4

votes

Tested positive for Gout, anything I should ask Doctor re: gout + paleo?

Answered on August 19, 2014
Created February 03, 2013 at 8:26 AM

Hi,

Last October I started paleo along with 3 nights a week doing a hard gym workout. A month into this I started getting these flare ups almost every other week that I now know to be Gout, but at the time thought was tendonitis or some such related to the gym workout. My blood work came back Friday as positive(my uric acid levels were over 9 and it should be under 6). I see my doctor Tuesday and I wanted to know if folks had advice on things I should talk to my doctor about on addressing gout and still doing paleo.

I have been having a bag of spinach a day along with mushrooms/chicken/venison/turkey which is obviously the reason I am in week 3 of this current flare up and it's shown no signs of going away.

I've seen the other posts regarding gout and plan to ask about the suggestions there but if there's anything else, I'd greatly appreciate it.

772baa4ca6dc1856a80448a4fa1f6674

on October 25, 2013
at 01:38 PM

My husband has had gout for years, and one of his worst triggers are mushrooms. If he even has the tiniest bite of a mushroom, he will have a flare up! Do not eat them!

2c3f71479664bd50ae5b28794e1b1a66

(20)

on October 24, 2013
at 08:23 PM

Docs have me on cholcrys and when i had flares were putting me on a steroid pack... loved that, pain became bearable within 20 minutes of starting the pack.

2c3f71479664bd50ae5b28794e1b1a66

(20)

on October 24, 2013
at 08:18 PM

Doc says my levels are still high and wants me on a different med. Company is in middle of changing medical providers so I havn't been able to fill it yet. Hoepfully I'll continue to remain flare free for as long as possible.

2c3f71479664bd50ae5b28794e1b1a66

(20)

on October 24, 2013
at 08:18 PM

I think in the last 5 months I have had near flares, where I feel a onset of discomfort, and I've learned to be quite attentive to that, second I do, I double check my water intake, take a cholcrys if I've been lax in taking it and up my intake of gout preventative foods like cherries etc. I've all but stopped eating spinach and mushrooms and taking asprin. I've had significant amounts of chicken, pork loin and bacon trying to find my trigger points but have yet to reach one so I feel safe eating chicken, pork loin and bacon on a regular basis.

2c3f71479664bd50ae5b28794e1b1a66

(20)

on October 24, 2013
at 08:18 PM

Thanks - a lil late but better than never 8) I've been relatively flare free for the last 4 or 5 months.

A lot of what your say seems to be true, as well as others regarding the diet itself. That flare in my hand that lasted a month that prompted diagnosis was so horrible and just wouldn't go away. Once I started feeling bad, I made a bit stock pot out of the ingredients mentioned and was having that. I was too miserable to really do anything else. I was taking tons of asprin and sleep aids to get some sleep.

Fdf101349c397fbe1ecb98b310fb3737

(358)

on February 12, 2013
at 06:32 AM

elduderino linked to the emotionsforengineers blog below. One thing is dehydration during and after hard workouts can lead to acute gout attacks. I have found that sometimes when I feel it coming on, I slam a LOT of water.

2c3f71479664bd50ae5b28794e1b1a66

(20)

on February 04, 2013
at 10:51 PM

I should also note that tendonitis was my self diagnosis, doctors never could tell me what was wrong and most times by the time I saw a doctor, the flare up was receding and I guess they never had the idea to check for gout.

B72e976b2df9e7f01315830062a5209c

(1365)

on February 04, 2013
at 10:40 PM

Dan, I disagree. Most times if you simply tell your doctor that you're opposed to certain treatments and would like to try a different avenue they're usually open to compromise. If you're not willing to take any advice or compromise from them, then you have no reason to be in their office in the first place. If they're not willing to listen to your concerns and beliefs, then you also have no reason to be in their office in the first place, but you don't have to be confrontational about it or even use the word Paleo. I just say that I eat a gluten-free whole food diet, and it goes over well.

B72e976b2df9e7f01315830062a5209c

(1365)

on February 04, 2013
at 10:27 PM

Yeah, i feel you. That's where the indocin has been a huge help. It's basically just a gout specific NSAID, and I've always tolerated NSAID's very well.

2c3f71479664bd50ae5b28794e1b1a66

(20)

on February 04, 2013
at 10:05 PM

I was trying to live out of my freezer during January as work stiffed me a $1000 expense check that I had already *spent* on xmas / new years / birthday. Spinach was the majority presence in my freezer given a stock up sale a few months back.

2c3f71479664bd50ae5b28794e1b1a66

(20)

on February 04, 2013
at 10:00 PM

toughed it out, sometime Sunday morning I had a handle on managing the pain with hot then cold pads and saw my doc first thing monday morning.

