from it unless the pain was unbearable (or I wanted a good buzz).
Indomethacin is not too effective for severe gout, in my experience.
What has worked to stop my severe attacks is prednisone (or prednisolone).? It's an oral cortisteroid that suppresses the inflammation in short order.? If only one joint is affected, you and your doctor might choose to inject a cortisteroid instead.
Stay on the allopurinol, it's usually the only way to control gout in the long run.
Good luck.
Advice: Find out your exact serum uric acid level (SUA).? “Normal” is not enough information.? A SUA in the 6-7 mg/dL range is “normal”, but will caused a goutie much grief.? Call your doc and have him prescribe generic colchicine. Try to have the script filled for less than $5 per pill.? If colchicine helps, you probably have gout. Also try Aleve (naproxen).? It's an over the counter NSAID that seems to work for gout. ?
Joint fluid analysis to confirm gout is definitive, but I don't think it's anything most GPs (or podiatrists) are prepared to do.? You'd need a rheumatologist for that.
Rest is good.? Prop your sore foot up and take it easy for a few days.
My 500+ colchicine pills from India are vacuum packed in the freezer.
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I would sooner have my eye put out with a hot poker than pay URL Pharma $5 for one of their Colcrys pills.
Think of a doctor the same way you think of a plumber… as someone you hire to do a job.? You tell the plumber what you want done.? He does it, you pay him, and that's that.
Why should doctors be any different, especially with something as simple as gout?
My last doctor visit I showed up with a chart of my thrice weekly uric acid readings, and a request for a year's prescription for 300mg allopurinol, .6mg colchichine, and? a course of prednisone to be used in an emergency.
I got the scripts, paid my bill, and that was that.
I've since learned that all three medications are available without a prescription on the internet.? I may not need to hire a doctor for my gout again.
Georgedn said:
Keith,
I am disappointed that the uric acid was not checked.? I like my doctor and find that he listens and discusses things with me, however…? When i see him again I plan to suggest that I see a rheumatologist to manage my gout issues.
You can buy a uric acid test kit and manage your own allopurinol dose.
Can I drink alcohol during a gout attack?
From my experience, beer is probably the worst alcohol for gout, gin the best.? If you’re going to drink, be sure to drink plenty of plain old water.? Dehydration from alcohol consumption can really set off gout.
What dosage of allopurinol?
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What was your SUA before starting allop?? What is it now?? How often do you test it?
FWIW, when I was in the throes of a debilitating gout attack in both knees last summer, I found that ice was very helpful in reducing the swelling.? Ice made it possible for me to walk a little bit.
It was disappointing to learn that ice probably makes gout worse in the long run.
newman –
I pay my own way at the doctors also, and I have a uric acid test kit. The doc put me on 100 mg. allopurinol per day and had my blood tested a month later. The test showed 6.4 mg/dL. They called that normal and told me to come back in a year.
Uh.. No. I scheduled an appointment and brought in a chart of my thrice weekly uric acid tests for the last two months. It clearly showed a drop after starting allopurinol, but there was a gradual rise as I backslid on my strict diet/ alcohol abstinance. There were spikes as high as 8 even on 100 mg. per day.
I said (paraphrasing) “Doc.. I pay my own medical bills. This visit is costing me money. Here is what I want from you: a year's prescription for 300 mg. / day allopurinol, a year's prescription for colchicine 0.6 mg / day, and a course of prednisone in case of an acute attack.”
I got what I asked for, no problem.
You have to take charge of gout yourself, especially if it costs $100 every time you see a doc, like it does me.
All that diet stuff helps, and you should eat healthy, be in shape and avoid immoderate alcohol consumption regardless of gout. But the bottom line is keeping your uric acid below 6 mg/dL. Below 5 is even better. You must know your uric acid level. I'd advise investing in a test kit. You can then see if what you are doing is working. Most of us end up on 300 mg. per day allopurinol. It works for me. (3.2 mg/dL this morning).
After extensive testing, it seems the best way for me to raise my uric acid level is to drink a lot of beer and abstain from water. The way to lower it is to drink a lot of water and abstain from alcohol. The results are apparent the next morning.
What were the side effects from methylprednisolone?
I had a real bad attack in both knees, feet, and elsewhere, last summer. After 12 days in bed I was able to hobble to a car and see a doc. I got a Medrol pack – 24 mg. prednisone the 1st day, 20 mg. the 2nd, etc. That helped a lot, but when it was done the gout came back almost as bad as ever.
I then got prednisone 40 mg. per day tapering over a couple of weeks. By the end of that I was pretty much OK, though it took maybe 4 months before my knees were recovered enough to go up and down stairs normally.
16 days is not all that long for a severe knee attack. It sounds like you quit the cortisteroids too quickly. If the side effects prevent you from taking oral cortisteroids, then get another shot.
Cherries and Black bean broth may help a little. Never tried colchicine during an acute attack. They say it works, if you don't mind sitting on the toilet all day.. but if you're down to one pilll, it's a moot point.
If you've already started allopurinol then stay on it. Talk with your doc about the cortisteroid side effects and figure out a way to take them orallly or get another shot. Get a load of colchicine in case you want to go that route.
The good news is that this will pass. And if allopurinol keeps your uric acid in check (it has worked great for me), you will never suffer from gout like this again.
For me, knees are the worst.
I am 51, and got my first gout attack about 8 years ago. It was always ankles or feet. I never sought medical attention till this past summer when it hit my feet, ankles, wrists, and worst of all.. knees.
Everything else rebounded quickly, but my knees have taken months. It's been 5 months, and my knees are still not 100%. I can walk, and (finally) go up and down stairs normally, but still cannot run or jump well.
