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I think soda in general triggers gout attaches. This has been my experience. When you drink lots of soda you don't drink the water your body needs to wash out the acid.
Diet Mountain Dew is Gout City.
Cut back on the soda, cut back on the gout attaches.
1. I built the PRAL tables from the USDA food analysis tables which are distributed in Microsoft Access (MDB) format. In the past, I've exported these into Excel and MySQL format, but I guess anything is possible. I lost my originals in a computer crash some time ago, but I can quite easily rebuild them. What format do you want?
I downloaded the USDA National Nutrient Database for Standard Reference release 21 but in a quick glance I didn't see PRAL numbers. Did I miss them? If so how do I locate them within the data? If they are not there Comma Delimited Text, Excel or Access would do. I don't use Access but I think OpenOffice can open the files and I could then export them to another format….I think. I don't use the database feature of OpenOffice but looking at the help it seems it would work.
Thanks for the information. I will do more research.
Gary S said:
[1.] Regarding your PRAL chart. Is it available in electronic format?
[2.] I assume the goal is to get close to neutral when planning a menu as I assume a very alkaline diet would not be very healthy. Is this correct?
1. I built the PRAL tables from the USDA food analysis tables which are distributed in Microsoft Access (MDB) format. In the past, I've exported these into Excel and MySQL format, but I guess anything is possible. I lost my originals in a computer crash some time ago, but I can quite easily rebuild them. What format do you want?
2. The goal is to alkalize. All this PRAL stuff started when I accepted that alkalyzing through baking soda seemed to have merits, but I did not want to raise my already elevated blood pressure. I do not like to over analyze my lifestyle, so I use the tables as a rough guide rather than calculating and monitoring specific goals. The general goal is to mix acid and alkaline foods in a proportion of approximately 1:3 or 1:4. My view is that this is more about general healthy eating than specifically about gout, though there should be a gouty benefit as uric acid is more soluble in alkaline conditions. There is a strong body of opinion that you cannot change the pH of blood, but at least an alkaline diet should prevent kidney stones. I am far from an expert in these matters, so if you really want to learn more, you should head for http://phbalance.wikispaces.com/ and discuss specific issues at http://acidalkalinediet.com/forum/
I had my first gout attack on Dec 31, 08. It lasted about 5 weeks during which I hobbled around all the time and was in considerable pain. I took Indomethacin as prescribed by a doctor and drank Dark Cherry Juice. I don't like to take unnecessary medication so I took it off and on as needed which may be why the attack lasted so long. I got my second attack on Feb 1st. I felt it start to come on about three days before it hit. I found this post and decided to give BBB a try so Wed night I made some and drank it over the next couple of hours. The next morining my foot still hurt but it wasn't the sharp pain I had before. On Thur I started taking 2 tbls of Apple Cider Vinegar three times a day and I continue to use it. After first using it within a couple of hours I could walk almost normally. So it would seem that the combination of BBB and ACV have helped since I only was hobbling around until I started using it and while my foot is still sore I can walk pretty much normally.
I do have a couple of questions. It seems from reading about BBB the maintenance dose you recommend is to take it once a week. How often can/should I take the BBB during an actual attack? Are there known side affects? Are there side affects from using ACV?
Regarding your PRAL chart. Is it available in electronic format? I assume the goal is to get close to neutral when planning a menu as I assume a very alkaline diet would not be very healthy. Is this correct?
goutanamo said:
What is that procedure called?
The procedure is called joint aspiration or arthrocentesis. It is commonly performed before a cortisone injection. By removing fluid from the joint the doctor reduces pressure, which can itself bring relief – the cortisone continues the relief by reducing inflammation.
The joint aspiration is a vital diagnostic weapon. The fluid can be tested for bugs to illiminate septic arthritis – this should be done, as a matter of course, before administering cortisone. More importantly, for suspected gout sufferers, the fluid can be examined for crystals by technicians schooled in the science of polarized microscopy. Correctly analyzed, a competent person can distinguish crystals that indicate gout, pseudogout, or both.
This test is important where there is any doubt about gout, e.g. when gout-like symptoms are not supported by high uric acid levels.
Speaking of uric acid levels, there are 2 important facts to bear in mind:
- Uric acid levels in the blood normally fall during a gout attack as uric acid has left the bloodstream to form crystals in the joints or other tissues.
