Vegan with Gout needs a Diet Plan

[Eia Jossi]

Hello,

I would like to request a vegan gout diet plan. I have had three gout episodes beginning over a year ago. The first one came after eating something with veganaise and cleared up completely on the first day. I’m not sure what triggered the second but I was eating a very low-fat diet of mainly raw foods and no soy. Since then I’ve adopted a ketogenic vegan diet which includes some soy but the latest episode occurred after eating popcorn.

I had my uric acid level tested after the latest attack and my doctor told me it was 3.3. She didn’t think it was gout. But the symptoms really come on like gout, it feels like a broken finger or toe and then after a day or two wears off.

I have a low BMI and am otherwise very healthy and active and not on any medications.

Thanks in advance…

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[nobody]

Hi,

What would be the purpose of this diet plan?

The main cause of gout isn’t what you just ate but uric acid crystals which can accumulate in one’s joints over the years. So the main point of a gout diet is usually to reduce the amount of uric acid in one’s blood. But assuming the test result you mentionned is 3.3 mg/dl (perhaps you could double-check both the number and the unit with your doctor’s office), that indicates a very low amount of uric acid already!
Now because these crystals accumulate over the years, it’s possible you might be suffering from gout even though the amount of uric acid in your blood is currently low. Indeed gout pain can be triggered by an improvement in one’s diet. But this type of gout is temporary. You might think of it a residue of past diets or lifestyles. The residue slowly dissolves and once the process is completed, one’s gout is cured.
I think you should get another blood test (if your last test was done only a few days ago, wait a few weeks) because the result of your last test might possibly be exceptionally low. It happens, especially after flareups.
But if the amount of uric acid in your blood is consistently that low, there is no point in changing your diet in the hope of lowering it further.

A ketogenic diet is something which might bring about uric acid problems but maybe your body can handle that well. Still, if you often carry out such dietary experiments and you suspect you are prone to gout, you might want to keep monitoring your uric acid.

But perhaps you have a goal other than minimizing uric acid such as preventing inflammation… in that case, please explain what you are trying to achieve.

[Rebecca Nahid]

I am also vegan I doubt it was Veganaise as I eat that every day
I did have pain after sweetcorn soup but I thought sweetcorn was low-medium purine?

[Rich Blazeski]

Hi, from what I ve read the crystals start to form at 6.8 mg/dl, you are way below to that, you might not havr gout, plus that you don t have the classic in the finger, perhaps you should ask another’s doctor opinion.

[Keith Taylor]

Sorry Eia, I think the application form got broke. But, it should be working OK now, and I’ve included it in this reply.

However, before you apply, you should consider the issues raised by nobody, and by Rich. Because it is impossible to have gout at 3.3mg/dL, except for 2 possibilities:

Either
1) You have had uric acid much higher than 3.3 in the past. Then you need help for a short time while your body adjusts to the sudden fall in uric acid.

Or
2) Your result is not 3.3mg/dL, but 0.33mmol/L. So, please check your uric acid blood test results carefully.

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Statistics don’t make gout diets – people do!

But, statistically, vegans are most at risk of gout. See Why Vegan Diet is Worst for Gout for more information.

[Eia Jossi]

Hello,

Yes, I double checked and my uric acid level was 3.3 the morning of the attack. I know this doesn’t sound right but I just don’t know what else it could be. This is the third attack, the first was in my toe and went away completely but the last two have been in my fingers and they have not completely gone away.

I have done some more research since yesterday and I think its possible a calcium deficiency may have contributed to my experience.

I would like to request that my doctor test the fluid in the joint but I’m wondering if anyone knows how painful this is?

I would like to look at what the recommended vegan diet is here and see how it compares with what I’ve been doing.

[Keith Taylor]

Seriously, Eia, you can’t keep putting your health at risk like this. Because you clearly do not have gout. But, you might have something that requires immediate medical attention.

Treating gout is very easy for most people. But, like all diseases, it is totally dependent on getting the diagnosis right. Because there are lots of diseases that have gout-like symptoms. So, what you need is a rheumatologist who is expert in differential diagnosis.

