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The adventures of uric acid and gout foot

UPDATE
The further adventures of uric acid and gout foot

So here’s an odd one. Over the last few years I started having problems with gout in my right foot. It’s odd because every time I go to the doctor for it they tell me to lay off the booze and eat less meat. The reason this is odd is the fact that I don’t drink, save for one pint (only one) of cider a couple times a month, and a rare shot of Irish cream liqueur once or twice a year. I’ve also been a vegetarian for the last 13 years, so cutting more meat from my diet isn’t really possible.

illustration arthritis_gout

I always thought Gout was some kind of old person’s disease, but it turns out even the relatively young (early 30s is still young, right?) can still have problems with uric acid build up. Somehow, my uric acid levels are getting too high, and when that happens, very sharp crystals start forming in my joints and start causing probably the worst pain I’ve ever experienced… at least the worst pain I’ve ever experienced that carries on and on all day and all night without end. The first day of an acute attack usually begins as a dull pain with some slight swelling. You can see my right foot is red and puffy, particularly around the big toe.

First day of gout

First day of gout

By the second morning, I usually can’t walk. In fact, the worst time I had with it was when I was driving from Savannah, GA back to Seattle. It got so bad I had to stop and get a cheap pair of shoes and cut the toe out of the right one. This let my big toe dangle out and, with the help of a cane, let me hobble around the French Quarter of New Orleans. I should have picked up a white suit and hat, it would have looked absolutely normal then!

Cutting up the shoe

Cutting up the shoe

Some kind of irony

Some kind of irony

Gimping around New Orleans

Gimping around New Orleans

Gimpin' around NASA

Gimpin' around NASA

The problem I keep running into, is that all the medical industry has to offer me is prevention advice that doesn’t pertain to me (cut out meat and booze), or uricosuric medications like benzbromarone, Probalan (probenecid), or Anturane (sulfinpyrazone) medications that will forcefully push uric acid out in my urin, possibly damaging my kidneys and definitely increasing the chance of other problems arising.

The only other source for information on the topic is Google, which leads me to literally thousands of sites either selling herbs or prophesying about the wonders of home remedies like cherry juice, tomatoes, and lemon juice.

Often times they contradict each other (citrus fruit bad, lemon juice good). Sometimes the anecdotes don’t seem to make much sense to me either. For example, one guy said this:

At breakfast, lunch and after dinner – drank a 24 ounce glass of half water/half unsweetened black cherry juice, a teaspoon of baking soda, and two tablespoons of Bragg’s (Apple Cider Vinegar). Within three days, I have stopped taking my indomethecin, and watched in amazement at the shrinking back to normal of my long swollen ankle.

Vinegar is an acid, and baking soda is a base. They cancel each other out in a nice foamy reaction (a la paper mache volcano). What you have left is a cidery tasting water… but maybe that’s the point? I don’t know, I just know I tried it and it didn’t seem to work.

I thought I had the solution one day when I noticed the pain starting in my foot. I was heading to a baseball game with Jenny and found myself wondering if I would be able to get up and walk by the end of the game. The stadium had “famous garlic fries” and I just had to try them. I bought two small “boats” of garlic fries and two small hot chocolates… $22 bucks! The garlic fries were actually just garlic with a few fries. There was literally more garlic in that fry boat than potato, and we couldn’t handle it. After a few fries we started to consider just tossing the fries out, but then the cheap side of me kicked in and suddenly there was no way I was going to throw away $15! So, I powered through it and ate both boats in 30 minutes, and basically burnt out my mouth and digestive tract for the remainder of the night… and next day… and day after that. Vampires two states over were wondering if they should move to the East coast to get away from the smell.

But, my point is, that night my foot really started to hurt, but the next morning it was all gone. All the pain had vanished! The thought at the time was that the garlic had done the trick and somehow got my uric acid levels to plummet. After that, I started reading how garlic was some kind of magic blood cleaner and that it cured all kinds of things. Well, I thought that was the answer… keep downing garlic and no more gout.

