Does this sound like gout?

[Olan Dravnieks]

Hello, I wonder if someone with experience with gout can give me some insight.

I’m fifty-five, generally healthy and of normal weight. I’ve broken my big toe a number of times over the years in various sports, its had very little flexibility for probably a decade, but no pain unless I bend it too far. I don’t drink, eat a moderate amount of meat (mainly beef or sardines) every second day, but eat a lot of dried fruit (love the taste) which has a lot of fructose.

I did a workout Wednesday which involved a lot of driving off my big toe, but didn’t really notice anything. I woke up Thursday with a mildly stiff big toe, but didn’t think much of it and worked and worked out as normal, it got sorer as the day went on. Woke up on Friday and it was noticeably more painful, but didn’t notice it being swollen (didn’t look either though). Genius that I am, I worked out and worked on it all day. By the time I went to bed it was painful (not excruciating, I didn’t need pain killers to fall asleep).

Saturday morning the general area of the big toe was swollen and pinkish, and painful to step on, though okay if resting. I went to a local clinic to get an Xray, the doctor told me he thought it was gout (because I didn’t remember twisting it on Wednesday, and first noticed the stiffness Thursday morning) – the xray shows no brake or anything else wrong. It feels like a sprain (I’ve had a lot over the years in various sports), but I’m reluctant to disregard a doctor’s opinion (I figure he sees a lot of these things).

I’m making an appointment with my GP to have him look at it and to see if my uric acid levels are high. He’s a busy doctor, so it’ll probably take a couple of weeks to get the appointment, and I’m wondering in the meantime if it sounds like gout, and if so, should I cut back on dried fruit (the only thing I eat a lot of which is high in something (fructose) that can cause gout?

Thanks for any help anyone can offer,
Olan

[Ron Avery]

If it’s swollen and pink in color it could very well be. However, the only way you’re going to know for sure is to get your uric acid level checked. In the meantime I would take anti-inflammatories if you have them and some type of pain killer like Tylenol.
If it turns out to be gout then you can decide whether you want to lower your uric acid level by altering your diet or by taking a medication like Allopurinol. Sometimes diet alone is not enough. Keith will guide you based on your levels and your preferred method.

Cheers,
Ron

[Olan Dravnieks]

The actual uric acid level was 194 – that’s in the normal range I’m told.

[Olan Dravnieks]

Quick update – swelling down, still hurts a bit when walking. Can’t see my doc for a couple of weeks, but office nurse went through files, had normal Uric acid level in general checkup blood test three weeks ago, and was always normal in previous years. As well, she says whether gout was there or not, definitely have a pulled tendon in lower foot (can feel now that swelling is down – the med clinic doctor didn’t even examine the foot by hand, just did a visual).

I’m guessing its probably not gout. BTW, this is an excellent web site, very informative.

[Keith Taylor]

I agree Olan, it probably isn’t gout. Good job really, because some of the advice you’ve been getting is poor (apart from the very excellent advice from Ron, above).

The only way dried fruit is going to cause gout is if substantially more than 25% of your daily calorie intake comes from it. Nothing to do with fructose or fruit. Any diet that is not nutritionally balanced can lead to gout, but the circumstances vary.

“Normal uric acid” is a phrase used by medical staff who are incompetent, or patients who have been misled. Don’t use it, unless you are a statistician.

Olan. your 194 (presumably μmol/L) is perfectly safe. It can only ever be gout-related if it has been significantly higher in the past. I do wish that doctors who suspect gout would keep their opinions to themselves until the test results come back. Pity really, as I got 3 posts off you in a day. I wish the real gout sufferers were so prolific.

Gout sufferers take note! Olan cured his “gout” with 3 posts in this gout forum. Just think what you can do if you really have gout, and choose to control it properly. Log in, and get posting!

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