Gout problems

[JohnL]

I have in the last six months or so had several acute gout attacks in my left big toe. I have been using non steroidal anti-inflammatory meds to relieve these attacks. I remember reading somewhere that the low carb diet should help with gout and since I've been lowcarbing for five years or so I am at a loss to explain why I am being afflicted at this time. I am sure I have seen something posted on gout by Dr. Mike but can't find the reference. Can anyone help with links and or advice on this problem.
Cheers; John

[Mitra]

I couldn't see anything in Dr Mike's blog, but in PPLP, there is a suggestion that people who suffer from gout would benefit from following the dilettante or purist approach, rather than hedonist (it's p344 in my paperback edition, in the section describing the dilettante approach).

There's also a Q&A on gout in Staying Power. (If you don't have a copy, you could use the "search inside" feature on Amazon, and search on "gout.") The gist of it is that most people with gout are either under-excreting uric acid from the kidneys, or over-producing it. On a high carb diet insulin levels are high, and uric acid is stored in the tissues. When carb levels, and hence insulin levels, are lowered, the uric acid is mobilised and can crystalise in the joints. They therefore suggest that if you suffer from gout it's a good idea to take some medication to prevent an attack as you start to reduce your carb levels, and to make sure you drink plenty of water, and supplement with magnesium.

Since you've been eating low carb for several years, presumably you're well past this stage, though they mention it's important not to go on and off-plan - I don't know if you've done that.

I hope you manage to find some answers, I know it's very painful.

[LisaS]

I'm wondering, are these your first gout attacks - or has it just "come back"? If it is your first time, are you certain it is in fact gout?

If it has come back after a hiatus, have you found your gout to be purine-sensitive in the past?

You might try the "what has changed in my protein sources" approach if so. did you start adding more seafood or cut dairy dramatically? Have you been binging on liver, sardines & asparagus :) ?

did you add or stop any other medications or OTC supplements during this time? Apparently diuretics, aspirin, nicotinamide (niacin) & others can all effect gout. Could you be letting yourself get too dehydrated?

so, you might want to ask "what has changed" in general, paying special attention to things known to influence gout.

As Mitra writes, gout symptoms can get worse when first low-carbing before they get better. Might you have recently "rededicated" yourself to lc and become more strict (relative to the previous year or so)?

On the other hand, could you have made changes that might have raised your insulin levels - gone off plan a little too much for a little too long?

[JohnL]

Thanks Mitra and Lisa for your rapid replies. That "search inside" facility on Amazon is a great feature Mitra. Thanks for pointing it out! I haven't made any changes to my diet in a long time. The meds I'm on at present are the only medications I have had in ten years so a change in meds isn't the cause. I don't currently take any supplements so maybe I should look in that direction. What is the mechanism involved with magnesium supplementation? Lisa I had an attack about the time I started lowcarbing. It cleared up quickly without meds and I put this down to the beneficial effects of the diet. I had blood tests done in December last year when the first of the new attacks occured and they indicated high uric acid levels. I've been working hard to keep up water intake etc. There is so much conflicting advice on the net and a few pay $47 type sites to download magic cures etc. (has anyone actually done this?). I'm reluctant to do this as I am sure it is probably just a scam anyhow. If these people had "magic" information it would surely be in the public domain by now.
Cheers; John

[Barker]

John,

You can ask your Dr for a prescription of Colchicine and take it on a regular basis for prevention of attacks or take it in heavier amounts at the beginning of an attack. I take .6mg daily to prevent attacks. Here's a site on it... but there are of course many sites you can find through google, etc.: http://www.theberries.ns.ca/Archives/colchicine.html

Bill

[LisaS]

I don't know if John is still reading the forums - but just in case - or if there are any others with gout or gout-y symptoms, Dr. Cordain's most recent newsletter talks about gout:
http://www.thepaleodiet.com/newsletter/newsletters/PDN_Vol2No4.pdf

[JohnL]

Thanks Lisa. I enjoy reading Cordains material so will go there now.
Cheers;
John