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I have started my gout lifestyle changes with diet and water and chianca piedra to help the kidneys flush the uric acid, about 3 weeks ago. My levels are at 9.1 mg/dl as of my first check today. How long ( I understand individual differences) should it take to get uric acid levels down to a safe level, using dietary changes primarily
You said in a recent response:
Herbs must be treated with the same respect as medications, since they are the original medication. That means that you should always monitor yourself while taking them the exact same way you would while on a medication.
In a similar vein, control of gout by herbal medicine and diet needs to be planned. The details are different from pharmaceutical gout treatment. But, the principles are alike.
We have one single uric acid test result (by the way, that needs to go in your profile). We need more test results before we can hazard any guesses about how long treatment might take. In the meantime, we must do all we can to make that time as short as possible.
First, you need to get your uric acid excretion rate tested. That involves collecting urine over a 24-hour period. See your doctor about this as soon as you can. It will tell us if we need to focus on uricosurics or XO inhibitors, or both.
Then we need more information about your diet and water and chianca piedra. I also need to know your height, weight, and exercise levels.
For diet, best to start a new topic, and post everything you eat and drink each day. Include any dietary supplements.
For water, can you confirm that you drink enough to make your urine a pale straw color? There is no fixed amount for fluid intake, as it varies with weather and activity.
For chianca piedra, how much are you taking, and how often.
Unfortunately I don’t have a doctor or insurance currently so getting the test can’t happen right now. So the first day of testing I tested 4 times that day levels went from 9.1 to 10 to 7.2 to 11, this was a day after I had some salmon. I decided that testing multiple times in a day was crazy so decided to do it each morning before breakfast but after meditation. the levels went as follows for the next 9.1, 8.2, 6.2, 9.1. My diet has been primarily vegetarian since reading about the dangers of this disease on your page, with some eggs and the occasional piece of chicken, I have also dramatically increased my water intake,(realizing that I was probably in a perpetual dehydration state before) yes my urine is pale straw or clear. For treatment my current regimen is two glasses a day of a combo of chianca piedra, chamomile, turmeric, tart cherry concentrate, and lemon(I am waiting for the banaba to arrive). I am 6′ somewhere between 195 and 200lbs, I try to exercise 6 times a week, in a combo of martial arts, yoga, weight lifting, hiking, archery, and meditation.
So one other question I have is how quickly do uric acid levels respond to a “stimulus”, so eating a piece of pork causes them to spike in 1 hour, a few hours, next day, are there any good books on this subject you could recommend.
So I know when I drank alcohol(scotch) I drank too much, I was also eating way too much meat(so the dietary changes are overall good), drank too little water, but also for a number of years, I really abused coffee, way too much, upwards of 10 cups a day I also took way too much ibuprofen, yesterday was the morning where my reading was 6.2, for the day before I had cut out coffee and hadn’t had any ibuprofen in a while. So I ended up taking some ibuprofen and drinking some coffee(I now about the inverse relationship to coffee and gout however with my level of abuse, I am wondering if it negatively affects my kidneys). If either of these are triggers could/would they change my uric acid level overnight.
Sorry it took me so long too get back but I have been a little overwhelmed with trying to understand this disease and I couldn’t talk about it for another minute for the last few days
DorianHey Dorian, I’m sorry if I’ve pushed too hard. I know how it is to be overwhelmed by gout.
Sometimes you just don’t know what to do for the best. I’ll try to help more.
I know I keep banging on about best practices, getting the right tests, treating uric acid properly, etc. These are important physical aspects of managing gout, but I need to focus more on the mental aspects.
Is it more important to get manage gout quickly, or is it more important to feel good about the way we are dealing with gout?
I think that, as long as we are not ignoring the longterm implications of excess uric acid, we should try to celebrate every little triumph.
From what you’ve written, I can see that you’ve greatly improved your lifestyle recently, and you continue to have an active life. That’s all good.
I think it’s time to stop worrying, and try to make small steps of progress at whatever pace suits you. I’m going to back off from suggesting how you should do things, and try to understand your situation better. Personally, I took the cheap and easy option of allopurinol. I know that doesn’t suit everyone. To advise you of the best lifestyle changes, I’ll wait for you to ask me about specific things you need to know. So, to answer the questions from above:
1. How quickly do uric acid levels respond to purine intake?
Just a few hours. If you eat a meal rich in animal purines, uric acid crystals will rise within a couple of hours and peak a couple of hours later. It varies from individual to individual. I’ve got some specific research on this if you want the details. I’ve learned that speed of purine metabolism is not particularly important, except for the timing of uric acid tests. Temporary uric acid highs will not usually cause gout flares. Uric acid crystals grow very slowly, and gout flares are usually triggered by something else. Never forget though – if you have no uric acid crystals, you cannot have a gout flare. The thing that is most overwhelming here is the “something else”Scientists are learning about new triggers, and getting better understandings of how a gout flare starts. Because there are many factors, in real life, the start of a gout flare seems random. Despite that, we all tend to get hung up on avoiding gout triggers. That is a truly overwhelming task. My best advice is to split your gout management plans between long term control of uric acid, and short term control of gout pain. That applies whether you choose pharmaceutical or alternative treatments.
2. Are there any good books on uric acid levels that I could recommend?
No.
