I just had my first gout attack. I'm in my early 30's, have a BMI < 24, work out > 3x /week (ran a marathon last year) and a healthy diet with little meat and moderate alcohol usage with the occasional overindulgence. Crystals weren't drawn, however, the rheumatologist confirmed my uric acid was high (9.2). I'm on a low purine diet and drinking water for 2 months and then will go back to the doctor. I think there is a convergence of events immediately prior to the attack that make me think this may be a fluke. I'm hoping to get some advice from the boards:
I did a full month cleanse with no red meat or alcohol (based on the book 'Clean' by Junger) to slim down for a vacation. While on vacation (where we ate and drank as we pleased) I fractured a small bone in my foot. Since the fracture, which occurred a month ago, I went to Europe twice for work. I took aspirin for pain and because my doctor recommended it to prevent blood clots due to the fracture. This was the first time I'd ever taken aspirin for as long as I can remember. A fracture, long flights and a walking boot can affect your circulation.
On the second trip while in the UK (British are 5:1 more likely to develop gout, I've read) we really over did it on the whole 'head to tail' cuisine thing. I decided to try all the foods I could since I don't go there often. It was the craziest eating week of my life, and of all real heavy nouveau British food that included lots of offal meats, game, shellfish, port and everything that is the worst for you in terms of purine levels. Every dinner had formal wine pairings. For example, After a 5 hour formal lunch with wine parings, I went to a happy hour where I had oyster ales and then went out with a group for Indian food the same night! At the end of the week on Friday, I was walking around and my big toe started hurting. I didn't think much of it since it was the same foot as my fracture.
Saturday, I woke up for brunch. I got there early, had a beer (hey, its the UK). I ate an English breakfast (Black pudding???), then had a few ales at the pub then a heavy seafood dinner. Saturday night I didn't sleep due to the pain. I took more aspirin and it didn't do anything! That was approximately a month after I fractured my foot.I had a swollen but not painful foot on the flight back; Sunday night was bad. I described my pain to the doctor who said it might be gout. After some internet search, I found out it would be good to quit taking the aspirin since it screws with uric acid.
So, my hope is that this is simply a 'perfect storm' of an injury to the same foot, poor circulation, a week of gluttony, taking aspirin for the first time, and the 7 lbs gained from the time of my injury. The story certainly seems plausible enough to put me in the small minority for whom this is a fluke. Any thoughts/suggestions?