Strawberries, Gout, and Histamines

[Abel George]

I was an ambitious/sensitive/hardworking/anxiety prone/perfection seeking individual. All of these lead to chronic health issues, high blood pressure and diabetes by 30 (10 years back). on medications for a few years. Also, I ended up having cholesterol and thyroid problems. so decided to go for naturopathy instead of standard medicines.

I first had my gout attack in 2007. Until last year (June 2016), I used to have occasional gout attacks 1/2 or max 3 times a year. Till date, maximum reading for uric acid is 7.3(Over 50+ tests in 10 years). Due to some stresses, attacks became frequent, once a month kind of from June 2016 until April/May 2017. I could not tolerate it and went to my doctor and he suggested allopurinol/febuxostat. I was somehow not keen on using the medicine as I already had enough.

Started with Naturopathy treatment from September 2017… sprouts+fruits as breakfast and low cal veg food with 0 salt, 0 oil. All my problems were vanishing and I am not on medication for bp, diabetes, and cholesterol. Then the twist happened. I ate chicken (roughly 100 gm with very little oil/salt). Exactly a week later, had an attack. 2 weeks later, ate some river fish (probably 250 gm cooked in very little oil/salt and the one not associated with high uric acid) and a week later had another attack. Then I stopped eating non-vegetarian food totally.

Things seemed fine for some time and then had an attack. After some research found cowpeas sprouts could be the culprit. So I stopped sprouts.
After a week or so I had an attack after eating onion paste gravy.
As I also have a general inflammation, I decided to try strawberries. A week back had 100 gm of strawberries for a couple of days. The second night had a very mild attack. Then, a few days back I tried strawberries again for 2 days and on the second night had a mild attack. I am still confused if it is a cold weather inflammation or gout as I am eating properly now.

I have a bad habit of rubbing the slightly painful bone to confirm the type of pain if it is gout or not. After doing that, pain becomes more.

Not sure if the strawberry is helping me or hurting me. Will have to go to a doctor to confirm.

My naturopathic doctor tells me to drink more water. Already I drink 4 litres each day. I feel a bit stuck as my medical doctor may get angry as I started another path with no medicines.
From last 1.5 years, I am maintaining an attack diary. From last month, started daily food intake (what I am eating and how much) dairy to see where it is all heading.

Any comments/suggestions would greatly help

regards
Abel

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Can strawberries with other fruit reduce uric acid?

[nobody]

Hi!

In my opinion, you’re being obsessive about food.
To the extent that gout is caused by what you ate, it can easily be due to what you ate three years ago rather than what you ate yesterday. So you shouldn’t be too quick to blame particular foods for your pain.
Sticking to a vegetarian diet is reasonable because it works and it’s an easy rule to follow, especially if you happen to tolerate milk or yogurt well (these are generally recommended for gout by the way).
But I’d say worrying about a few strawberries is taking dieting way too far. If for whatever reason your body doesn’t like strawberries, fine: don’t eat any. But you should be comfortable eating a wide variety of plants, including fruits.

It doesn’t matter if you’re taking drugs or not as long as your tests are good.
But if your joint problems are indeed due to gout, 7.3 is too high. What’s your average?
If you need uric acid control and you don’t want to take drugs, you’ll have to treat your naturopathy as if it was a drug: you need a large enough dose, you need to be regular about it and you need to watch for side effects. There are plants which are known to lower uric acid but taking a small amount from time to time won’t work, and neither will wishful thinking.

[Abel George]

Thank you very much for your response. My Average uric acid level for past couple of years was close to 6.7/6.8 and occationally see a 7/7.1 (maximum being 7.3 once). I am visiting a doctor today. Yes I am getting a bit obsessed with Gout lately. For the last 2 occations, joint pains were too mild (barely noticable). The thought that it could be gout and then subsequent rubbing of the bone to see if the pain indeed is originating from a bone and nothing else is making it worse and the pain continues for few days. With a gallstone found recently and existing ailments, slightly concerned. Thanks again for your post.

[Jean Clyne]

I am similar to you in that certain foods trigger symptoms. I have what is considered normal uric acid levels but family history and poor circulation in hands and feet have contributed to it. I tried allopurinol for 6 mos but the side effects for me were way worse than the gout. I control with celebrex, an anti inflammatory, cox2 inhibitor and lots of black cherry, sour cherry juice . A little wasn’t working but taking between 300 and 400 mls per day is helping a lot. Without it, a meal with beans lentils or chickpeas , all high in vegetable purines was triggering mild symptoms. I was just about ready to go on uloric (febuxostat) when I tried upping the juice. No booze no meat for 2 yrs now has helped. Sugar is my other trigger so stay away from that as much as possible. Things that are very high in histamines such as strawberries, tomatoes to name a couple also seem to be problematic. Some of your food issues may be with high histamine foods, try go ogling that. I keep a rigorous food diary and if I stay away from the triggers it seems to be working. It sounds like you are on the right track.

[Keith Taylor]

In my opinion, you’re being obsessive about food.

Actually, it was probably worth quoting the whole reply. But that’s the highlight.

Food is what we eat to stay alive and we are lucky to live in a time where healthy eating is easy. Obsessing about one or a few food items to the detriment of a balanced diet is bad for health in general. By which I mean you raise your risk of many diseases as well as gout.

Failing to put uric acid control first when you suffer from gout can only make that situation worse. Because gout attacks will get worse if you do not control uric acid irrespective of food obsessions.