- Tests described as “normal” may still be high enough to be indicative of gout. The actual value is important – not a description such as high or normal. Many labs include values up to 8 or 9 as normal. Whilst it is true that some people can have these levels without developing gout, anything over 6mg/dL is alarming, and for a gout sufferer, dangerous.
Don't worry about all the stuff you read about high purine foods. All you need to do is maintain a healthy weight. A simple measure is BMI, and you should aim for low-normal.
Obviously, there is a lot more to weight control than that. Key points are to include plenty of fruit and veg, and eat frequent small meals rather than bingeing and fasting. Plenty of fluids is important.
That's 4 Key Points:
- Maintain low-normal BMI
- Plenty of fruit and veg
- Frequent small meals
- Plenty of fluids
If you have only just started taking allopurinol, it is far too early to start looking for something else. Uric acid lowering treatment comes in too phases.
Phase one is to get uric acid crystals out of your body. Anything under 6mg/dL should allow the crystals to dissolve. Most practitioners aim for 5mg/dL. Phase one lasts until all the crystals have gone – signified by 3 to 6 months of no gout flares coupled with continuous low uric acid. This can take many months, but it is important to persevere because it is the only way to get the uric acid crystals out. If you don't do this your gout will get worse until it totally cripples you. Uric acid levels need frequent monitoring – at least once a month.
You will need pain relief during phase one. Discuss the choices with your doctor. (Gout Pain Relief Guide coming soon)
Phase two is to maintain your uric acid level at a maximum of 6mg/dL. Usually, you can reduce the dose slightly, but make sure you are getting frequent tests – at least once a week. On no account must you allow uric acid to rise above 6mg/dL.
Allopurinol does not last long in the body, so it is important not to miss a dose – ever.
If problems taking allopurinol continue, there is a new drug, febuxostat (sold as Uloric or Adenuric), which appears to be a valid alternative. Clearly, as it is new, it does not yet have the track record of allopurinol.
By the way, how often do you take the allopurinol? Guidelines say only take 300mg at a time – higher doses to be split 2 or 3 times a day.
the allopurinol at 600mg. is really playing havic with my stomach i have loose bowels i will try this for a few days if it doesn't stop i'll have to call the doctor .i have been reading all the infomation i can get on gout .i have it on all my hands and feet my elbows knees .i have been trying a lot of other things plus the allopurinol it is not coming out for the last year so i taught i was doing good . but; i caint seem to get my uric down . i try to watch what i eat but the uric acid just willno't budge .what else can i do.
I know I occasionally moan about doctors, but sometimes they must get really frustrated.
Your doctor has prescribed 900mg (the maximum dose) for a reason, and that dose will be recorded on your medical records.
If 600mg fails to be effective enough, your doctor, or any other medical professional who consults your records, cannot advise you properly.
Find out your doctors reasons for prescribing 900mg, and discuss with him the possibility of lowering the dose to 600mg.
If his reasons surprise or confound you, please discuss them here.
Sorry Mark, but this is wrong.
Pseudogout has nothing to do with uric acid. It is a joint problem caused by calcium crystal deposits. The symptoms are often similar to gout, but the treatments – apart from pain relief are different.
In fact, treatment of pseudo gout is more difficult than gout, as there is no “pseudo allopurinol”. I.e. allopurinol restricts uric acid production in gout sufferers, but there is no equivalent medication to reduce calcium deposits. In many cases, sudo gout is caused by an underlying condition, and treating that may be the answer.
It is possible to have gout and pseudogout at the same time, in which case gout does need to be treated with uric acid lowering therapy. Allergic reactions are often difficult to treat, and should be referred to a specialist. However, be sure that the reaction is allergy based. Many reactions to allopurinol are simply caused by insufficient fluid intake. You must keep hydrated whrn taking allopurinol to help the kidneys flush it's by-products from your system.
Ok here goes. I find that ALL pharmacuticals have serious problems. Not to mention the price! Here however is what works for me, eat 2 bannanas, drink cherry juice (even with my diabeties the jucy juce which says its no added sugar but tastes like marashino cherries works just fine) take ibuprofin and drink tons of water. I have effect in 24hours! For those like me who believe that there are actually several types of gout but find doctors unwilling to consider the FACT apple cider vinegar actually made it worse,much worse!
