[This gout weight loss discussion transferred from old forum July 2010]

Rapid Weight Loss and Elevated Uric Acid Level

How much does rapid weight loss contribute to elevated uric acid levels?

I’m 50 and have had gout flareups for about 8 years. I’ve spent the past two weeks bedridden with swollen knees, feet, and ankles. I’m finally walking around (with some pain) after getting a course of prednisone.

Anyway, this last episode was so bad that I decided finally to do something about it. I ordered a uric acid test kit, and I swore off alcohol and red meat.

Last Friday, day 12 of the gout attack from hell, the test kit arrived, and it showed 6.3 mg/dL. A little high. Today, day 15, it showed 6.8 mg/dL. Incidentally, there is more pain in one of my feet than there has been for a couple of days.

The thing is this? with the change in diet.. no alcohol (I used to drink quite a bit of beer), no meat.. basically a healthy vegetarian diet with lots of fruit and rice and a little chicken, I have lost a lot of weight quickly without trying, despite being sedentary. I’m drinking 3+ liters of water per day, eating all I can stomach and am always full.

Yet I’ve dropped easily ten pounds since this thing started. I’m 6′ 1″ and now 198 lbs (was around 210 when the attack started).

How much might this rapid weight loss contribute to my high UA level? Is it reasonable to expect that as I get used to the new diet and my weight starts to level off, that the UA level will come down?

I am hoping to achieve a good UA level w/o drugs. Any insight would be appreciated.

[Gout forum members contributed some great gout weight loss comments, then the original poster returned with a remarkable progress chart showing his uric acid levels history]

What does your doctor recommend you do about your gout? Any mention of allopurinol over the last 8 years?

Yes, weight loss with accompanying lean tissue loss releases a lot of nucleic acid byproducts. Several of these break down to uric acid.

I’ve never seen a doctor about my gout. Well, last week I went to a clinic and got prescriptions for prednisone and colchicine, but that doesn’t really count. I did all kinds of things? lost weight, took celery seed, and cherry juice, used ibuprofen and indomethacin for flare ups. I thought I had it under control. I was wrong.

I want to let things stabilize here.. as far as diet and weight and UA level before I consult with a doc on what to do. I’ll probably see a doctor sometime in August. I’m willing to go on allopurinol if necessary, but would really prefer to get my UA level down without drugs, if possible.

Maybe I should order a pizza tonight and eat more to keep my weight loss down to 1 lb per week max.

I’m trying the veg diet, no alcohol thing. I’ll be checking my UA a couple of times a week. We’ll see what things look like in a month or two. If I can’t keep my uric acid level below 6 mg/dL on my own, it will be allopurinol for me.

Keep us posted on the numbers. What many of us have experienced and the literature agrees is that DURING an attack our uric acid levels are lowest. Between attacks it goes much higher.

What this 15 day attack might indicate is that you are approaching what is called CHRONIC GOUT, continuous pain and increasing joint disfigurement brought on by years of uncontrolled gout.

[MyFootHurts did, indeed, keep us posted on the numbers, and returned with a very well received chart…]
Update –

Things are pretty good here. My SUA readings have been so low that I recently halved my allopurinol dose. No attacks of any consequence since last fall. The knees took months before they were anywhere near normal, but now they are working perfectly.

I’m back to eating some meat, not a lot. I am eating a lot better than I was a year ago, and walking 4+ miles most days. BMI is currently 25.8 vs. 28.6 a year ago.

Below is a chart of my SUA since 7/2010 showing the result of various allopurinol dosages.

Uric Acid Levels With Allopurinol Doses Chart
Uric Acid Levels With Allopurinol Doses