Am on allop 300mg per day and testing uric acid frequently. I'd advise any goutie to know their uric acid level.
Lose weight if you can. It really helps.
Knees are the worst.
Zyloric goes by the name Allopurinol in the U.S. Many of us take allopurinol with great results.
I have been on 300mg per day allopurinol for a few months. I can eat/drink whatever I want. I test my uric acid regularly. It's now down in the 2s and 3s when I don't drink alcohol. It's in the 3s and 4s when I drink a lot of beer and eat a lot of meat. It had been 7 to 8 mg/dL before. I had gout attacks off and on for maybe 8 years, culminating in an extremely bad one last summer. It looks like all that is over now. Allopurionol has been a godsend for me.
As far as natural approaches to lowering uric acid… nothing works as well as allopurinol, but it helps to eat a good, mostly vegetarian diet, abstain from alcohol, and drink a lot of water each day.
You say you have seen aggravation. Do you mean you have had gout in the past? If you have had gout before, and your uric acid is in the 9 mg/dL range, you should do something now to get it below 6 (hopefully below 5).
Allopurinol (Zyloric) works great for many of us. Talk to your doctor about it.
zip2play said:
Lynda,
I want a Dolby/DTS theater system for video BUT only the very highest end receivers (over $1000) commonly have humble stereo phono inputs.
Get a phono preamp:
http://www.bhphotovideo.com/c/…..ifier.html
I's cheap, and it works. I used the more expensive USB version of the above, and it worked wonderfully for digitizing some of my old vinyl.
The standard practice is to do 100mg for a month, look for adverse side effects, then re-test the UA and adjust dosage. I'd be very surprised if 100mg does it for you, but it's only for a month, so cooperate with the doctor and get on the proper dose as quick as you can.
I am twice your age, but only had a UA in the 6-7 range. 300mg allop now has me in the 2s and 3s when I don't drink, 3s and 4s when I do. When your UA is under control, drinking a few times a month shouldn't be a problem.
zip2play said:
My Foot Hurts,
Give it a year at these 3.5 readings to clear out a reasonable amount of urate. I recommend you stay at 300 mg. allopurinol becasue it is working very well for you, and it is the dose that most people find works best.
How long will you be in “maintenance”?
…for the rest of your life!
But there are worse things than popping a cheap pill a day!
That's what I'm thinking… stay on 300mg for a year and then maybe try 200mg. I'm sure glad it's a cheap, time tested generic drug.
trev – what do you mean by “maintenence”? I'm three months removed from my gout attack from hell, and still getting minor twinges. Allopurinol has done a good job keeping my SUA real low. Am I in maintenence now, or does that start months from now, when all the crystals that are going to dissolve have dissolved?
hansinnm – I'm already a bit touched, so I'm not worried about frequent (2 or 3 times a week) testing driving me any crazier.
I know the figures vary quite a bit, and don't put too much stock in any single reading. This is not like diabetes.I needed reassurance that a -LO- reading once in a while is not a problem. It seems that it's not. It's certainly preferable to a -HI-.
odo – for the sake of consistency, I've been testing 1st thing in the morning after the night's fast. Looking at the averages, it's clear that allopurinol. is working:
Average SUA –
w/o allop.: 6.9
w/100mg: 5.6
w/300mg: 3.5
The manual says that the lowest reading is 3.0, but that is clearly incorrect, as it has given me two 2.7s and one 2.5. When it said -LO- I immediately re-tested and got another -LO-.
If I called my doc I bet she'd go into CYA mode and put me through a lot of expensive and unnecessary tests, so I'm not going there right now.
Guess I'll stay on 300mg for a while and see what develops. The last reading before today was 4.0, so it's not like I'm consistently in the 2s.
I will have to drink more beer.
They were given 600 mg allopurinol per day. A bit more than most gout sufferers are prescribed.
gtaus said:
Is there a test kit/tester for taking your SUA at home? I go into the doctor about every 3 months and they take blood. My levels, according to the doctor, have been back to normal with daily AP. But that was before my latest flare up due to jogging. Is there a simple way to check your SUA at home without having to draw blood?
There are UA tests available for home use, that I know of.
They work like blood glucose monitors, if you've ever used one of those. You prick your finger and apply a drop of blood to a test strip.
I've been drinking BBB daily for the past few weeks.
It kind of grows on you. I can't say it tastes good, but I enjoy sipping a tall glass of BBB on ice once or twice a day. It's kind of refreshing. I make a gallon at a time and keep it in the fridge.
How much BBB do you guys drink?
I've been boiling a pound of beans in a galllon of water and keeping it in the fridge. (That's 454 grams in 3.8 liters for you metric types).
A cup a day? A liter a day? More?
How much prednisone did they put you on? After I could finally hobble to the doctor after 12 days in bed with gouty knees and feet, I got six days of prednisone.. 24 mg the first day, 20mg the second, 16mg the third, etc. That helped, but the attack was already ending by the time I started the prednisone.
After the six days, pain and swelling returned (not as bad, though) and I went to a different doc and got 40mg prednisone for 3 days, then tapering off for a total of 15 days.
The higher dose made me almost pain free, at least for now (I'm on day 5). Rather than messing with something like vicodin and tramadol (which is basically codeine) see if they can't give you a decent dose of prednisone. At your weight you ought to be able to handle 50mg per day initially.
I found that soaking in very hot water helped. Drink lots of water and keep the knee elevated.
It's normal for UA levels to drop during an attack. I guess a lot of UA precipitates from the blood and lodges in the joints.
Hang in there. This will pass, and hopefully the experience will motivate you to stay on the allopurinol.
