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Gout, a fluke for a healthy 30 year old who is not overweight?

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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?
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replied March 13th, 2012
any help? I see the post has been read quite a few times. thx.
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replied March 15th, 2012
Foot Fracture and Gout?
Gout30, your post was very interesting to me. I am 30 years old, in pretty good shape and just this week got diagnosed with Gout by my orthopedic doctor who I had been going to because of foot problems that he thinks is a stress fracture (still no answer there or why foot is giving me problems), but I went back b/c of horrible toe pain near where I was having problems. The doc said the two are not related and that it appears that I have Gout in addition to whatever foot injury I sustained. I have taken a 24hour urine analysis and awaiting the results for confirmation on Gout diagnosis, but I wonder if there is any connection between the foot fracture and the gout?? I also had somewhat of a disaster week in terms of purine intake before my "gout" flared up. I have never before had any symptoms of gout before. I will reply if I have any further updates. Good luck.
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replied March 15th, 2012
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replied March 15th, 2012
Thanks, Hadz.

The basic question we're asking is whether there are particular confluences of events - injury, poor diet, bad circulation, meds - that make an acute attack more of an anomaly rather than something that portends future problems. I don't even know if it's medically possible to say go from normal uric acid to > 9 from one bad month. if 90% of people who have a gout attack have a second one, 1:10 doesn't. Is there something about those 1:10? Or, do the individual circumstances not matter much because mathematically/medically it takes so long for uric acid to build that the course of events of the last month just accelerated the inevitable?
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replied March 20th, 2012
I had a fall with injury to my right ankle. By the way, my right foot is the part most affected by gout for last 6 years. And now I have gout near right ankle. So you see there seems to be some link between injury & gout as in your case. The underlying cause of course is uric acid level in blood. I think you should concentrate on taking medicine to lower this. Aspirin also seems to be another culprit (search web for aspirin & gout).

As far as eating, I just have this to say & I have been following this myself. Live to eat (not eat to live). Just take the right medicine & enjoy your life.
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replied March 20th, 2012
I am also a 30 something [37] that now cant seem to shake Gout. From the UK and like yourself would eat everything but in moderation, drank but not much. I now cant seem to shake off Gout.

I'm not fat, stressed, old or anything that traditionally goes with this condition but i am clueless as to why this has suddenly happened.

I am now watching everythign i do, that i intake, but still it doesnt seem to do anything, change anything. I dopnt eat read meats, game [never did anyway], avoid certain vegetables, dont drink in the week, but still it comes back.

I'm trying Apple Cider Vinegar as that is said to neutralize blood levels, milk for possible calcium deposits, Vitamin C, keep well hydrated, but still i cant shake it. I'm havent eaten shellfish, which i love, for years, just incase its a cause.

I have to live on what forums and the net informs me as the Doctor simply wants to give me more drugs and increase doses. I cant try Allupurinol because i cant shake the Gout to be clear from it to start taking it. I cant find anythign like a food allergy test to see what food ins me particularly raise acid levels in my blood.

Apologies, i didnt mean to make the post about me but i just wanted to list what i have tried so others may try or help or comment.

Im going to continue on with these things as most are good for you anyway and wont do any harm in the long run...

Let us know how you go Gout30
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replied May 16th, 2012
Update
So, Gout30 here with an update. 2 months later my uric acid is 5.5 - a pretty good improvement from the 9.2 after my attack (it was 6.8 a month ago). I've had no further attacks but have felt like I was coming close sometimes. I've taken colchricine twice a day, but no other meds.

For the first 2-3 weeks, I didn't drink any alcohol at all and was total vegetarian. Then, I introduced a bit of meat (usually chicken or fish) once a day. I'd have an occasional glass of wine but no beer for the whole two months. I ate red meat a handful of times (maybe six or eight) over the entire time. I did break down and drink a whole bottle of wine two or three times (including the night before my uric test - btw).

Knock on wood that it continues. Thought it would be worth sharing!
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replied May 16th, 2012
more info
oh, and I took cherry pills/juice, drank a ton of water, and exercised 4-5x a week (but I had that habit beforehand).

One thing I'm wondering is that my joint by the big toe still looks slightly red. I still have discomfort sometimes, though I've been running a bit. I don't know how much of it is psychosomatic vs. real. Does anyone know how long it takes for crystals to dissolve?

I thought I had some tingling from the colchricine, but ultimately after discussing w/ doctor turned out not to be.
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replied May 21st, 2013
you're asking questions that no one really knows the answers to. Sounds like what you did (with the pigging out) could give anybody an attack. There are many people who have one attack after drinking cheap beer and have no problems ever again. That might be you or it may not. Keeping your weight down and exercising is probably the best things one can do to avoid future attacks is my experience.
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replied April 30th, 2013
Gout
Hey guys, I have the same problem with gout, I have been living with it for about two years, I'm 32. Cherries and cherry juice does help to break up the gout crystals in your feet and provides some relief, but that is a lot of sugar. Gout is brought on by the lack of vitamin B-5 also known as Pantothenic acid. You'll find it at the store in a B multicomplex vitamin or just Pantothenic acid. You body uses magnesium in conjunction with vitamin B-5 to get rid of the uric acid in your body that creates gout. Taking just one of the B vitamins for a long period of time can throw your body out of wack with the other B's. it is better to take the B multicomplex, taking one magnesium vitamin will help the process. The B-5 dissolves the gout crystals really well, take care.

Day
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