[Sandeep]

Hi Keith,

Thanks for the link but India is a diverse country and the food habits are diverse as well. I searched extensively but couldn’t find any advice for South Indian diet. And I am not a vegan. I love cheese a lot and used to drink at least 1 glass of milk everyday with Protein supplment. Ultimately when I doubled for 4 months. At the same time I was taking certain biscuits as healthy snack alternatives and turns out they are protein rich as well. And I didn’t know that Peas are high on protein as well. So I believe it is this faulty protein-rich diet that led to my gout.

And I am seeing a rheumatologist this week for checking my uric acid levels two weeks after my allopurinol start and I would check with him if he has any dietary recommentations. In India we don’t get low-fat milk or low-fat curd. I get the Toned milk(first one in this link):
http://www.heritagefoods.in/product.html.
And Yogurt is prepared in our house through this milk. Since I have been told to stay away from sugar and Protein supplements, I am not sure how I should be drinking my milk now. Because without any sugar the milk tastes bland and for while I thought about a powder called Horlicks but my doctor said that it is mostly sugar and thst wouldn’t help my cause.

Previously I used to eat an omlette every now and then but now I am making a conscious effort to have at least 4 eggs per week. 4 soaked almonds everyday. Peanuts+Chickpeas paste in the morning. These are my protein sources.

I am going to stick with Allopurinol because I am not having insomnia as I did when I had febuxostat. Allopurinol causes mild joint stiffness every now and then but overall the symptoms have abated. It’s not as bad as it was for the first 2 days. I got to monitor my uric acid levels this week to see if Allopurinol has worked. I will ask my doctor about options in case I have a sudden attack midnight.

Thanks for your advice Keith.

[Sandeep]

Can Allopurinol cause Joint Pain?

Hi Keith,

Thanks for your reply.

I am noticing a decrease in my joint stiffness now. It’s better than what it was a couple of days ago.

My uric Acid Levels are as follows
Feb 20-> 7.0 md/dl
After using febuxostat 40mg for 6 weeks
Apr 1-> 4.0 mg/dl
Discontinued the febuxostat and after 11 days
Apr 12-> 7.0 mg/dl

I am wondering if the uric acid lowering medicines just mask the symptoms of high uric acid level but they never get rid of the crystals that are deposited in the joints. So from my understanding the moment we discontinue the medicine the uric acid level rises again. And it keeps adding to the crystals that are already there. It looks like these crystals can only get bigger and more painful but they would perhaps never fully vanish from body. Also I notice these tinges in many other joints in my fingers and toes unlike many who only seem to have it at a single joint.

Indian diet is different from what western diet is and for us rice and pulses are our staple foods. I am an eggitarian but live with my family. It’s baffling really. I asked my doctor couple of times what to eat and what not for my gout diet but he just said I should stay away from meat and asparagus,mushrooms. I am already avoiding foods with high purine as per info on the internet. But in the South Indian context, that info is not all that helpful. There are many other oils, spices, pulses that we use in our diet. I am compiling a list of all food items that we use in our kitchen and hopefully you can help with some of the foods.

My doctor switched me to Allopurinol now but from my research on the internet both febuxostat and Allopurinol can cause serious side effects but I guess we do not have many options now. The natural or home remedies do not seem to do any good.

[Sandeep]

Hello,

Thank you for your reply.

Regarding my protein intake, these days I am not even having protein intake of 2 eggs a week. When I said I was taking 24g of Protein per day, it was through supplements alone. I consume peanuts almost every day in some form and once or twice a week beans and peas as well. Those are my other protein sources. Right now they are the only sources for protein in my body. I also take soaked 4 almonds every alternate day. That could be another minor protein source. As per some links in google, soy protein does indeed risk for gout.. please check

[pubmed/21859653] Messina, Mark, Virginia L. Messina, and Pauline Chan. “Soyfoods, hyperuricemia and gout: a review of the epidemiologic and clinical data.” Asia Pacific journal of clinical nutrition 20, no. 3 (2011): 347-358. Soyfoods, High Uric Acid, and Gout PDF.

Anyway, I want to know how people meet their protein requirements through supplements when they can’t have meat. Is whey protein or Casein good for gout? I found a casein protein supplement and I have decided that I take 2 per day at least to meet min protein requirement.

Casein Protein Powder for Gout

I saw the doctor for my uric acid levels only 45 days back. So yes I only have 2 Uric acid tests done
Feb 20, 2017 the Uric Acid level was 7.0 mg/dl
After feburic 40 mg(febuxostat), April 1,2017 Uric Acid level was 4.0 mg/dl

I asked my doctor if I could take my feburic after dinner. But he insisted that it has to be taken after breakfast. Because of the horrible sleeplessness that I had, I wasn’t able to attend my office and requested my doctor to see if I can stop my medication to see my uric acid levels in a month. So my next test would be in the first week of May.

I stopped taking the feburic 40 mg tablet 4 days back, my sleep has improved. But I feel these light stabbing sensations underneath my nails in fingers and toes during the night and also sometimes during the day as well.

This may seem unusual but when I first started getting my symptoms I also noticed that when I tried removing mucous from my nose I smelled bad. When I was taking the feburic medicine it almost stopped but since the 4 days I quit that again I notice this bad smell when I am getting rid of mucous.

I limited my consumption of purine rich foods now and this should eliminate the source of uric acid to an extent I hope. One more point worth mentioning is that I have been suffering with bad knees from 4.5 years now and it might have adversely affected my metabolism. I am already having plenty of trouble running from one Ortho to another to diagnose what exactly the issue is and now I have to tackle this as well 🙁

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