Heres my stats I think are important to this
Im Diabetic. Have both plaque pshoriasis and Standard everyday Arthritis in several joints, add to this profile I have had Gout attacks for 8 years. Aluprinol worked wonders, but of course now we find lots of associated risks. I have managed to control the diabeties with diet, I watch it very closely. Oh yeah almost forgot the yogurt. As soon as I feel an attack comming on I get yogurt.
I happen to like yourt, so it goes down very easilly. So heres my Rx
2 Bannanas,At least 32oz of non fat yogurt,A bottle of Chery Juice, and Ibuprofin
While I realize this probably wont work for everyone, we all are at this point willing to try anything and this combination has very little risk and my own personal seal of approval.
debs said:
Can you get gout in two feet? He still has his gout in one big toe now he feels tingles in the other toe???
Yes, I'm afraid you can get gout in any joint, and often more than one at the same time. That is why it is important to get treatment to lower uric acid below 6mg/dL as soon as possible. The longer you leave it, more joints get affected and more frequently.
Can you get gout in two feet? He still has his gout in one big toe now he feels tingles in the other toe???
Hi,
Yesterday, I suffered my first gout attack 🙁
I'm Steve, by the way. I'm 36, and live in London.
It came right out of the blue, (affecting my left ankle), and (obviously) it's still incredibly painful today…although last night was excruciating.
I'm dosing myself up with Nurofen (Ibruprofen), but happened upon this forum whilst Googling for natural gout remedies.
This particular post has intrigued me…especially the Black Bean Broth.
I asked my wife to try and find some Black Beans today. All she could find were “Black Turtle Beans”.
Are these the same as discussed here?
If not, is there some other name? Do they come dried, or fresh?
Sorry for all the questions, and thanks in advance for any light you can shed!
Cheers,
Steve
debs said:
can cod liver oil still be taken when you have gout?
Cod Liver Oil is a good source of Omega 3, and like flax seed oil, is likely to be beneficial. Good dietary sources of Omega-3 are soya beans, rapeseed oil, and oily fish, such as sardines, herring, mackerel, trout and salmon.
Your husband's doctor is right, to a certain extent, saying gout pain should subside in a few days, but this is not the whole story.
Inflammation can linger, especially where continuing high uric acid and reduced blood flow cause other joints to become affected (there are about 30 joints in the foot)
The important thing to remember is that once the pain subsides, your husband must work with his doctor to lower uric acid. Monthly uric acid tests are the first step.
The exact treatment for lowering uric acid will depend on a professional analysis of your husband's medical history and test results. It is important to maintain the level below 6 mg/dL. Very little else matters, despite what you might read and hear about brutal dietary restrictions or wonder supplements.
dr said husband should be out of pain with in a few days of gout attack but 5 days later he is still very swollen including part of his toes now and cannot get a shoe on?
Ask the doctors to try febuxostat – a newly available drug marketed under the brand name Uloric in the US and Adenuric elsewhere.
Please let us know how he gets on.
You really need to talk to your father's doctors about the future of his treatment.
The operation to remove tophi is simple from a surgical point of view, but surgery is never a welcome option for gout sufferers. Many patients report gout attacks following surgery, probably due to anaesthetics.
Tophi will grow again after removal, unless the cause is dealt with – high uric acid.
You should be discussing treatment options that lower uric acid below 5mg/dL. This will dissolve existing tophi, and prevent new ones forming.
Where gout is complicated with other diseases, as in your father's case, it is vital that cardiologists and rheumatologists work as a team to find compromises that give your father the best quality of life.
Greg said:
I will definately be taking febuxostat once it is approved – it works better than allopurinol. I was part of a phase III clinical trial for this med and was on it for more than a year – during which time I had no gout flairs at all! Too bad the study ended – allopurinol is only paritally effective for me.
Febuxostat now has FDA approval. It is released as Uloric.
From medterms.com:
Definition of Prospective study
Prospective study: A study in which the subjects are identified and then followed forward in time.
These are quite cheap to do, because they just use data (in this case from over 45,000 men). They identified subjects who did not have gout, then profiled them after 12 years. Statistically coffee drinkers developed less gout.
The data has been used for a range of other analysis – and each time it produces a separate report, presumably bringing reward to the authors.
