Primal and gout
So I've been doing the primal eating thing and losing weight since February. I've lost a significant amt. of weight fairly quickly. About three months ago I woke up one morning feeling like a hot poker was lodged in my foot. I tried to get up and found I could hardly bear weight at all.
I suffered all day and then all that night. The pain was so intense overnight that I would have gone to the ER if I thought there was any way in the world I could have gotten to the car. I tried everything I knew to try to make it better. I couldn't imagine what I had done to it. Ended up with x-rays, lyme screens, etc. etc. and the only thing that ever turned up was elevated uric acid.
So apparently I'm a rare case, I'm 35 and female and very few women develop gout prior to menopause. I know my hormones were totally jacked up prior to weight loss and changing my diet because I hadn't gotten a period in ages so that probably contributed to it. Also been on a mild diuretic for years which also elevates uric acid. I've been getting a regular period now for the last six months but the damage was done. I guess it was just building up and settling in the joints and the weight loss or switching my eating habits did something to activate the crystals.
The uric acid is coming down, it was at an all time high of 14 back in March and my last check about six weeks ago it was in the 7s. Ideally I need it to be under 6...that's supposedly when the uric acid crystal deposits in my joints will dissolve and hopefully the flares will stop.
In the meantime I'm on a noxious cocktail of meds to try to control the pain and flares as much as possible. Daily prednisone (I know in excruciating detail how horrible the drug is and exactly what it's doing to me...I hate taking it but I can't walk at all without it right now and I have to take huge dosages when I get a flare and then taper down to a smaller maintenance dose in between flares...) uloric and daily colchicine.
So I know that fasting, losing weight rapidly, starvation, etc. all can bring on gout flares. I just read in another thread a small study with starvation diets showed that a couple participants developed gout while on a water and vitamin fast.
What part do you think eating primally has played in this gout development? I wonder if I would have it if I had just cut calories? Esp since the gout I eat very, very moderately and not too much of any one thing. I just can't do the organ meats/sardines/shellfish because I'm terrified of provoking a gout attack. I work on my feet and live in fear of the pain. I have started limiting my meat to 4 oz a day. I don't drink any alcohol. I do eat 3 oz or so of fish a couple times a week. My first big attack was after eating a pork shoulder dish two nights in a row so now I'm scared to eat pork. Basically everything I eat is on the high purine food list. I already have cut so many things it's hard to start chipping away at what's left. Some of the most nutritious foods are foods I'm supposed to avoid. The organ meat and shellfish, spinach, leafy greens, mushrooms, asparagus. I know I could probably go to something like an 80 percent fat diet to avoid the purine sources but I really haven't been wanting to do that. I can't even imagine going back to eating grains and stuff like that regularly and have to find another solution.
I'm just super frustrated. When these flares happen I can't do my daily walks, work is a nightmare and it's very discouraging, not to mention the dismay I feel regarding the continued steroid use.
Alcohol and sugar (fructose) are prime candidates for gout flares.
An article for you: https://www.marksdailyapple.com/gout-primal-paleo-diet/
If you are prone to it I would consider supplementing C like it says in the end of Mark's article.
Last edited by Neckhammer; 12-30-2012 at 10:04 AM.
Dr Georgia Ede is someone I trust for sound advice:
Got Gout but Love Meat? » Diagnosis: Diet
This is her take on gout. She saying that it's not just about the level of purines in any given food but about some foods, especially sugar (fructose) and alcohol, interfering with the body's ability to process the purines.
Do you use any artificial sweeteners? Those can also cause huge problems if you have gout.
Also, are you on any blood pressure meds? Water pill type bp meds can cause gout problems.
I first experienced gout in 1999 when doing Atkins for the first time. I was royally pissed! I had recurring gout after quitting Atkins at the rate of 1-2 times per year. By about 2005, I was way into the Metabolic Syndrome...gained 50lbs, high bp, high trigs, fatty liver, pre-diabetic, hypothyroid. I was getting gout attacks every 6 weeks that left me bedridden for days. I was taking Colchisine with the directions: 'take 2 pills, then 1 every hour until you get diarrhea' Lovely. Made me want to die!
I lived like that from 2005-2010, finally saw the light. Lost nearly 100 pounds with Primal Blueprint. Off all meds. No gout since 2010.
I think in my case it was caused and exacerbated by heavy drinking and tons of high fructose corn syrup. Giving up those, and wheat, flour, grain, sugar, and seed oils made all the difference in the world.
Some people have a problem clearing Uric Acid. You may be one, but I'd bet your problems go away with adherence to Primal Blueprint or even better the Perfect Health Diet with lots of potatoes and starch. Perfect Health Diet - A diet for healing chronic disease, restoring youthful vitality, and achieving long life
I posted a study a couple weeks ago, but can't find now, about Uric Acid levels rising in ketogenic diets. If you are starting out the Primal Blueprint in ketosis, you may want to stop.
Good luck. Gout bites!
I have no alcohol at all and very, very little sugar in any form. I have frozen berries mixed in plain yogurt about twice a week, I do eat a wide variety of veggies, some high sugar (onions, peppers, tomatoes, etc.) but the amts. I eat don't convey any significant sugar into my diet.
Originally Posted by Neckhammer
I have begun keeping a detailed journal of exactly what I eat and how my feet feel the next day. So far I have found exactly nothing that has produced the same results twice.
Nope, I don't touch any artificial sweeteners at all.
Originally Posted by Vega
Yes, ten years of a mild diuretic certainly set the stage for my current predicament.
Originally Posted by otzi
I am waiting for my vastly improved eating habits and weight loss to help remedy the situation. It's hard to be patient when I've missed a lot of work. It's frustrating to have my health improved ten fold in so many other ways and then to be taken down with by the gout. I've lost almost 200 lbs now but I still have another 100+ to go. My BP is still too high; it is certainly my goal to get off all the meds I'm currently on.
I've also done that particular colchicine regimen and it is pure hell...I already can't walk and now I'm running to the bathroom constantly on what feels like a broken mangled foot and the worse part is I got no relief from the colchicine even after all that...the mass dose of prednisone had me walking normally within hours. The relief was enormous but the side effects are so terrible.
I am trying to tough this out. The rheumatologist seems to think I'll be okay in a few months but these flares are so torturous and I am so sick of being bedridden for days every couple weeks.
Muumuu i sympathise, you have it real bad.
I had gout last year and couldn't believe the pain. Think it was triggered by a rare glass of gin and tonic.
I am a 46 year old woman 5ft 7" and weighed approx 157lb.
I put it down to eating a lot of meat and not drinking enough water. I was also having berries which I stopped.
I have read that you are more susceptible to gout if you yoyo on and off a low carb diet.
I think that gout always starts with a broken liver. I would say your's is certainly impaired.
Originally Posted by MuuMuu
Congrats on 200lbs of weightloss! How did you do it?
For your next 100lbs, I would highly, highly suggest you buy a copy of Perfect Health Diet and follow it to a T. Pay SPECIAL attention to where it says eat close to a pound of potato or rice per day and eat quality seafood as your primary meat. Also, do all the stuff they say concerning supplements, bone broth, macro ratios, etc...
PHD is Primal Blueprint's twin brother. Mark Sisson even wrote the intro. You need to focus on 'anti-inflammatory' dieting. PHD is very anti-inflammatory. At this point, you could be severly sabotaging yourself with these items:
- Too little starch
- Not enough fish (Omega 3)
- Too much fat and protein
- Too few nutrients
I'm just guessing since I don't know what you eat, but you need a very strict diet that focuses on the anti-inflammatory markers.