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bigdiesel717 11-15-2012 08:11 AM

Gout
 
So I've had gout for a few months now and a few days ago my big toes started to get achy and stiff. Well I started to take indomethacin and it didn't work. So I went to the doctor and he gave my naprosyn and it hasn't really worked either. Now I'm lost. Any help would be appreciated.

mc7 11-15-2012 03:26 PM

Re: Gout
 
As your doctor probably told you, gout can be from excess of a few things. Uric acid (a common protein breakdown product) is the big well-known culprit, but calcium plays an important role too. Could your protein or amino acid intake be too high? Or could your calcium intake be too high? Could your kidney function be low for any other reason? Is your potassium intake low? Too much sugar?

Gout is basically a sign that your kidneys are not filtering well enough to process your diet (at the rate that you eat it). Drinking more water may help especially drinking water apart from meals. Eating slower and smaller meals may help.

Potassium citrate is the potassium buffered salt of citric acid. It's very common naturally as a significant component of pretty much every juice. You might find potassium citrate helps. It actually stimulates and supports kidney function. It helps the kidneys clear more uric acid and calcium from the blood. Citrus juices are good food sources of potassium citrate--especially low sugar lemon & lime juices. (And you probably want to avoid calcium fortified juices.)

Bear in mind that excess potassium citrate will deplete other minerals, so you definitely don't want to overdo it. (Overdoing it can cause porous, brittle bones, teeth and fingernails. Also note that it shouldn't be taken (if taking pure potassium citrate) with food as it hinders digestion (like all minerals).)

Also remember, I'm no expert. I just learned all this from talking to my friend about her gout. (In her case it was also associated with some sort of (until then unnoticed) yeast/fungal infection too, so that possibility might be something to consider as well.)

bigdiesel717 11-16-2012 02:38 PM

Re: Gout
 
Hey, thanks for the reply. Well one thing I noticed is that the orange juice I drink is calcium fortified. I mainly drink water but if there are times where water just won't work for dinner and instead of grabbing a pop I'll have orange juice. Information about gout is pretty scarce really. I mean you can get the basics online but nothing further. I guess it's because only 2 million people in the U.S have it. When you get a chance could you ask your friend a quick question for me? I need to know if I should skip eating things like chicken totally while trying to get rid of an attack. I had a salad last night with a little bit of chicken and my big toes are still achy and that is with taking the anti-inflammatory. I sure hope this gets easier with weight loss. It's hard to eat meals without meat. I know that sounds ridiculous but I'm talking about chicken. The last time I lost a bunch of weight I ate a lot of chicken salads, chicken subs from Subway, and grilled chicken/rice/broccoli. Well thanks for any help.

mc7 11-17-2012 10:44 AM

Re: Gout
 
There are things that are harder for the kidneys to remove: sugar, inorganic phosphates/phosphoric acid (very high in pop/soda, processed food, soft cheese, sour cream & other dairy), calcium, starch and protein breakdown byproducts. The uric acid itself is from protein (and nucleic acid), but the problem of it accumulating excessively is because diet is depressing kidney function too much from the other foods you eat.

Eat more vegetables and low sugar fruits. I would replace sugar with stevia, a calorie-free sweetener (that can help with weight loss too). Fresh squeezed lemon juice is probably the best thing you can take to kick in better kidney function. You can use it in food you prepare (like as salad dressing). Or dilute it in water if you want with some stevia for an especially gout-healthy lemonade.

Orange juice is often said to be bad for gout because of the high purine content and sugar (though the potassium and citric acid of it are helpful). Definitely don't drink one with added calcium. And I would say yes, during an attack, you must avoid all animal and dairy protein completely (and seafood).

bigdiesel717 11-17-2012 06:45 PM

Re: Gout
 
Thank you. This is pretty rough. I wish I had a time machine to go back to March of last year when I was rolling great on my diet and exercise regimen. I was gout free. Ha

writeleft 11-17-2012 08:16 PM

Re: Gout
 
I am prone to gout due to end stage kidney failure. Uric acid is a medication I need for other issues, and it leads to gout in me. To counteract gout once it has started I use allopurinol daily. You might ask your doctor while you sort out what your cause is. Gout is so painful, prevention is the best course.

bigdiesel717 11-18-2012 09:29 PM

Re: Gout
 
I contracted gout because I'm obese and my kidneys don't work as well as they should. So what do you eat?

bigdiesel717 11-26-2012 09:31 PM

Re: Gout
 
So I went to the doctor and she gave me prednisone (spelling?). I've been taking it since Friday and I figured by now my feet would be feeling great. My big toes are still achy and I haven't been eating that many foods with high purines. I read somewhere that a fast drop in weight can cause an attack. I'm not sure why it can but I have been losing weight pretty quick since I've been on this diet.

mc7 12-04-2012 09:13 PM

Re: Gout
 
Apparently my friend with gout started taking calcium citrate (rather than the potassium citrate I thought would be ideal) and she looks and feels great. She lost all the puffiness that had accompanied the gout.

