Jyy2,
i am currently experiencing my first prolonged bout of gout (8th day), and obviously looking at ways to manage it. I am interested in your views regarding the effect of eating foods with low ph. I have looked at your site at http://www.Icuredmygout.Org/ and the ph levels of foods at http://vm.Cfsan.Fda.Gov/~comm/lacf-phs.H tml.

You have mentioned tomatoes (ph 4~5) and cucumbers (ph 5.12 - 5.78) as possible triggers for gout due to their acidity.

However, on looking at the list at http://vm.Cfsan.Fda.Gov/~comm/lacf-phs.H tml, there do not appear to be many foods that have ph > 6 and of those a lot of them appear to be either high or medium purine foods. Which doesn't leave much to eat!

What ph level foods would you consider to be reasonably "safe" during a gout attack and to avoid an attack. If it is not as simple as this, what other factors need to be considered in putting together a gout-friendly diet.

Thanks.

I am very sorry you are having a gout attack. "emergency gout treatments" section in http://www.Icuredmygout.Org describes what to do in such situation. Based on the 86 responses to my survey, 51% said baking soda in water is "extremely useful", 17% "very useful", and 15% "useful" in treating gout. Also, based on the limited number of people who wrote me, baking soda seems to work the best when it is taken with nsaids or colchicine. Check with your doctor before trying baking soda as it may not be appropriate for you.

Gout can be triggered by sudden increase or decrease of the blood uric acid (ua) level. It can also be triggered by lowering of the joint fluid ph as the results of the lowering of the blood ph, injuries to joints, flares of other types of arthritis, etc. It is very common that when allopurinol or benemid is initiated, it rapidly lowers the blood ua level to cause the imbalance of the ua levels between the blood and the joint fluid which causes the shedding of the urate (msu) crystal coatings and triggers gout attacks. It has been reported that gout attacks also occurred after having big purine-rich meals -- presumably causing sudden increase of the blood ua level and triggers gout attacks. People also reported to have gout attacks after eating too many (low ph) tomatoes, cranberries, etc.

Most of the foods and drink are acidic. We maintain the blood ph at 7.4 by excreting acid substances by our lungs and the kidneys. While the rate of excretion is rather stable over time, the rate of the lowering of the blood ph caused by the consumption of foods and drinks is not. Therefore, it may be ok to eat certain number of tomatoes throughout the day; whereas, it may not be ok if the tomatoes are eaten altogether only in one occasion in the day. The main idea is: consume less low ph foods and drink, and avoid eating and drink them only in a few occasions during the day. Use of alkalizer, including baking soda in water, helps raise the body ph.

Modern medical and dietary advice no longer insist on strict low purine diet for gout patients because it can lower the blood ua level by 1 mg/dl whereas the ua lowering drugs can do it by 2-3 mg/dl. Besides, the strict low purine diet often causes mental stress to patients; and, mental stress itself is a gout trigger.

As to what to eat and drink during gout attacks, the main idea is: to keep purine intake constant to avoid fluctuation of the blood ua level, and to raise the body ph. That means: keep your regular meals, drink 2-3 litres (quarts) of alkaline (ph>7) water a day, avoid alcohol, acidic foods and drinks, drink baking soda in water (if it's appropriate), etc. Dark colored cherries and berries contain anthocyanines which is anti-inflammatory and can soothe the gout. You have to eat about 30-40 fresh cherries or equivalent amount of dark colored berries or their juices every 2-4 hours. You may like to go over section 3 of http://www.Icuredmygout.Org to see if anything mentioned there can help.

P.S. Many medicines do not list gout as a side effect, but they can trigger and prolong gout attacks. For example, lipitor does not include gout as its side effect but it does include generalized swelling, and pain and inflammation in joints -- the conditions that can trigger and prolong gout attacks. If you have changed your medication lately, you may like to examine their side effects and take appropriate actions if necessary.

Hope your gout attack will be over soon. Take care.

Thank you for all the info. As with your site they are very informative.

You suggest to avoid acidic food during gout attacks. But as you also mention, most foods are acidic. On looking at the list at http://vm.Cfsan.Fda.Gov/~comm/lacf-phs.H tml, there do not appear to be many foods that have ph > 6 (very few above 7) and of the highish ph ones a lot of them appear to be either high or medium purine foods. Which doesn't leave much to eat at all!

What ph level foods would you consider to be reasonably "safe" during a gout attack, eg foods with ph > 6 or ph > 6.5? Does it depend on the tolerance of each person? Does your experience suggest any rule of thumb: eg avoid foods ph < 5 (except cherries!); limit foods with ph between 5 and 6?