Then a few weeks ago I started getting that now familiar feeling in my right big toe (see above picture). I went right for the garlic and started chopping up cloves. After burning out my entire system for 2 days, it wasn’t going away. I really thought I had the answer, but the fact is garlic every day only keeps people away, not gout. So, I really settled into finding a solution, because being out of commission for 1-2 weeks is not an option, especially now that the sun is coming out for summer. I settled in and read just about every crazy site there is on the subject. This is what I found.

After trying all kinds of things, one at a time, over the course of two weeks, including eating nothing but tomatoes, the only thing I found that works for me is cherries, figs, almonds, and water. Now, a lot of people suggest eating cherries and miraculously their gout goes away almost instantly. For me, the trick wasn’t to eat cherries, it was to restrict my diet to only almonds and cherries, and drinking a lot of water, for three days. As soon as I started that diet, the pain steadily decreased until it was a very low level irritation, then I started eating other foods like figs for another couple days, then I began eating normally. If you try this diet, I hope you’re able to stay near a toilet at all times. You will be thoroughly “cleaned out”, so to speak. – READ MY FINAL “CURE FOR GOUT” POST!

Now it’s been a week or two since I last had pain in my foot, but the aftermath is still visible in that the structure of my foot has changed. This bump will probably be there for another month or two while my body tries to repair the damage done by all those crystals tearing up my tissue.

Physical changes to the foot

Physical changes to the foot

So that’s how I got rid of it, but why, with my diet, did I get it in the first place? I can only assume it was from a combination of things that include;

#1) over eating – excess food only turns to excess uric acid

#2) supplements containing niacin, which slows uric acid extraction & excretion

#3) acetaminophen and aspirin based pain relievers, which slow uric acid extraction & excretion

So now I’m looking to lose weight through eating less and working out more. To that end, we’ve taken to going on bicycle rides through the beautiful backroads our town has to offer. I secured a bin to the back of my bicycle so we can bring the dog (he’ll poop inside if we leave him for too long). Don’t worry, he’s secured in the bin with a short leash 😉

img00304-20090525-0909 img00307-20090525-0909

img00303-20090525-0906

As you can see we’ve both become happy little chunky monkeys, but by the end of summer we should be all ship shape… just in time to pack it on for the winter hibernation 😉

UPDATE
The further adventures of uric acid and gout foot

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18 Responses to “The adventures of uric acid and gout foot”

  1. Chris Friel says:

    Is there any link between diet sodas and gouty attacks? I drink alot of diet soda, which I know is bad for many reasons, but I’d swear it makes my gout worse.

    Thanks.

  2. Amal says:

    Hi Chris,

    I don’t drink a lot of soda, but I do know if I start to feel any soreness in my foot (usually a precursor to a full on attack), if I have anything to eat or drink, especially sugary stuff, then full on gout hits me by the end of the day. However, if I drink around 2 gallons of water over the course of the day and eat VERY minimal raw food snacks (almonds, cherries, fruits, nuts) I’ll be fine and it will not progress into a full on attack.

  3. […] May I posted about my adventures with gout and the things I was doing to try and fight off acute attacks. Well, since then […]

  4. Jay says:

    Thanks for that it helped us.
    London UK

  5. Alex says:

    Gout is a terrible disease, i am suffering many years, been to hospitals, visited doctors, took medicine, started diet, but this thing just hits you again just when you thing you’re over it. I’ve had it on both feet (not simultaneously) and in my right knee one time, when it was terrible really.

    I’ve tried really everything imaginable, and still after time it comes back again. Some things I can share, include the cherries and the almonds as well, lots of cold showers to ease the pain from the swelling, double or triple socks around the foot during the night, subtle foot physiotherapy in your bathroom, lots and lots of water and ofcourse say goodbye to alcohol, pizzas and fried stuff.

  6. Terry says:

    What about toasted / roasted almonds? (the raw ones are just NASTY!) And…Black Cherry Extract, even though it works sometimes….if you have too much is a “POWER Laxative! (MAN, Is it!!)

  7. Amal says:

    I would say almonds are an OK snack (a handful at most), but overall I’ve found that the fat in almonds is not good during a flare-up. After much study and self-experimentation, this is what I’ve determined is the best course of action to resolve flare-ups and keep them at bay in the future;

    During a flare-up

    – Drastically reduce fat intake.

