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New gout sufferer..what do i do next?

Male 46 5"7 250 pounds. No family history of Gout AFAIK. I have been overweight a long time, and have not watched my diet. About 6 months ago i started feeling twinges in my big toe joint, and while it was annoying, it didnt really hurt and went away on its own. It come and goes but not very painful nor did it swell up.

However - Last week my ankle swelled up and hurt like hell. I thought it was sprained and i could not walk on it, but a quick trip to the podiatrist revealed Gout. Doc gave me a weeks worth of Colchrys and told me to take Sulindac until the inflamation went down. he also sent me for blood tests. A few days later - No pain, no swelling, foot is totally fine.

Results came today:
Uric Acid: 8.3
Glucose Serum: 105
Hemoglobin Alc: 6.0
C-reactive protein: 15.7
Cholesterol: 223
(Tri:194, LDL:146,HDL 46)

Not too good thumbsdwn

Im supposed to call the doctor to discuss these results and a treatment plan.

I have read lots of conflicting information on line about what foods i can eat - and even about how much what you eat even matters. I also know i have to diet to lose weight, which in the past consisted of lean chicken breast and salmon (with rice, vegies and fruits). The 2 diets seem to contradict each other. If i cant eat chicken or salmon...how can i lose weight? beans or no beans? its very confusing.
I cant imagine living on just fruits and vegies. The allowable cheeses, pastas and breads on the gout diet is not allowed on any weight loss diets.


Any Advice would be appreciated.
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replied July 4th, 2013
Let me tell you that first off, changing your diet is only a tiny part of gout. The MAJORITY of the time, you have high uric acid because your body either CANNOT get rid of enough of it, OR it makes too much. It has little to do with food, although it does have an affect.

What exactly did your Dr do to confirm gout? Did he just sit there and poke around on your foot? Did he even look/feel your foot? Even if he did, theres no way he could confirm gout with taking a sample from your joint and looking at it under a microscope to see the crystals.

What I would do is tell your Dr you want more tests done to CONFIRM gout, or the possibility of something else wrong. I went through 4 different diagnosis' before my rheumatologist ordered an MRI and saw I had a fractured foot! It started with gout too!

What I would do for the time being would be to take colchicine daily, and tell your Dr. you'd like to try allopurinol to decrease your uric acid levels.

Honestly, do not worry about anything diet related right now. If it actually IS gout, allopurinol will lower your uric acid just fine...mine went from 9.0 to 6.0 in a month taking allopurinol. Either way, tell your Dr you want a fluid test to confirm gout...

I went through a lot of lazy doctors before finding a rheumatologist that honestly cared about what was going on!!! She described to me in detail about everything that could be going on, and we went through the process of elimination for each one until we found a fracture.
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replied July 4th, 2013
Thanks for your reply!

The doctor diagnosed it by the fact that i had sudden pain which lasted only 2 days before completely dissappearing. He felt around the foot and took a history and was certain (he said he has seen this many times in his long career). The xrays were negetive. I feel confident that gout is the correct diagnosis. My uric acid has been high for many years. And im very overweight.
Since i wrote the post above, ive had a second attack last week. Exactly the same as the first, same spot same duration. Doctor told me to take colchrys for a week, and to have my primary care physician prescribe me uric acid lowering medication. The Dr, a podiatrist said he could get me through these acute attacks, but long term care should come from my PCP. Im not sure why the Podiatrist thought i wouldnt have another attack for a year.

I hate medication due to the side effects, but i have to lower my uric acid, and dieting (which i have yet to start) and watching purine intake probably wont be enough to do it.
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replied July 4th, 2013
Thanks for your reply!

The doctor diagnosed it by the fact that i had sudden pain which lasted only 2 days before completely dissappearing. He felt around the foot and took a history and was certain (he said he has seen this many times in his long career). The xrays were negetive. I feel confident that gout is the correct diagnosis. My uric acid has been high for many years. And im very overweight.
Since i wrote the post above, ive had a second attack last week. Exactly the same as the first, same spot same duration. Doctor told me to take colchrys for a week, and to have my primary care physician prescribe me uric acid lowering medication. The Dr, a podiatrist said he could get me through these acute attacks, but long term care should come from my PCP. Im not sure why the Podiatrist thought i wouldnt have another attack for a year.

I hate medication due to the side effects, but i have to lower my uric acid, and dieting (which i have yet to start) and watching purine intake probably wont be enough to do it.
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replied July 6th, 2013
Speecher, I had 2 doctors tell me they were confident it was in fact gout, until my rheumo ordered an MRI and found a fracture in my foot. I showed every sign of gout, just like you. Gout does not usually flare up back to back like yours is doing, which is why I'd recommend having your Dr. get either an MRI or blood test to see if you're HLA-B27 positive, which is a genetic marker that indicates arthritic auto-immune disease. Also, my x-ray did not show my fracture, only my MRI did. I had no side effects while taking allopurinol by the way, so don't worry so much.

I'm also overweight, and my uric acid level was 9.0 when I got mine tested. Not ALL people with high uric acid have gout, that is a known fact. Also, even people with low uric acid levels have gout attacks. Do yourself a favor and just worry about confirming gout by having that joint fluid tested before you do anything else. If the Colcrys doesn't help, or you got an attack while taking it - even more of a reason to get more tests done.

I'd also take .6 mg a day of Colcrys, that is what you will have to do while you're taking meds to lower your uric acid levels anyway....keep me updated!
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replied July 18th, 2013
Gouty arthritis caused by deposits of crystals in the joints can be managed best by using uric acid lowering drugs like Zyloprim.
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replied August 17th, 2014
Its been a year since my initial set of attacks listed above. I was not prescribed any medication. My rheumatologist felt that since i respond quickly to Colcrys, i should just wait and see if another attack occurs and take the Colcrys at FIRST sign of pain.

I was lucky. No problems all year. I also did not watch my diet in any way or form which pains me to write, since im desperate to lose weight.

This past week i went to 3 parties and ate myself silly. I had an attack last night in the same ankle as a year ago. I took Colcrys today (.6 twice). My ankle feels much better already. Dr. wants me to continue Colcrys for 3 months to make sure.

I have to decide if going forward i want to:

1) save the money and side effects and take NOTHING, like i did all of last year and take my chances.

2) Ask about ongoing meds to lower UA.
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