2c3f71479664bd50ae5b28794e1b1a66

(20)

on February 04, 2013
at 09:57 PM

Thanks - when I was actively hitting the gym I was keeping a really good diet log, I'll go back and review that, sadly, once I kept getting knocked out of the gym I let the logging fall of the grid. But it looks like now that I know what I'm eating is a factor, maintaining a diet log will help me pinpoint problem foods etc. I really wish i had the log leading up to the recent flare up, this flare had me sitting crying screaming wishing it would just stop... and of course started like this at 1am Saturday morning where an expensive emergency room visit would have done nothing for me.

2c3f71479664bd50ae5b28794e1b1a66

(20)

on February 04, 2013
at 02:59 PM

I also throw in some cabbage / fruits / other veggies during the day. But what I'm gathering is that the foods might not be the main issue I'm having, its the removal I've been having problems with. Thanks for your input folks, those were links I had not seen yet.

2c3f71479664bd50ae5b28794e1b1a66

(20)

on February 04, 2013
at 02:49 PM

From the onset of this program, I have cut out drinking, and followed a pretty rigid set of diet guidelines that I havn't deviated too much from... During the day I eat nuts and seeds, and recently been coming home, cooking up a meat and having the spinach. To be honest it wasn't every night but close too it, I was also having collards and turnip greens so it wasn't nonstop spinach. I do keep drinking 2 sugar free monsters a day.

2c3f71479664bd50ae5b28794e1b1a66

(20)

on February 04, 2013
at 02:42 PM

In the last 3 years, i have had it occur 3 times in my wrist with the current one being one the worst. Normally it is in my feet, occurring between the ankle and the toes, but never in the actual toe. Asprin/ibuprofen barely touch the pain, and the answer to it almost always is to walk it off, taking a sick day and not walking on it never fixes it. However putting a shoe on going to work, more often than not, will see vast improvements by mid afternoon. Except recently where the pain just wouldn't go away for weeks.

2c3f71479664bd50ae5b28794e1b1a66

(20)

on February 04, 2013
at 02:35 PM

I have a history of this dating back to when I was 12, almost over night my foot becomes unbearably painful occuring once roughly every 6-8 months, as I've grown old and more specifically the last 5 years, the pain comes roughly every 2-4 months. I had accepted the early reports from my doctors stating that it's pulled/pinched/etc type damage due to my weight (always been way over weight)... Since it affected my ability to participate in this program, I decided enough is enough and been going to the doctor to diagnose and treat it.

194d8e8140425057fe06202e1e5822a7

(3979)

on February 04, 2013
at 06:45 AM

Your doctor is probably the last person you want to ask about Paleo.

3eca93d2e56dfcd768197dc5a50944f2

(11697)

on February 03, 2013
at 01:21 PM

I agree. He should not be eating the same vegetable every day.

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6 Answers

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1
B72e976b2df9e7f01315830062a5209c

(1365)

on February 04, 2013
at 08:19 PM

In my experience with my own gout, and talking to other sufferers (both Paleo and SAD) it seems like everyone has a trigger. For me it's alcohol, and more specifically beer. The less beer I drink the less acute attacks I get, and the less alcohol in general I eat the less soreness in the affected joints I get on a day-to-day basis.

For me, food has very little to do with the equation, although I notice if I suffer an acute attack fasting does help relieve the symptoms. I've recently been prescribed indocin (http://www.rxlist.com/indocin-drug.htm) as a compromise with my doctor, and I've had good results with it. I only take it if there's an acute attack (now down to about once a year from once every few months). My doctor wanted me on a daily medication indefinitely, but I like this much better.

For some people, food does seem to matter. I have a coworker who's trigger is seafood. He is a SAD eater, so I have a feeling it could be other factors, but I have seen that almost everyone has something that makes it worse.

My suggestion would be to discuss honestly with your doctor what you want to achieve and don't be too afraid of acute specific medication. It's absolutely amazing that if I do have an acute attack I can get rid of it in < 24 hours instead of 4-5 days now. Start paying attention to what you eat and make sure to try and find what your trigger may be.

2c3f71479664bd50ae5b28794e1b1a66

(20)

on February 04, 2013
at 10:00 PM

toughed it out, sometime Sunday morning I had a handle on managing the pain with hot then cold pads and saw my doc first thing monday morning.

B72e976b2df9e7f01315830062a5209c

(1365)

on February 04, 2013
at 10:27 PM

Yeah, i feel you. That's where the indocin has been a huge help. It's basically just a gout specific NSAID, and I've always tolerated NSAID's very well.

