Vegan with gout

[Thomas Toscano]

I am a gout sufferer that has been desperately trying to control my UA levels with diet. My diet can best be described as a vegan who eats seafood and I have been this way for nearly 20 years (I am 50). I had my first bad attack about 2 years ago. I think I had smaller ones before that that I thought I had just stubbed my toe never thinking I had gout. I have read all about the foods high in purines and here are the ones that I did eat and the order in which I gave them up:

Shellfish (gave up completely after my first attack in 2019)
Other fish (went from 3-4 times a week down to 1-2 times per week)
Plant based protein shakes (used to have 2 a day for 40 grams, cut down to 1, then eliminated completely)
Sweets (still have occasionally but greatly cut back)
Wine (used to have a glass a night and have not had a drink since mid August. Never drank beer or any of the hard stuff.)
Salty processed foods, like chips (was never a huge eater of them but now totally avoid)

I am also not overweight (6’1″ and 180lbs) and I lift weights almost every day in the winter and cycle 5,000 miles per year, mostly in the summer. I did everything I could to avoid going on Allopurinol but relented and started 100mg/day a month ago after my last doctor blood test was over 9 after all the foods I gave up. I also test daily with the UA Sure meter and my results range from mid 5s up to low 9s.

I had 1 attack while on AP but it was very brief (about a day compared to my prior attacks lasting weeks). I am trying to figure out what causes my levels to jump and nothing seems to make sense. I test 1st thing when I wake up. For example, yesterday I tested mid 8s the day after I ate nothing I would think would cause an elevation (I had gnocchi pasta the night before and I wonder now if even the complex sugars could be causing it). The rest of my diet the day before was all vegetables with some fruit and nuts. Last night I had salmon for dinner, had a few sweets also, yet my level this morning was 5.9. I eat a ton of vegetables, including juicing, and there is a lot of spinach and broccoli in my diet. My diet is probably better than 99% of adult men, and, aside from the wine, I don’t have any vices (never used illicit drugs of any kind, no steroids, etc.), which is why I am so frustrated about this. I know it is genetic as my younger brother, who is 6 years younger, has had a few attacks (my 3 year younger brother eats tons of animal protein and has no issues). Curious if anyone has any insight. Thank you in advance.

[nobody]

Hi!
Don’t waste your time trying to understand your SUA fluctuations. The amount of uric acid in your blood is going to vary randomly at this stage (even more than it would usually). Just make sure (with your doctor and a bloodwork including liver function numbers and whatnot) that you are tollerating allopurinol well and increase your dose a bit.
Your diet may be generally healthy (other than the alcohol), but isn’t good for uric acid. The information out there about diet and uric acid is mostly terrible. If you tolerate allopurinol, you won’t need to be very careful about your diet anyway. Just avoid eating loads of small animals or shrooms and in particular stay clear of the stuff made from single-celled organisms that is sometimes used as substitutes for animal products.

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