Thanks again.

You can start with foods and drinks that have ph>6.5. If there aren't enough to eat and drink, you can then move down to >6, then >5.5, ... The main idea is: the higher the ph the better, and to have smaller portions of foods and drinks that have lower ph. Dark colored cherries and berries have anthocyanins which is anti-inflammatory and can soothe the gout. But their ph's are rather low. I wonder if we can increase the efficacy of their juices by mixing baking soda in them to raise their ph.

During the gout attack it is more important to keep the blood uric acid (ua) level stable than to lower it, because sudden lowering of the blood ua level can worsen and prolong gout attack. Therefore, even if your regular diet is high in purines it is better to stay with it than to change it to low purine diet suddenly. You can change to low purine diet gradually after the gout attack is over.

Just a comment on the power of baking soda to increase ph. Baking soda is a powerful agent to increase ph in the body. Not only for humans but also horses. For the last 2 decades baking soda has been used by horse trainers to greatly increase the performance of race horses in sprint and middle distance races, by administering baking soda as a drench prior to racing. This increases the alkalinity (ph) in the body and thus the negative effects of the lactic acid produced in high intensity racing is greatly reduced by the alkalinity and the horses run faster. The issue of trainers using baking soda milkshakes became so large in australia that all horses are now tested after winning for alkalinty levels and very severe penalties are given for "baking soda milkshakes"

Thanks for the very interesting info. By the way, can horses have gout too?

According to my former rheumatologist, humans are the only mammals that get gout. All others have a natural enzyme in their blood that breaks down the uric acid. Birds can get gout, so they are sometimes used for laboratory experiments about the disease because mice, being mammals, don't get it. There is even one published study showing that high levels of sodium bicarbonate (baking soda) can induce gout attacks in broiler hens. I can only guess that the study was undertaken because sodium bicarbonate is often added to their feed.

It is incorrect that "humans are the only mammals that get gout". The mammals that get gout include: swine, cattle, chimpanzees, gorillas, dalmatian dogs, ....

Thanks one and all for the help! I have had gout for many years and control it only with natural and advil& tylonol at times in the past I have had steroid shots and all the other related medicine. The breathing thing is what gathered my intrest. I like swiming and when I am, I am breathing stronger. I cant remember having gout during those times. Hence I will practice breathing more regularly during the day and at stressed moments when my breath unconciously go to rabbit pace (short shallow strokes). Also I love cherry tomatos and two days ago I ate a whole plant worth mmmm good, Yeah I'm really paying for that stunt. Thanks to youall my recovery time will be shortened, and I am very thankfull to you compasionate friends
Don

I had my first episode with gout this time last year. I was in denial at first. I thought gout was for old overweight people, not me. I am 53 and in pretty good health, except for my back. It is mid July and my garden is in. I love fresh tomatoes. I usually don't buy them, but rather wait until I grow them to eat many. I love fried green tomatoes, baked green tomatoes, tomato sandwiches, and tomatoes as a side for all meals.
This time last year I had what seemed like a pulled muscle on top of my left foot. It came on very suddenly, overnight. It lasted about 4 days. I asked everyone I could about it, but no help. About 3 weeks later I had a similar attack on top of my right foot. It lasted 2 weeks, and much pain. I made an appointment with a DR. but the attack had subsided by the time I got to see the DR. He suggested gout, but I didn't believe him.
I haven't had an attack for a year now, until this week. Over the weekend the joints in my left hand were sore. Monday my right foot started to be sore in the ankle joint. Tuesday morning I couldn't walk. I got back on the computer and started researching again. I started tracing my eating habits, and came up with the tomato idea. I found this site, and similar sites that suggest it was possibly from tomatoes. My last tomato was on Monday. My foot is MUCH better on Wednesday morning. I can even walk on it today straight out of bed (Wednesday). I expected to be down for a few weeks, but I do believe that I have found the problem. I still think that I can have an occasional tomato in moderation. I also believe that my overindulgence caused my attacks.

Your overindulgence in tomatoes may be a contributing factor, but if your gout attacks come on while you are asleep, the principal cause is probably sleep apnea. Your gout attacks are a warning of sleep apnea. Get checked out for it, and follow the recommended therapy to overcome it. You will greatly reduce your risk for developing many serious diseases, and you will also cure your gout so that you can indulge in eating tomatoes to your heart's content.