    – Eliminate all fructose intake, especially high fructose corn syrup. Fructose is shown in studies to contribute to the production of uric acid, even fructose from fruits (the study involved apples)

    – Take standard doses of Alive (naproxen) as early into the flare-up as possible. Do not go over recommended doses and do not mix with ibuprofen or other NSAIDs.

    – Drink at least 16oz of non-fat milk or skim milk. The casein protein appears to assist the kidneys in excretion of uric acid, however milk fats negate this affect… so be sure to drink only skim or non-fat milk.

    – Restrict caloric intake to 700-1200 calories a day during the flare-up. Eat low fat sparing meals to keep uric acid production at low levels.

    – Drink a moderate amount of water. Drinking too much water does nothing for gout but reduces the effectiveness of digestive processes.

    To keep flare ups away

    – Avoid high fructose corn syrup based foods and beverages. Regular fruit intake should be fine, especially when you consider how much actual corn you’d have to eat to equate the amount of HFCS you’d consume with even a single can of soda pop… it’s staggering.

    – Drink a glass of non-fat milk a day. If you use milk in cereals, and/or cooking use only non-fat milks. The proteins in the milk help the kidneys get rid of uric acid, but milk fat will counter the effects, so use non-fat or skim milk only.

    – Avoid high fat diets

    – Avoid overeating regardless of what food you eat… overeating results in surges of uric acid production.

    I’ve got a couple pending posts that update my research into gout but they are not ready for posting quite yet. I will include this short-list info along with those posts when I have time to finish them off.

    Amal 😉

  8. Gina says:

    Hi Amal
    Thanks so much for your posting. When I read it I felt like I wasnt crazy. I have had gout before but, like you, drink very seldom and not much and dont eat meat. Every doctor seems to put it to alcohol use and I dont feel they believe me when I say I only drink a few times a year. this is not the reason. Now I feel like its not just me. My father suffers with gout and so obviously there is a genetic component to this. Also I am allergic to other pain relievers such as aspirin and nsaids and so only use acetaminophen products. Interesting…why havent i heard this before? Also will check my vitamins and supplements for niacin levels. Thanks so much

  9. Amal says:

    Hi Gina, you’re welcome and thanks for posting your comment.

    I have a very an important post about gout coming up so keep your eyes peeled. The post may be broken up into two parts, but the short of it is I believe I’ve cured my gout for good.

  10. Lana says:

    Hi,
    Thanks for sharing your story. I recently went through something that was likely Gout. I am 28 years old so its unusual. About 2 weeks ago, over about 2 days I noticed the ball of my foot and arch was a bit sore on my right foot. It felt like muscle soreness and so I wore good shoes and my boyfriend was generous with foot rubs. Then one night I woke up at 2am with awful pain in my right big toe joint. It was hot, swollen (dime sized bump) very tender to the touch (a blanket resting on top was too painfu). I finally went back to sleep after a few hours. When I got up it still hurt but slightly less intense. I hobbled around for the day. The next night I had the same sort of 3-5am episode of intense pain. I took advil and my pain nearly went away for the day so u was able to go to work. I saw a doctor who said Gout. Then again that night same toepain episode that went away with advil during the day. After 3 days I finally got in touch with my general practioner who says it is not gout bc I am too young. Says its bunions. Pain and night episodes went away a day later (4-5 total) and swelling went down but I still have a bump 🙁

    I’m doing the low purine diet and upping my fluid intake dramatically (at work I had not been drinking water at all bc the restrooms are soo far from my office). Last year I got unconfirmed kidney stones (probs bc of not drinking at all at work! Lesson learned!). Its been difficult to figure out what to eat now that I am essentially vegetarian, i was a big meat and seafood eater. I drank alcohol only once a month if that. I am really motivated to prevent this from happening the pain was like someone putting out cigarettes in my toe joint 🙁 sounds like I need to get an emergency stash of cherries and almonds!

    Thanks for letting me share its hard to find young folks who have dealt with this.

  11. Tom says:

    Back to the garlic fries at the game: Maybe it was the greasy potatoes that fixed the problem:) The best prevention I learned was to start taking ibuprofen at the first sign of an attack coming on. It knocks it out every time for me.