Significantly, it was this data that led to the suggestion that vegetable purines do not contribute to raised uric acid – but again, I am unaware of any reliable blinded study that properly analyses different sources of purines on uric acid.
Quite simply, there is nobody on the planet going to finance this type of study.
So we just have to struggle on – with or without coffee cup in hand.
opa6x57 said:
I am a big coffee drinker – so this is important to me.
On the page – Home remedies for gout choice: Water – it says, “Some drinks contain caffeine or other diuretics. Do not include these as part of your water intake. If you drink lots of tea, coffee, cola or other diuretic drinks, you should increase your water consumption to compensate.”
However, on the page – Gout and Coffee, I read, “One other benefit of coffee for gout is it's water content. Though coffee is mildly diuretic, it still counts towards your daily fluid intake. I cannot overemphasize the importance of hydration.”
So, which is it – should I drink it and count toward total fluid intake? Or should I drink it to obtain the benefits reflected in the study but NOT count it in my total fluid intake? Or – avoid it – and make sure I drink plenty of water?
opa6×57,
Please accept my apologies for the confusion, and my thanks for pointing out this inconsistency.
The first page you mention, Water as a Home Remedy for Gout, is wrong, and I will correct it as soon as I can.
There is sufficient evidence to suggest that coffee is beneficial to gout sufferers.
Not only that, but when I wrote that page, I was misled by information I had seen about the diuretic effects of coffee. It is now clear to me that no amount of coffee will produce negative hydration – i.e. the small diuretic effect of caffeine is more than outweighed by it's water content.
You should follow the advice on the Gout and Coffee page, which is based on more recent research.
Apologies for the confusion – we're all still learning.
zip2play said:
metamorph,
Explain to me what you mean by black bean BROTH. If it's not the soaking liquid then is it the liquid after COOKING the beans and discarding them (such a waste)?
Or is it a puree of the beans with a large excess of water…what I call black bean soup?
zip2play,
Black bean broth is the liquid we get after we boil it. Yes, it may seem a waste to discard all the beans but that's how it works. You mentioned that you puried the beans and ate all. I am afraid you are actually eating the bean which might have contributed to you gout pains. It is the “anthocyanins” in the skin that works.
Hope the black bean broth will help rid you of your gout pains too, just like it works for me!!!! Happy gulping!!!
opa6x57 said:
metamorph said:
Boil 150gm of black beans in 2 litres of water for one and a half hours in slow fire. Discard the beans and drink only the broth, which is purplish black in colour.
You don't mention soaking the beans, first – so, just so I'm clear – you take the dry beans, cook them as directed – throw out the beans and drink the liquid you cooked the beans in, right?
Or, do you actually soak them first, then cook, then drink the broth? I'm just wanting to be sure I do this right.
You don't need to soak the beans. Just rinse them quickly and then boil them in a pot. I started boiling them in a strong fire then reduce my hot plate setting to No.2 and let it boil for another hour. It's alright to boil it slightly longer as the broth will be darker.
Actually, besides relieving gout pains, black beans have lots of other benefits to our health. Try it and you will be amazed how fast it works. Within hours my gout pains disappeared!!!
Go to the NET to find more information about the “efficacy of black beans” and “anthocyanins” which abounds in its skin or hull.
It is common for gout to affect the whole foot and ankle in this way.
try to keep the foot warm, but not tightly bound – i.e. 2 pairs of loose fitting socks with velcro-fastening shoes are a good idea. Impress your wife / partner with bed socks.
Drink plenty of water to encourage excretion of uric acid, and to avoid dehydration.
There are many pain relief options. I personally find ibuprofen best for me, though other people have similar reactions to yours with indometacin. I'm sure a certain zip2play of this parish will be along soon to extol the virtues of colchicine.
What you really need to push with your doctor is the need to lower uric acid. Most doctors wait far too long before considering this. It seems to be in the feint hope that gout will go away from lifestyle changes. This rarely happens, but even if it does, you still need regular uric acid testing to make sure it is truly under control. Failure to do this is a surefire way to have a few years of uric acid crystal buildup with the inevitable prolonged, frequent, gout flares and accompanying crippling bone erosion.
Gout flares happen when your immune system senses uric acid crystals in your body and attacks them like a virus. Unlike a virus, you cannot kill a uric acid crystal, but once your white blood cells have coated the crystal, it no longer triggers the immune response, and so the gout attack fades. For more information, see Uric Acid Crystal Meets White Blood Cell – And The Winner Is …..