To explain, differential diagnosis is a series of assumptions about your disease. Then tests to confirm or deny each assumption until you get the correct diagnosis. Because only then can you start to treat your ailment. Also, you need an expert to determine those life-limiting possibilities that need to be ruled out, or treated, first.

It’s good that you have taken the first step. Because you’ve assumed it is gout. Then you took the test and ruled gout out. But if you continue without expert help, this could take you a lifetime. So, I think it’s time to seek out an expert rheumatologist in your area.

As for my “recommended vegan diet”, unfortunately, I have no such thing. My approach to diet is:
Either
1) We analyze your current diet to see if we can make gout-friendly improvements. But, you don’t have gout. So, this can’t apply.
Or
2) We work on your preferences to amend your choice of Foundation Gout Diet to suit your gout. But, again it won’t work for you as you don’t have gout.

My diet planning choices are because gout can only be treated with a personalized plan. And that applies to drugs, herbal, or lifestyle gout treatment. I have no idea what applies in your situation, Eia. So, I think you should eat healthy whole foods. Then take supplements that your vegan nutritionist recommends. Thus avoiding malnourishment from missing essentials.

Finally, my best recommendation would be a vegan alkaline diet. Unfortunately, I don’t know any reliable resources. For the sake of your health, use Google Scholar or PubMed if you want to research it properly. As this is not about gout, I can’t help you with that research here. And, I’ve had to put my Foodary project on hold until I get GoutPal back at the top of my game.

To conclude, I’m really sorry I can’t help you more at this time. But, if you can’t find good quality help elsewhere, you can push me to restart my nutrition project, with you first in line.

[Keith Taylor]

P.S. I missed:
“I would like to request that my doctor test the fluid in the joint but I’m wondering if anyone knows how painful this is?”

Get this done by the expert rheumatologist that I mentioned. Never ever get a joint fluid test from a doctor who does not have immediate test facilities. Also, check that those facilities include all appropriate tests, not just a polarizing microscope.

If fluid cannot be tested as soon as it is drawn, it is a complete waste of time.

If tests do not include all life-limiting possibilities, you put your health at serious risk.

Finally, if it is done correctly, you will not feel anything at all. Trust me, as I’ve had my ankle done by a properly trained rheumatologist. I had to ask when the test was going to start after it had already been done! But, a less qualified medic might not have the right quality of needle to ensure a painless fluid draw.

[Eia Jossi]

Hi Keith,

Thanks for your input. I don’t mean to contradict your opinion but I have been doing a lot of research and I found this tidbit of interest regarding why my uric acid might still be low in spite of having gout symptoms. I found this on the mayo clinic doctors blog, (http://emblog.mayo.edu/2015/01/23/gout-it-is-always-gout)

“What about a blood draw? Wouldn’t we expect the white cell count to be elevated in septic arthritis? Or the serum uric acid level elevated in gouty arthritis?

Dr. Bongartz’ s Answer: In the acute setting, laboratory testing is of limited value. The white cell count is not a useful test to distinguish between septic and non-septic arthritis. In half of the cases of septic arthritis, the white cell count was within normal limits (Li et al., Acad Emerg Med. 2004).

The serum uric acid level is just as limited. During a flare of acute gouty arthritis, the serum uric acid level is often within normal limits. Therefore, the sensitivity of an elevated serum acid level for diagnosing gout is low (Zhang W et al.: EULAR evidence based recommendations for gout. Part I: Diagnosis. Ann Rheum Dis. 2006 )”

For my part I’m going to treat this as gout and try to experiment with some alternative treatments to medication. If you are interested I can update you on my progress…

[Rich Blazeski]

Hey, how old are you and what sex? I have tested my uric acid level in the last 2 months 5 time, values ranged from 4.3 to 5.9, is it possible to still have low values to the acutr attack? Who knows, I also decided to treat it as gout, with medication for at least 3 months and after I am going tontry only diet..I want to have my u.a lvl under 4. Anyhow I recommend you to try see anothrr dr. I will do that as soon as I ll have the chance.

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