Vit D and Gout

[akkers5]

I have had gout for 21 yrs. In the first 3-4 yrs I used to get 5-6 attacks per yr but then it stablised to around 2 attacks per yr (in spring and then in autumn). I was eating a little bit of chicken and bit of fish and still only experiencing 2 attacks. That was a happy setup which I stuck to.
Come 2019 and I was disgnosed ith Vitamin D deficiency and my doctor started me on VitD supplement. It was ok at first but after a few months I started to get gout ‘storms’. Since March 2020 I have been having gout flare-ups, treating it wityh Colchecine and then 2 weeks of peace and then another gout flare-up. This has been relentless and I have suffered attack after attack, even though I have not had any offending food since March 2020 (I cut out the little bit of chicken and fish).
What could be causing this? Could the Vit D be indirectly producing more uric acid? Or could the Vit D have kickstarted uric acid extraction through urine thus affecting the old built-up uric acid to break free and circulate in blood to cause further attacks?

[nobody]

Hi!
Gout attacks getting more frequent is the expected outcome without effective treatment so there is no need to look for an explanation.
How bad was your deficiency?
You probably are still having “offending” foods by the way but that probably makes little difference unless your uric acid happens to be just right. You can’t expect a dietary change to have much of an effect so quickly anyway.
Why don’t you simply take allopurinol or something and cure your gout?

[akkers5]

I have been with 2/yr attacks for some 15 yrs. So why suddenly the dramatic change and escalation in attacks. I am convinced Vit D is reponsible in some way.
Orininally one of my doctors told me to take alloprunlol but when I saw a senior dr at the surgery he advised me against it because of side effects. His advice was diet control. And I guess I have done well in last 15 yrs with only 2 attacks per yr.
They did not say how bad the VitD deficieny was but they gave me a ‘big’ shot of D2 for 4 weeks and then asked me to take off-the-shelf D3 supplements.

[nobody]

2 attacks per years is a problem because that’s more than zero. The longer you don’t fix this, the higher the risk of complications.
One of the milder complications is attacks every other week. People often get something like this without taking D. That said, I have no idea what D2 might do (I take lots of D3).

[Keith Taylor]

Orininally one of my doctors told me to take alloprunlol but when I saw a senior dr at the surgery he advised me against it because of side effects. His advice was diet control.

All those years ago, gout management was even more of a lottery than it is today. Then, most doctors had no clue about how to safely manage gout. Also, everyone was less aware of the progressive nature of gout that leads to increased joint pain, joint damage, and organ damage.

Now, all those years of untreated excess uric acid are taking their toll. So you are experiencing the common symptoms of unmanaged gout. The answer lies in getting uric acid under control. So get it tested then we can discuss a plan to get you safe treatment.

I don’t want to say at this point if allopurinol or diet is the best way for you. Because that depends on your uric acid test results. Also on a full dietary assessment if you think diet changes are a feasible option.

[akkers5]

I thinnk I have come to a point where allonpurinlol is the way forward. But thats if I can get a gap in the attacks!

[nobody]

If there is no gaps or they are short, you might as well start allo as soon as you get your genetic test (if applicable) and baseline blood tests done (unless you already have the data).
People who do have long gaps between attacks or who only had one attack thus far should indeed wait until symptoms are completely resolved (and then some) before getting that baseline blood test and starting allo but if you’re having attacks all the time anyway, the timing is irrelevant.

[akkers5]

I have read so much about the causal link between gout and Vit D deficiency yet no one has done a study to see if Vit D deficiency is responsible for Gout.
Just for info, I a male born in an asian country, moved to UK when I was 10yrs, got gout when 39yrs. I have been back to my homeland a few times and asked around if any young or middle age people have had gout. Unfortunately, I could not find any such example (only end of life people had had gout). Bearing that in mind we have around 150 people from that area or their children here where I live. Of those 150 people around 10 have gout (young or middle aged).
Surprising that the people back home do not get gout yet poeople of same stock/race here in the UK are getting gout.
Thats why I am convinced that there may be a link to Vit D deficiency (that we are missing on the sunshine and hence Vit D deficiency).

[nobody]

Surely there are also dietary differences between the UK and your ancestral country.
And mild or chronic gout is often misdiagnosed.

There are links between D deficiency and many diseases, but it’s typically unclear if D deficiency contributes at all to these diseases. Indeed, a third factor (such as lack of physical activity) could cause both D or the disease.
And even if D deficiency directly contributed to gout, I’m not aware of any evidence that D can cure it.
That said, it would make sense if D deficiency had a connection with bone-related gout complications and I would be interested in looking at any D/gout studies.

[akkers5]

Thats what I am saying there are no studies to say ‘lets give these gout patients Vit D over a year perios and see if gout is cured’.
The only studies I have seen online were related to other things but it was noticed that all patients had VitD deficiecy.
The other problem prevelant in teh west is leaky gut – is that proven or still a theory? Could uric acid be getting into blood stream through leaky gut?

[akkers5]

btw I am going to see the GP as soon as I can get an appointment. Out of 7-8 doctors they only have 3 working, so appointments are hard to get.

[Author]

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