Gout & Exercise
Prompted by an interesting question, “Do endurance athletes get gout?“, I realized I mention exercise quite often, but I have not written a comprehensive view. I need to study gout & exercise more thoroughly to get better studies on controlled gout investigations, but here is a simple overview.
Exercise is an important part of gout diet.
Exercise, by itself, is only one part of a complex series of processes that affect gout in different ways.
You need to consider where you are at, and where you are going.
Before I look at at exercise, you must remember what gout is – a uric acid imbalance where excess uric acid forms crystals in joints and other body tissues. Of itself, and contrary to popular belief, it is not a dietary problem, though bad diet can make gout worse, and occasionally it is the only source of excess uric acid.
There is an important test, when first diagnosed with gout, but before uric acid lowering treatment starts. That test involves collecting urine over a 24 hour period, which is then analyzed for uric acid output. This tells you if you are an over-producer, or under-excreter. With this knowledge, managing exercise & gout together becomes easier. Whether you get this test or not, uric acid blood tests are vital. Exercise can affect gout in different ways, and if you do not know your precise uric acid level (a number, not a label), you will not be able to judge the benefits or pitfalls from your exercise program.
Now, this article is concerned with athletic endurance and strenuous exercise. We know that gentle exercise is good for gout, as it improves mobility without the added complication of raised uric acid from exercise stress[1]. So does this mean that strenuous exercise is bad for gout?
Like many aspects of gout management, managing gout & exercise is not about good and bad, or right and wrong, it is about balance. It is about balancing your physical and psychological need for exercise against inherent risks. We have seen, from the first study, that there is a risk of increased uric acid from strenuous exercise. However, that report also indicates that these effects can be avoided. Individuals who know that their uric acid excretion is not impaired will also benefit from staying hydrated during, or immediately after, strenuous exercise.
In a later article, I will look at specific benefits of exercise reported for gout sufferers. A statistical study offers some insight into the benefits of exercise[2]. In that report, men running 5 miles per day had 50% less incidence of gout than least active men.
Though statistical studies need careful interpretation, this is supported by other specific studies that i will summarize later. There seems little doubt that exercise will benefit most gout sufferers, but it is pointless in isolation. If you have ever had a gout attack, the maximum safe level for uric acid in your blood is 5mg/dL (0.30mmol/L). Exercise might help you achieve this, but you must take uric acid lowering treatment if necessary to maintain that safe level. If you do not, the crystals will build up and erode bone, cartilage, and tendon.
Exercise your mind and control your uric acid, before the deposits cripple you and permanently deprive you of physical exercise.
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