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Gout in Ankle for a long time

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March 9th, 2012
Hi Forum,

I am getting gout more and more and i wonder if anyone has any ideas:

I'm 37
5'10"
13.5 Stone/85Kg
Dont drink much
Dont smoke
exercise regularly [or did before Gout]
Eat fresh, cook fresh
Drink plenty of fluids, black coffee once a day
Not overly stressed although do work long hours
My diet is very low in salt and sugar, hardly any bad sugars such as fructose, and dont drink carbonated drinks at all.

I have had Gout in my ankle for 3 months on and off. When its off it hasnt been for long which is why i say 3 months. I dont appear to do anything that is a classic cause of Gout so i am perplexed as to why this happens. Its about the 5th or 6th time I've had gout. Oddly my Gout gets less painful each time but longer. I put the less pain down to understanding what it is and being able to look at what i have done, eaten, and get the right tablets.

so far, from information and forums;

I'm avoiding drinking too much alcohol, which i didnt anyway.
Avoiding asparagus and Spinach
Game meat, again, which i didnt eat anyway
Completely stopped eating shellfish after the first attack.

I have started to try Apple Cider Vinegar and thought this was a cure but the Gout suddenly disappeared from one ankle and 3 days later appeared in the other.

I'm trying desperately to identify what i'm doing differently and wouldnt mind if anyone had the time to comment on this points:

Ive noticed that different shoes cause me problems. I have flat trainers and the gout always appears when wearing them. Changed trainers to a more firmer cushioned pair and the Gout went.

Im not stressed but work long hours. Could that class my body as stressed?

I've given up traveling by train and drive, can that cause Gout? sat in one position for a long time? normally 2 hours each time.

People talk about ACV and honey. What amounts are people taking/recommending?
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painfree
replied March 11th, 2012
Experienced User
andihawes - Do your gout attacks begin during sleep, so that you first notice them when you awaken? If so, they are probably the result of your reduced oxygen intake caused by sleep apnea, which is the frequent cessation of breathing during sleep for many seconds at at time. If so, get checked out for sleep apnea, which if left untreated can lead to many conditions other than gout that are much more serious, even life threatening. The gout news is that if you follow the treatment to overcome the sleep apnea, you greatly reduce your risk for the development of those diseases, and you could also cure your gout. Gout is an early warning of sleep apnea!
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andihawes
replied March 12th, 2012
a lot are after sleep. Although this 'attack' (although not painful, just stiff ankle) has lasted a long time. Can this 'attack' be pronlonged by the same thing, Sleep Apnea?
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painfree
replied March 12th, 2012
Experienced User
Yes. A single attack, initiated by nascent urate crystals being formed in a joint, usually lasts for 7-10 days, until those crystals are sheathed so that their presence is no longer sensed by the immune system. But if nascent crystals are being formed more frequently than that, then the gout sensations will not subside.
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andihawes
replied March 12th, 2012
whats your expertise painfree? Are you qualified? or do you have experience in this field and sleep apnea?
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painfree
replied March 13th, 2012
Experienced User
My expertise began 8 1/2 years ago when I learned that I had sleep apnea, took steps to overcome it, and found that my frequent overnight gout attacks ceased immediately. To my amazement, none of the many doctors that I asked about why that would happen could explain it to me, except for one. He is a nephrologist who immediately hypothesized that the reduction in oxygen leads to increased acidity of the blood, so that uric acid is more likely to precipitate from its solution in the blood in the form of the monosodium urate crystals which cause gout. Since that time I have read very many medical journal articles about gout, uric acid, and sleep apnea. I found articles in pulmonology journals which confirm his hypothesis, plus two other effects of the oxygen reduction which cause excess generation of uric acid fed into the blood plus reduced kidney function so that the removal of uric acid from the blood is slowed. In short, my expertise is self-taught. A few gout practitioners are slowly beginning to catch on to the connection. Most are still in the dark. My own primary care physician has had all of his patients tested for sleep apnea, finding that a large majority of them were diagnosed with it, even when he had no other reason to suspect it.

The resolution of my sleep apnea not only caused the immediate cessation of my gout attacks, but it also more gradually led to the cessation of my atrial fibrillation heart arrhythmia and my diabetes. I post this information so that others may be spared from medical problems similar to mine. I was lucky that my medical problems turned out to be reversible. Others who are unaware of or ignore the gout warning of sleep apnea may not be so lucky.
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andihawes
replied March 13th, 2012
thank you pain free

i was reading another forum post on here with someone saying about this and you were saying to the poster that this could not be true. years later i see you added posts saying it was true. Did i read this correct?

and can i ask how old you are and where you live, which country?
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painfree
replied March 14th, 2012
Experienced User
andihawes - I don't think that I have ever reversed my position, but I need you to direct me to the specific posts to comment further.

I am in my sixties. I live in the US.
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andihawes
replied March 20th, 2012
My apologies, and i should have checked, but its someone posting against you in your forum post saying Sleep Apnea is not a cause, not yourself.

How do i test or how do i know if i have sleep apnea?
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painfree
replied March 20th, 2012
Experienced User
There are a number of telltale signs for sleep apnea, but none is definitive. Indicators are snoring, often feeling uncontrollably sleepy during waking hours, awakening from sleep with a headache, large neck circumference, frequent arousals from sleep to go to the bathroom. Perhaps the strongest indicator is a sleeping partner witnessing periods during your sleep when you stop breathing, and then often restarting with a loud snort. Definitive diagnosis is made by an overnight sleep study conducted under the auspices of a sleep physician, either in a sleep lab or by using portable equipment at home.
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andihawes
replied March 20th, 2012
While i'll never rule anything out, i dont have any symptons like that. Dont snore much, dont wake, dont toss and turn, dont get up in the night.

I am tired a lot but thats from having a small son, working away from home, and travelling long distances. So when i do get to bed I generally sleep well...
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