There are some good texts on different aspects of uric acid, but I’ve never seen a comprehensive up-to-date book. My particular favorite is “Pathogenesis of Gout,” but it’s 10 years old, and our understanding and treatment of uric acid has changed in those years. I once started to summarize it at "The Manner Of Development Of Gout" but it all proved a bit too much for me.
Let’s think about which aspects of your life can be improved by better knowledge or treatment of your gout. What are your most important concerns? Take it a day at a time. Update your profile as often as you can, and join in discussions here. If it is useful for you, I’m happy to help you write your own gout website – that certainly worked for me! If that’s a step too far for now, I can help you with one or more articles that summarize what gout means to you.
You’re struggling with gout. I’m struggling with the best ways I can use my gout knowledge to help you (and other gout sufferers). Let’s all try to find ways to make it easier.
Keith you did nothing wrong, I have an obsessive personality so I obsessed and was overwhelmed by how little is known, and how much conflicting info is out there say about beans, peas, and certain veggies. I feel better now that the last two mornings(as I understand it a time when the levels will be at a high from the night before) I have been at 5.2 and checked it later in the day once and found it at a 4.3. So at least I know that what I am doing is working, as the levels lowered I had a flare, which thanks to you I understand why and I see it as a good thing, the sign that my body is starting to expose and get rid of these little fuckers. I intend to stay on this regimen for a while longer, I have also added a 1/2 teaspoon of baking soda at night in order to alkalize my body a bit more, since I don’t think this is something I want to take long term I will phase it out soon. Probably in 30 days or so I will decide how to proceed, with deeper changes, seeing how I can change what in Chinese medicine they call the root. The way to get my kidney and liver functioning in a proper way so the occasional piece of chicken or beef doesn’t seems like a death sentence. I have to say that this has been the most useful site I have found and while I lean more towards the use of “alternative” medicine, I applaud your caution in that area, there are a lot of false claims in that arena. I am also looking at that list and study you provided of the plants that have the ability to interrupt xanthine oxidase and comparing it to the herbs I use in Chinese medicine, to see which ones are appropriate for a gout condition, and trying to understand more the root of this condition. In addition though this falls in to the very (for many) way out there idea I have begun a specific meditative practice that is supposed to correct underlying imbalances in the body. I did feel positive changes early on though the standard is to practice at least 100 days before a full change is felt. If this works I can pass it on to any on these pages who may be interested.
You’re too kind Dorian. I too have certain obsessive traits, so I should know better. I need to focus much more on what gout sufferers need to achieve as people. Low uric acid is my obsession, but I shouldn’t frighten people with my own fears (cue a gouty version of Philip Larkin’s This Be The Verse).
Moving on…
The confusion about veggie purines is completely down to old science. It changed (from memory around the 1970s). Researchers began to realize that not all purines are alike. The latest professional rheumatology guidelines recognize that vegetable purines are not a threat to gout sufferers. Recent research confirms that, as part of an alkalizing diet, vegetables are the best food for gout. I use this as one of my main tests when I am reading gout information. If there is any mention of avoiding asparagus, beans, and similar old-school gout “problems” I stop reading, usually accompanied by exasperated cussing.
Obviously, you can’t see me at the moment, but I’m dancing for joy. Fantastic uric acid results. Let’s see what we might do to maintain that, and perhaps get lower.
I mentioned alkalizing above. There is some evidence that artificial alkalizing with bicarb can help gout. We’ve discussed it several times over the years. My view is, if you’re determined to choose chemicals over food, potassium salts are better than sodium ones. It’s a long time since I debated this, so I hope someone starts a new topic about which chemicals are best to alkalize the body.
But chemicals? Really?
I’d much rather alkalize with food. Real food, not food-like substances that are packed with additives. I started looking into this when I realized that baking soda has a bad effect on blood pressure. I was worried about that at the time, though it now appears I have normal blood pressure, but White Coat Syndrome. I’m now recognized as a leading authority on Potential Renal Acid Load. It’s one of the best estimates of alkalizing food potential, until I invent something easier.
I like the mention of Chinese medicine. I’ll see if I can wake @odo for some wisdom.
I also like the mention of meditation. That’s the push I need to write about the mindfulness of gout.
Dorian, your wide-ranging comments have made my day. The perfect gout topics – mostly plants and exercise of the mind, with occasional chicken or beef for added pleasure. 😀
By the way 3.7 this morning, so all is working, I will stop the baking soda tonight I only did it for 3 days but I would like to not use it at all and see if that changes things. I was also curious about “regular” uric acid levels do you have any info on what the average person without gout walks around with on a daily basis. Another question I have is I looked at your chart on foods with that number/index in the last column of-4.9 etc.. for meats and I am having a hard time understanding it.
It will be interesting to see if stopping baking soda leads to a rise in uric acid. If so, you could maybe use it on an ad-hoc basis whenever uric acid rises above 5. Or on a temporary basis until you can improve the alkalizing effects of your diet. Very interesting!
Average uric acid scores are harder to find than I realized. I think it’s because most studies I read focus on gout patients, so average “regular” uric acid is harder to find. In the end, you inspired me to post https://gout-pal.com/gout-pal-forum/please-help-my-gout/regular-uric-acid-levels-without-gout/
If the chart you are looking at is the one I’m thinking of, I think the number is me being over-complicated. It’s probably best if I remove that meaningless, confusing column. If you remind me where it is, I’ll amend it soon.
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