So I guess it's worth repeating, calcium is NOT bad for gout. It's only bad for gout IF it's interfering with kidney function because there's too much of it.

Oh and it's wonderful it's relieving, but be careful about taking prednisone for too long. I've seen it seem to make people go bonkers after a while.

migrainelady 12-05-2012 04:47 AM

Re: Gout
 
[QUOTE=mc7;5099443]Apparently my friend with gout started taking calcium citrate (rather than the potassium citrate I thought would be ideal) and she looks and feels great. She lost all the puffiness that had accompanied the gout. [COLOR="Magenta"]I have had gout and in runs in my family. I researched it and it is caused from too much uric acid building up in the affected joint capsule. There are medications for it that are rather unpleasant, but if you can study the foods NOT to eat that are high in purine. Purine increases uric acid. Prednisone is a sometimes necessary, but pretty nasty drug; one to be avoided if possible. Good luck to you and your friend.[/COLOR]

So I guess it's worth repeating, calcium is NOT bad for gout. It's only bad for gout IF it's interfering with kidney function because there's too much of it.

Oh and it's wonderful it's relieving, but be careful about taking prednisone for too long. I've seen it seem to make people go bonkers after a while.[/QUOTE]

mc7 12-05-2012 08:09 AM

Re: Gout
 
I totally agree, migrainelady, it's much better if you can control it with diet and not have to use drugs unless necessary. And yeah, the biggest thing is avoiding high purine foods like seafood, meat, yeast, mushrooms, asparagus and alcohol. And drink lots of water.

About calcium, I was referring to the fact that if the kidneys were functioning at 100% you couldn't get gout because the uric acid would be removed before accumulating to high levels. Because the kidneys are what removes uric acid from the blood, other things that depress kidney function can act as facilitators of developing gout (while uric acid remains the ultimate causal factor).

At first I had thought maybe the calcium fortified juice wouldn't be as good as unfortified because it's more work for the kidneys, but apparently calcium citrate actually really helped my friend, so probably the calcium juice wouldn't hurt unless calcium levels were already too high (like from chronically high calcium and/or vitamin D consumption). Calcium is good for weight loss too.

Potassium citrate helps by increasing kidney function while simultaneously protecting the kidneys from being damaged by the acidity they're working with. That's why it's taken it for polycystic kidney disease.

People seem to say apple cider vinegar helps too. Some people say cranberry can help. A number of people say digestive enzymes help.

You asked about what people eat, bigdiesel717. Apparently people with gout like nuts and dairy for protein. And it helps to eat more vegetables.

teteri66 12-05-2012 09:04 AM

Re: Gout
 
I hate to throw a wrench into this dialog but I just wanted to add that the dietary component of gout is currently thought to not make much difference.

Rheumatologists coming out of training now will tell you that it doesn't make a big difference in what you eat. Patients are now being counseled that foods high in purines might make a small difference, but are not the cause of gout and eliminating them from the diet will not keep the person from having an attack of gout if the person is predisposed to it.

bigdiesel717 12-23-2012 09:15 PM

Re: Gout
 
So I woke up this morning with a "gout-like" pain in my left foot and took a few indomethacin but the pain is still there. I'm assuming this means it's not gout but is there any reason an anti-inflammatory wouldn't work?

bigdiesel717 01-24-2013 09:17 PM

Re: Gout
 
Question. I'm not urinating that much but I do take two 80 mg lasiks a day. Will the lasiks help remove the uric acid?

mc7 01-25-2013 09:32 PM

Re: Gout
 
[QUOTE=bigdiesel717;5122627]Question. I'm not urinating that much but I do take two 80 mg lasiks a day. Will the lasiks help remove the uric acid?[/QUOTE]

First of all, you know that it could be extremely dangerous for your kidneys to be taking a high dose of a strong diuretic regularly and not be urinating regularly? Do you ever have kidney pain?

Also I don't know much about it, this is the first I read about it, but googling turned up medical papers that said Lasix REDUCES uric acid excretion by 40-50% (in HEALTHY animals/people). So it seems like you should talk to your doctor about this. Lasix seems like an exceptionally bad drug to take for gout.

Instead of a diuretic, I might ask my doctor about taking Polycitra (prescription potassium & other citrates). It is commonly prescribed for kidney failure, marginal kidney function, PKD and many other kidney problems. It is also diuretic, but it actually improves kidney function instead of just pushing the kidneys really hard like other diuretics do.


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