  12. Tom says:

    All of the foods below can be responsible for excessive uric acid production. Even though some do not contain purines, they can still cause the system to naturally produce uric acid. They are as follows: alcohol, anchovies, asparagus, cauliflower, mushrooms, consommé, herring, meat gravies, broth, bouillon, mussels, sardines, red meats, organ meats, processed meats (hot dogs, lunch meats, etc.), fried foods, roasted nuts, any food cooked in oil (heated oil destroys vitamin E), rich foods (cakes, sugar products, white flour products), dark greens vegetables, dried fruits, fish, caffeine, beans, lentils, eggs, oatmeal, peas, poultry, yeast products, acetaminophen, and low doses of aspirin.

    While under a Gout Attack all of the above foods should be completely avoided as well as the following.

    Extremely Acid Forming Foods – with a pH of 5.0 to 5.5
    Artificial sweeteners, HFCS, Carbonated soft drinks & fizzy drinks , Cigarettes , Flour (white wheat), Goat, Lamb, Pastries & cakes from white flour, Pork, Sugar, Beer, Brown sugar, Deer, Chocolate, Coffee , Custard with white sugar, Jams, Jellies, Liquor , Pasta, Rabbit, Semolina, Table salt refined & iodized, Tea black, Turkey, Breads White / Wheat, White rice, commercial vinegar.

  13. sangeeta says:

    Thanks for the information. in my case those rogue crystals keep migrating from one joint to other making me almost invalid. only baking soda has worked till now. wish there was some way out of it. suffering since age 30 now nearing menopause its worse.

  14. Bruce Maples says:

    You’ve got a link to the “final cure for gout” at p=3641, but it returns a 404 error. I read your post at 2401 and found it helpful — just wondering if there’s another that I missed.

    Thanks for your work on this!

  15. susan says:

    I am a 64 year woman I think I had my first gout arrack 6 mos ago. I had painful swelling and redness in the midle toe on my left foot. I went to the doc and he thought I had an infection in my toe. The toe was swollen red and hot. He told me to use antibiotic cream on the toe. The cream did nothing and my toe continued to hurt for another week. It would seem ok during the day and then hurt at night. Very slowly the pain went away although I still feel some numbness in that toe and it does seem to move like it used to. Last week my big toe on my right foot became painful red and swollen I could barley walk and it hurt so bad at night it brought tears to my eyes. I went to the doc agin and now he says its probably gout he gave me some medicine colsys which took away the pain now I just have a swollen toe and top of foot around toes. I am worried because I have already had gout in 2 places hopefully I will not ever get gout both places at once. Does anyone here ever get gout in more then 1 joint location at the same time.

  16. Betsey Olson says:

    I am a gout sufferer of many years and I feel your pain. Do you have kidney disease? I didn’t realize I did until I went to the doctor with chronic gout flare ups. If the kidneys aren’t functioning properly and the uric acid isn’t being excreted, you’re going to have a gout flare up. The only thing that helped me is a new on the market med called Uloric. I can’t take the old gout standards: allopurinol and colchicine. I know you don’t want to tae meds but at the end of the day, the only cure for gout is healthy kidneys that excrete uric acid. Herbal remedies do not work. Good luck to you.

  17. Fred says:

    Two things that I have found to make a difference when I have a severe gout attack:

    # Drinking water with baking soda, though is not recommended for extended periods of time
    # ibuprofen 800 mg every 8 hours but not to exceed 10 days, as is not good for your liver. The over the counter recommendation does nothing.

  18. Elasto says:

    Oh! should I say that it is an answer. I am in that condition as I am writing this comment. I have tried medical people and what they sold me are gel like G-Derm, Lofnac gel to rub on the swollen toe but still this is my 9th day having this problem. I have never drunk any beer, eat very little meat and not frequently but this thing oh yes is terribly giving me no rest. I go to work with sandals. I never put on shoe. It was when I decided to google on fresh garlic when I have come across this vital info and good comments. I will try this otherwise I can not sleep comfortably nor walk normally. I am worried really. I am planning to get an off from work so that I can remain in doors till this disappears. Please anyone with more convenient remedies to this condition, please post them.

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