When you take allopurinol (or reduce uric acid by other means), uric acid crystals start to dissolve, and the protein coating from your white blood cells falls away. This can lead to renewed gout flares, as the crystals are exposed to the immune system (unless they dissolve immediately). For more information see Why It Hurts To Get Rid Of Gout.
Anticipating the risk of gout flares when allopurinol is started, many doctors prescribe colchicine at the same time as a preventative (often described as prophylactic) dose. The colchicine itself has no effect on lowering uric acid, and so some gout patients decide to only take it (or some other pain relief) if and when they have an attack.
If in doubt, it is always best to discuss your choices with your doctor. The most important thing is to get the right dose of allopurinol to lower your uric acid level below 6mg/dL. To be sure this is happening, you must have frequent uric acid tests. This monitoring process is often overlooked which can lead to inappropriate allopurinol dose. If this happens it can prolong the period of time you remain at risk of gout flares.
Please keep returning and let us know how your uric acid levels are going and how you are coping with the treatment. In the UK, doctors often use a different scale of μmol (AKA umol or mewmol). It's OK to quote these values. To convert uric acid in mg/dL to μmol/L, multiply by 59.48.
Excellent news
I really think you should insist on regular uric acid tests.
Without them, there is no way to tell if you have really got the gout under control.
GoutPal said:
Good Luck, Rowland.
I'm particularly interested in the aftercare you receive – frequency of checkups, uric acid test results etc.
Has your doctor suggested what to do if you get a gout attack whilst you are taking allopurinol?
I look forward to your reports
Hi
Just thought I would let you know how I have got on.
Good news: I have not had a gout attack since taking allopurinal despite being warned that I may get one immediatly after starting the medication. I have had one or two twinges but I took a couple of indometacin and it seemed to do the trick.
I did not regulate my diet at all – especially over Christmas – sort of as an experiment but I have moved back to a more gout friendly lifestle now!
Not so good news: Follow up from my GP has been very limited. He asked me how I have got on when I saw him recently but that is all. My repeat presciption expires in two years and unless I go to him he does not plan to see me before that.
Best Regards
Rowland
Carlos said:
I am wondering if I am just getting over a gout attack on my achilles. I have had gout attacks on the big toe and ankle, but it had been a few years. My ankle was swollen and my achilles was so tight that I didn't have good range of motion. I couldn't bend my knee forward because it was so tight. I told my doctor I didn't have any tauma to my foot, but my ankle and achilles were hurting. I do sports, so after an MRI and visits with a podiatrist and PT they just said it was a tight achilles and gave me exercises. WHat happened was my achilles suddenly felt fine after my toe on my other foot started hurting (it was weird). So I have an appointment with my doc next week to discuss.
I am going through the same thing–intense pain and tightness at the base of my achilles and around the sides of my ankle bone–what did your doctor say?
There is no doubt that us poor gout sufferers are not immune from the ravages of time.
Indeed, there is strong evidence to suggest that prolonged uric acid crystal buildup can lead to joint damage.
As far as I know, only xrays, and more recently, ultrasound scans, can reveal the extent to which pain is caused by joint damage.
It sounds from your description, that not all uric acid crystals have dissolved from your body yet, though I am surprised after over 10 years.
Don't really know what else to say, except that I'm glad you can manage to exercise regularly – mobility is such a precious thing, and easy to lose for gout sufferers.
Perhaps a thorough joint checkup is in order to ensure that the exercises you do are not contributing to joint damage.
No, No, No!
Don't stop taking allopurinol once you start taking it.
Whilst it is true that doctors usually advise waiting until an attack has subsided before first starting allopurinol, once you start taking it, you must continue.
The great thing about allopurinol is that it is excellent at lowering uric acid. This means that, if your dosage is correct, uric acid crystals that have been building up in your body will dissolve.
Unfortunately, this can cause a temporary gout attack until all the crystals have dissolved. But you must keep taking the allopurinol, or else you will stop the dissolving process and end up back where you started.
If the pain gets too much, even with the diclofenac, a local doctor may be able to give you a corticosteroid injection to ease the pain for the few days it will last.
For more information see Allopurinol Medication: Why It Hurts To Get Rid Of Gout.