[Abel George]

Thank you Jean and Keith for your responses. I met the Doctor yesterday and as expected he suggested Alluprinoal for 3 weeks. He says, once UA comes below 6, I can stop. I do not think I believe him. When I started my diabetic medicine almost 7 years ago, doctor suggested something similar. I did the same for a month and then I stopped. Later I saw my sugars going even higher as the body got used to. Currently taking some anti inflammatory meds, suggested for 4 days. Will start on Alluprinoal after I go for another check in couple of weeks. Thanks again.

[nobody]

Uric acid can indeed rise higher after stopping allopurinol than it was before you started taking it. There is a difference with glucose and such however: it’s not the uric acid in the blood which is damaging your body. The main point of taking allopurinol is to get rid of the solidified uric acid that can build up in your body. Lowering the amount of uric acid mixed in with the blood is the way to do that. But once the solidified uric acid is gone, having a moderately high amount of uric acid in the blood for a while isn’t an issue.
The flipside of that it: it will likely take more than a few weeks to complete the cleanup.

[Jean Clyne]

Good luck with the allopurinol, as suggested on many places on this site, start with a low dose and gradually increase it to your full recommended dose. It may be helpful to split dose to twice a day, hope you are being given good guidance on this. The interesting thing I found with foods that were reactive for me was that they tended to be things that have high histamine levels. Strawberries, tomatoes, mushrooms, spinach are a few that others on here have commented on as being reactive, are ones with high histamine levels. I wonder if there is a connection between gout and high histamine levels, or it might just be that many of these are high in purines as well? I try to eat a well balanced vegetarian diet, with many of the recommended gout friendly foods and now certainly feel 100% better than before. It is hard to change a lifetime of eating habits.

[nobody]

I have no idea what’s going on in your body but theoretically, histamines make more sense to me than purines as a cause to your reactions. It may also be something else that is often found alongside histamines in foods. Anything that gets the immune system in high gear could potentially end up triggering gout symptoms.

[Keith Taylor]

Strawberries, Gout, and Histamines

I read a gout study today that reminded me of the mentions of histamines in this discussion.

Johnson, S. “Effect of gradual accumulation of iron, molybdenum and sulfur, slow depletion of zinc and copper, ethanol or fructose ingestion and phlebotomy in gout.” Medical hypotheses 53, no. 5 (1999): 407-412.

There are other aspects of gout diet. But this was the first time I spotted mention of histamines in a gout study…

Red wine and beer, two notorious culprits, contain all the ingredients required to bring about a gout attack: iron, alcohol, histamine and purines […] histamine helps
to arouse the immune system for inflammation […] The histamine produced by some bacteria during the fermentation of some alcoholic beverages (wine, beer, etc.) can trigger the inflammatory response […] histamine in beer, wine, sauerkraut and other foods promotes inflammation.

Figure 1: Multiple Interactions in Gout

Now, there’s a lot more than histamine in this study. As evidenced by Figure 1. But I’ll leave that for another day. Because I was intrigued to see if the “other foods” referred to includes strawberries. Then further intrigued to see there’s a lot more to this than first meets the eye.

Before I look at the histamine content of strawberries I should mention my previously known facts about strawberries and gout. Because strawberries have long been considered as one of many fruits that are good for uric acid and gout. But here we are looking at the other side of gout management – inflammation and pain control.

It turns out that histamine is a complex subject. So I’m not going to try to explain it here. Because anyone with histamine intolerance is going to know far more than me. But while we wait for that person to come along, I’ll attempt to get the ball rolling from a gout point of view.

There are foods that contain high levels of histamine. Many of these are listed in …
Maintz, Laura, and Natalija Novak. “Histamine and histamine intolerance.” The American journal of clinical nutrition 85, no. 5 (2007): 1185-1196.

But Strawberries are not included in the high-histamine foods list. Instead, they’re included in “Foods with suggested histamine-releasing capacities”. Also known as “histamine liberators”.

Finally, there are other complications of histamine:

• People have different tolerances.
• Some foods block histamine effects – Diamine Oxidase (DAO) blockers.
• Cooking and fermentation affect histamine availability.

As yet, I can’t find any specific advice regarding strawberries, histamine intolerance, and gout. But logic tells me that strawberries might help uric acid control if you are histamine tolerant. Though that needs to be part of a comprehensive uric acid control plan.

If you are histamine intolerant then you should avoid strawberries. But this should not be a major problem for gout sufferers. Because there are plenty of other ways to control uric acid, inflammation, and gout pain.

[Charles Rew]

Would changing my diet to a more vegetarian diet help out.. Not 100%
vegetarian, I mean as to eating lots of salads and fruits and minute
amounts of meats(mostly chicken)

I am also looking to try the cherry idea.. I will do just about anything to get rid of this.

[nobody]

Eating less meat (ideally, eating none at all) would help. But what you need from your diet is first and foremost proper nutrition so replacing meat with salad and fruits will only work if you were eating too much protein in the first place (which would probably make gout worse regardless of the protein source).
You really need to consider your diet as a whole as well as your other medical problems. If you are obese, losing weight may matter more than the amount of meat you’re eating for instance. And eating lots of fruits may not be a good idea if you are even mildly diabetic.

For most people, the way to get rid of this is simply to take a pill every day.

[Keith Taylor]

For most people, the way to get rid of this is simply to take a pill every day.

That’s very true. Also, consider that diet changes are likely to take a long time to be effective, if ever. So it makes sense to get uric acid treatment now. Such as allopurinol, Uloric, or whatever suits your individual condition. For example, uricosuric treatment might be appropriate if you are a uric acid under-excreter.

That way, you get uric acid safe to stop further damage to joints and tissues. Which gives you time to adopt better eating habits. So future uric acid blood tests might indicate to your doctor that you can lower treatment dose – down to zero if you’re lucky.

In any case, you need that 24-hour urine test to determine your uric acid excretion rate. Otherwise, how can you know which diet changes to try?

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