Keith’s GoutPal Story 2020 Forums Please Help My Gout! Your Gout Was it the combination that triggered the first attack?

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    I am 53, 5'4, 139 lbs.  I (until lately) have never been a big veggie eater. OK – I am on a business trip – night 1 – alcohol consumption – way more than moderate (whisky and coke) probably 6-7 drinks in all, plus, big bowl of steamed mussels.  Next day, no alcohol, drank about 2 Qts of bottled water, had a sub sandwich (with salami – who knew!).  that evening, dinner, Thai food, no alcohol, but chicken with red curry, next day, salad for lunch, dinner was 2 lamb chops with 2 beers followed by 1 jack Daniels and coke at a bar later.  That night, toe is itching, though it was athletes foot.  Next morning, ouch… worse, flying home, toe swelling (not the bug toe, the second).  Go to Dr. and get gout pain med. Took first pill Friday night, pain and symptoms gone by Sat evening.  Now I am (of course probably going overboard) but – no alcohol for 1 month, lots of water, cherries, cherry juice, yogurt, salads, veggies.    So… was this just a freak combo of all the “worst of the worst in three days (whiskey, mussels, salami, lamb and beer)?  The only “oddball” thing I ate out of my “norm” was the mussels and the lamb.   My plan is to “reduce uric acids level this month through diet/exercise) then ease into a “normal” diet and alcohol consumption from there.  While i want to believe this was just a “freak” thing, I don't want to 'tempt fate”.  Any thoughts?



    My first thought is “What is your uric acid level?”

    Without this, and a month by month history, it is extremely difficult for you to know where you are heading and what you need to do.

    Doctors will tend to say that, if this is your first attack, then with an alcohol ban and severe diet restrictions, you can manage your gout.

    This is wrong – you can only manage gout by tracking your uric acid level. Without that, you are only managing pain, and you can be fairly certain that the gout will bite you again – harder, more often, and in more joints.

    I do believe that it is possible for some gout sufferers to manage uric acid through diet and lifestyle changes. This starts with keeping a record of uric acid levels (at least once a month) and you need good discipline to maintain a very strict, probably vegetarian, diet until you maintain uric acid level below 6mg/dL for two consecutive months. After that first phase, you can introduce some “indulgences” slowly, but never allow uric acid to rise above 6.5mg/dL.

    By way of a challenge, I’d like to say that few gout sufferers have the patience and willpower to get through the first phase of this. It is also largely irrelevant for gout sufferers whose gout is caused by heredity, environment, trauma, or other medical conditions. For those people we are lucky to have allopurinol and other uric acid lowering therapies.



    If you search this forum you will find posts from me a couple months ago that essentially say EXACTLY the same thing as your did. Right down to the big bowl of mussels just before my first attack.  You will also find posts from me about “managing uric acid through diet and lifestyle changes”.

    I can tell you that I quickly learned the lesson all new gouties have to learn….once you cross over into goutland, there is no going back. I have been trying to manage my lifestyle and diet carefully and for several weeks I managed to keep my level below 6.0. I bought the at home test kit and use it religously. I bike 15 miles to work and 15 more home every single day. I drastically cut back on red meat, alcohol, chocolate and other foods.

    End result is that even after spending months being careful it only took a total of a half dozen beers in a one week period for me to get another attack.

    Managing your gout via diet/lifestyle will work for a time….but what is really happening is that you are hovering just below the attack threshold and it will only take a bit of weakness….just one slip of “eating/drinking X just once wont hurt” to bring on another attack. Do you really want to go the rest of your life never drinking alcohol or eating red meat?

    You also need to look at the long term impact of uric acid in your joints. You could go as long as a year between the painful attacks but you will ALWAYS have uric acid in your joints and over the years it will cause severe damage to those joints. Potentially crippling you.

    I guess what I am saying is the same thing so many people have said – the best way to manage gout is to take a drug like Allopurinol that will reduce the uric acid in your body. Start with a low dose and increase a little at a time until you reach a point where you are stable at a nice low number (like under 5.0).

    It took me three attacks in 4 months to learn this lesson. Tomorrow I see the doctor to start the drugs. I HATE the thought of taking a drug every day for the rest of my life – but I would rather do that than be crippled every few months with an attack and not enjoying the occasional cold beer.

    The gout community will support you regardless of the path you choose, I only hope your path is one of not just no pain, but also is a path that lets you enjoy what life has to offer (in moderation of course!).


    I apologize, I didnt directly address the question you probably want answered the most…

    “So… was this just a freak combo of all the “worst of the worst in three days (whiskey, mussels, salami, lamb and beer)?”

    The answer is no. Your uric acid has been building up for years and years – those three days just pushed you over the tipping point. It would have happened regardless, without those specific days it might have been as much as a few more months, but it would have happened eventually. Guaranteed.

    Its a surprise to everyone when it happens. I went to the doctor thinking I had broken my toe. I had never even heard of gout. What broke my cherry was a night of casual beers with friends and a wedding reception the next day with 5 more beers and two big helpings of mussels and clams. Three days later – BAM! 5a.m. wake up call via my big toe.


    Wow – I can't thank all of you enough!  I have, (just the first week into this as of tommorow0 but i have changed my eating habits. Atually, it's lunch now and I am eating tilapia with double helping of mixed veggies.  I really appreciate the advice. I will pursue the meds ( Allopurinol)with the Dr. as well.  I do not plan to live a life of “deprivation”.  I will try to take all the good info on this site (and there is soo much!) and use it.  I plan on “moderation and the “right mix” of foods.  Yes, this first month, I have full plans to “lean heavily” to the “low acid” foods but then balance out slowly. I hope that is a sensible approach.  What's funny is, I didn't drink alcohol for 17 years (just started 2 yrs ago (another story, another time)  – and not excessively (ie- like the night before my first attack!) so, it's not a biggie for me to swing to “moderation awareness” at all times or just stop again.  I am not happy about the gout but there are many worse things that can happen – with all the good info, I am confident things are manageable and that, if nothing else, it gives me a reason to be more careful (and healthful!) abourt what I put in my body.  I will see the Dr in about 6 wks for a test and post updates. 


    GoutPal said: regarding diet….

    …..It is also largely irrelevant for gout sufferers whose gout is caused by heredity……

    Just to back up what GP said. I have been hardcore 100% vegetarian for almost a decade. I eat very healthy diet  and am very fit, active, not over weight at all. I have been hit with what is most likely to be Gout too. My blood uric acid readings are in the 7 to 9mg/dL range constantly. Last 3-4 months I have constant low to mid level toe pain. There is absolutely nothing more I can do as far as diet is concerned, heridetary factors did not care about my excellent diet. Sad part is that unlike most here I actually find my vegetarian diet extremelly tasty and enjoyable. Also never saw the point of filling myself with alcohol…..but despite all those good lifestlye choices for almost 10 years I could not correct my genetic time bomb! I really did not want to be hit withall this in my 30s Cry



    It's NOT the food, it's the inability to manufacture and excrete uric acid in proper proportions.

    Chasing after which food “done the deed” is a fool's chase.

    Reality is: take allopurinol and eat what you wish! Keep your uric acid below 6 mg/dL.

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