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Estrogen as gout treatment ?

I was diagnosed with gout Sept/07 I had a cross country flight. Previously I have had bloodwork that showed that I had high uric acid levels but I never had an "attack" so I was told that it was normal for me and not to worry. About a day after I arrived on the east coast I woke up with a horrible pain and I could barely move. My big toe joint was very swollen. I couldnt even have a sheet on it to cover it I was in so much pain. I went to the ER and was diagnosed with gout. Now I was 26 years old at the time and I am a female and I don't typically eat foods that cause gout. I was also only about 20 pounds overweight at the time. The doctor seemed puzzled. My uric acid level was around 13. I also do not have a family history of gout.

My attacks seem to be somewhat atypical. I will get the primary attack which will last an abnormally long amount of time, usually around 2 weeks even with colchicine, indomethacin and various other treatments that dont seem to work at all for me. Then it sort of subsides into this chronic throbbing pain with a little swelling and it can be like that for around 12-16 weeks and then its settled down and I am fine. During the chronic stage I cannot wear socks or shoes because that is still too painful, I can only limp or walk using the side of my foot, and I cannot bend my big toe back (to stand on my toes) or put any weight on the ball of my foot.

I have tried every treatment I could find from gallons of cherry juice concentrate (the stuff is disgusting) to eating nothing but cherries for days. All fruit fasts, strawberries, avocados, bananas, baking soda, cayenne pepper tinctures, various soaks and rubs and balms, elevating my foot for days at a time, massage, reflexology, accupuncture, getting more exercise and blood flow. I also tried the traditional nsaid meds and allopurinol which makes things worse every time I take it.

Now I am a 28 year old female and I absolutely hate this and its crippling my life. I can't wear shoes or go out for months and have to live like a freak because I have this gout and can't figure out why and nothing helps to either take away the pain or dissolve the uric acid. Also, I don't drink or smoke, get regular exercise, follow a healthy diet, don't have any caffeine (once in a blue moon I might have a diet coke but not regularly and nothing at all during an attack). I initially thought that this was due to me walking around in tight stiletto boots all day and the plane ride after the first attack but after reading a bit more, I am wondering if it could be due to low estrogen levels?

I have always had some hormonal issues. I have hypothyroidism and pcos. My estrogen is lower than it should be and my testosterone higher than it should be. I am not on birth control or anything that would raise my estrogen levels but from my understanding if women get gout, which is unusual to begin with, usually they are postmenopausal. If I understand things correctly, estrogen helps excrete uric acid. So if I were go go on birth control and/or progesterone to balance out my low estrogen, could it help protect me against future gout attacks and more importantly, help get rid of the one I have had since the end of Feb! It is spring and I want to go out and enjoy myself and I still can't wear shoes!!!

Has anyone ever tried anything like this?
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First Helper JYY2

replied April 20th, 2010
Insulin resistance and gout
Insulin resistance is connected with gout. Insulin stops the body excreting uric acid. What does your diet precisely consist off? Do you eat peanuts or corn?
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replied April 24th, 2010
Experienced User
PCOS, Hypothyroidism, Hyperuricemia and Gout
Hi barefootinpain,

Very sorry you are in pain.

The blood urate (commonly called "uric acid") level of the women in reproductive age is only about 1 mg/dL lower than that of the ones in post-reproductive age. Therefore, the estrogen therapy you mentioned may reduce your blood urate level only by 1 mg/dL which is too little to keep gout away. To be free of gout attacks, gouties need to keep their blood urate level at 5~6 mg/dL or lower.

PCOS can cause weight gain, insulin resistance and type 2 diabetes. Theses conditions, as well as hypothyroidism, can cause hyperuricemia (high level of the blood urate level) and gout. So to cure your gout you need to keep PCOS, hypothyroidism, weight, and hyperuricemia under control.

Hyperuricemia, especially in gouties, can cause kidney stones, and is associated with metabolic syndrome. I strongly suggest that you find a good rheumatologist to take care of your hyperuricemia and gout. In the meantime I have the following FYI.

1) The key to the effective treatment of gout attacks is to take the effective dose of colchicine, Indomethacin, etc. at the first sign of gout attacks. Otherwise, the size of the inflammation and the pain will increase exponentially thus the gout attacks become much more difficult to treat and will last much longer. You have the lingering pain and the swelling still because the attack has not been treated with right kind of medicine at the right dosage, or there are some causes that kept triggering the gout. The possible triggers in this case could be: premature use of the afflicted joints, wearing tight shoes, drinking too much or too little water, eating gout triggering foods and drinks...

2) Watch out for possible kidney stone formation. Drink sufficient water to produce about 2 quarts of urine a day, or take enough water until the color of the urine is light yellow. Also keep the urine pH above 6. Urine alkalizers include baking soda (if you have no problem taking extra sodium), potassium citrate, etc. Talk to your doctor about it.

3) Good gout diet is elusive and has to be found by gouties themselves through experiments. Fresh cherries are good; processed cherry products could be questionable. Not all animal products are bad. If you use them, start with one kind in small amount to test if it is safe for you first. Not all fruits and vegetables are good, e.g., spinach, broccoli, avocados, bananas, peppers, strawberries, tomatoes, whole grain wheat, beans, nuts, etc. can trigger gout attacks in many gouties. If possible, prepare the meals by yourself. Commercially prepared foods contain additives -- many of them are gout triggers.

4) If you are trying to lose weight, lose no more than 1/2 pound per week. Otherwise, it may trigger your gout.

5) Exercise is good. But overdoing it can trigger gout attacks. Avoid being thirsty and over-heated. Also wear loose and comfortable shoes

6) When allopurinol, probenecid, sulphinpyrazone, etc., are initiated to lower the blood urate level, they can trigger gout attacks in the initial stage. So you need to take low-dose colchicine or NSAIDs with them as prophylactic therapy for the first few months to prevent or minimize the level of gout attacks.

7) Gout is painful and debilitating. But you need to cheer up yourself because depression is another gout trigger.

Take care.
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