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Hi Keith and Gout Pals, I find that Celebrex is a better NSAID for gout than naproxen or ibuprofen. Unfortunately, getting Celebrex in US is like pulling teeth – they don’t want to prescribe it due to pharmacy restrictions. However, it is the best one for gout in my opinion. Brad
Keith, Thanks for the pointer to onions and quercetin. I am a big cherry juice fan but was not aware of the potential of onions to help manage uric acid. While the results are not as dramatic as I might like, I did find a recent paper – out of U. Leeds – that does show a benefit from onion consumption on blood uric acid levels. This article is: British Journal of Nutrition, Volume 115, Issue 5; 14 March 2016 , pp. 800-806. The title is: “Quercetin lowers plasma uric acid in pre-hyperuricaemic males: a randomised, double-blinded, placebo-controlled, cross-over trial.” It would be interesting to see teh effect on higher uric acid individuals – hopefully someone is working on it!
Cheers for the New Year!
Brad
Hi Brian, sorry to hear you’ve joined the gout club! I too got introduced to gout through the alcohol trigger. For me it was warm weather, low hydration drinking that first brought my attention to gout. So, the first thing is to drink moderately and always include plenty of water, especially before going to bed. Secondly, Keith is quite correct you need to know your uric acid levels – by managing this through diet, supplements, drugs and lots of water, you can probably remove the triggering effect of alcohol, at least alcohol in moderation.
Home testing or lab testing will work just fine, whichever is easier, more cost effective for you.
Good luck!
A second article that shows the high incedence of tendon involved uric acid deposition and the clinical utility of dual energy CT is: Rev Bras Reumatol Engl Ed, 2017 vol. 57(1) pp. 64-72 “Relevant aspects of imaging in the diagnosis and management of gout”
While most MDs won’t have access to this imaging technology, it still shows they need to be aware of the high impact of gout – and the need to exclude high UA as part of any diagnosis. Seems MDs on both sides of the Atlantic are often missing this point!
The first article is a study of hyper uricemic gout patients compared to runners and OA sufferers. It very clearly shows the high incidence of Uric acid deposits in the tendons. This can be found in: Clin. Rheumatol., 2016 vol. 35(8) pp. 2039-2044 – “Tendon involvement in patients with gout: an ultrasound study of prevalence”
There is a strong association between gout and tendinitis that is only recently well described in the medical literature. Particularly in the knee and tendons of the quadriceps, high uric acid can lead to substantial inflammation and pain. Reduction of uric acid does lead to improvement.
On a personal note, I have experienced a similar pain in the knees, which is now much improved as a result of gout management.
If you are interested, I can send some recent references.
Brad
Eric, in the US, you can get a uric acid meter, which is the fastest and most economical way to do uric acid testing, but you have to order from amazon or something like that as US drug stores don’t carry these. You can also pick one up in the UK if you are fortunate enough to travel there occasionally. These are also commonly available in Asia.
Most labs don’t support self-ordered tests, which is dumb, but that’s how it is here in the “land of the free.”
As to beer vs. wine, wine is generally low in purines, so provided you don’t drink to excess and do stay hydrated, I think wine is a better choice as far as gout risk goes. Beer can be quite high in purines, but it is very difficult to know the purine content for a specific beer, especially the tasty local brews for which no data is available. I have found that for me personally, I can’t have both beers and a high meat meal without risking a flare, so for me it is one or the other, but not both! I can’t overstate the importance of water when consuming any alcohol.
Good luck and let us know how it goes with a meter purchase here on the forum.
I have found that greatly reducing meat in the diet has been very helpful. I try now to keep my meat consumption to 6 oz per day or less, and this – along with a daily dose of cherry juice has done a lot for my gout management. I haven’t had an attack in several months, but can still detect swelling/stifness in the big toe now and then.
Prior to reducing the meat content of my diet, I over-blamed beer consumption, which also must be limited, but a pint of craft beer is only a few mg of purines. On any given day, I can have a beer or I can have some meat – but very careful about having both :}
Hydration is incredibly important, as it effects how well one excretes uric acid and the concentration of uric acid in the blood directly.
If you’re nearly vegan now, what do you think is your most problematic food? Mushrooms, artichokes, broccoli and legumes are known to be pretty high in purines, by the way!
Hope this helps, keep posting!
Is pain climbing stairs from gout in knee?
Hi All,
I have high serum Uric acid and frequently get gout in the classic big toe joint – I have started experiencing a pain in one knee when I climb stairs. There is no obvious injury otherwise, and I wonder if any one else experiences this from gout.
Your experience much appreciated.
BK