2c3f71479664bd50ae5b28794e1b1a66

(20)

on February 04, 2013
at 09:57 PM

Thanks - when I was actively hitting the gym I was keeping a really good diet log, I'll go back and review that, sadly, once I kept getting knocked out of the gym I let the logging fall of the grid. But it looks like now that I know what I'm eating is a factor, maintaining a diet log will help me pinpoint problem foods etc. I really wish i had the log leading up to the recent flare up, this flare had me sitting crying screaming wishing it would just stop... and of course started like this at 1am Saturday morning where an expensive emergency room visit would have done nothing for me.

2c3f71479664bd50ae5b28794e1b1a66

(20)

on October 24, 2013
at 08:18 PM

Thanks - a lil late but better than never 8) I've been relatively flare free for the last 4 or 5 months.

A lot of what your say seems to be true, as well as others regarding the diet itself. That flare in my hand that lasted a month that prompted diagnosis was so horrible and just wouldn't go away. Once I started feeling bad, I made a bit stock pot out of the ingredients mentioned and was having that. I was too miserable to really do anything else. I was taking tons of asprin and sleep aids to get some sleep.

5
A402a961303d312055dc0b253f29deac

(320)

on February 03, 2013
at 11:26 AM

Ideas: Medical stance is that gout is through excessive eating of purine-rich foods (mostly meat). Paleo/scientific stance is that gout is induced through fructose and alcohol, with possible flair-ups through fasting and tough workouts.

Furthermore, I'm not completely happy with your "gout" diagnosis. You described your pain as tendonitis-like, not arthritis-like. An isolated hyperurikacaemia (increased levels of uric acid in the blood) is not sufficient for a diagnosis of gout. Where exactly is your pain, i.e. in which joints? Did it spread?

Good news is, gout can be fixed through lifestyle.

EDIT: You will love this link, very helpful.

2c3f71479664bd50ae5b28794e1b1a66

(20)

on February 04, 2013
at 02:35 PM

I have a history of this dating back to when I was 12, almost over night my foot becomes unbearably painful occuring once roughly every 6-8 months, as I've grown old and more specifically the last 5 years, the pain comes roughly every 2-4 months. I had accepted the early reports from my doctors stating that it's pulled/pinched/etc type damage due to my weight (always been way over weight)... Since it affected my ability to participate in this program, I decided enough is enough and been going to the doctor to diagnose and treat it.

2c3f71479664bd50ae5b28794e1b1a66

(20)

on February 04, 2013
at 02:59 PM

I also throw in some cabbage / fruits / other veggies during the day. But what I'm gathering is that the foods might not be the main issue I'm having, its the removal I've been having problems with. Thanks for your input folks, those were links I had not seen yet.

2c3f71479664bd50ae5b28794e1b1a66

(20)

on February 04, 2013
at 10:51 PM

I should also note that tendonitis was my self diagnosis, doctors never could tell me what was wrong and most times by the time I saw a doctor, the flare up was receding and I guess they never had the idea to check for gout.

2c3f71479664bd50ae5b28794e1b1a66

(20)

on February 04, 2013
at 02:42 PM

In the last 3 years, i have had it occur 3 times in my wrist with the current one being one the worst. Normally it is in my feet, occurring between the ankle and the toes, but never in the actual toe. Asprin/ibuprofen barely touch the pain, and the answer to it almost always is to walk it off, taking a sick day and not walking on it never fixes it. However putting a shoe on going to work, more often than not, will see vast improvements by mid afternoon. Except recently where the pain just wouldn't go away for weeks.

2c3f71479664bd50ae5b28794e1b1a66

(20)

on February 04, 2013
at 02:49 PM

From the onset of this program, I have cut out drinking, and followed a pretty rigid set of diet guidelines that I havn't deviated too much from... During the day I eat nuts and seeds, and recently been coming home, cooking up a meat and having the spinach. To be honest it wasn't every night but close too it, I was also having collards and turnip greens so it wasn't nonstop spinach. I do keep drinking 2 sugar free monsters a day.

3
0b4326a4949718451a8571b82558dc10

on February 03, 2013
at 09:00 AM

I would not eat a whole bag of spinach every day...overdose on oxalic acid and vitamin k...How big is the the bag?

3eca93d2e56dfcd768197dc5a50944f2

(11697)

on February 03, 2013
at 01:21 PM

I agree. He should not be eating the same vegetable every day.

2c3f71479664bd50ae5b28794e1b1a66

(20)

on February 04, 2013
at 10:05 PM

I was trying to live out of my freezer during January as work stiffed me a $1000 expense check that I had already *spent* on xmas / new years / birthday. Spinach was the majority presence in my freezer given a stock up sale a few months back.

1
6eafc6df899bbc81892079d1ab43a51a

on February 04, 2013
at 07:02 PM

Have a look at the following. I hope it will give you some useful information. http://gouthealth.com/2011/08/14/gout-facts/

1
7905232e31a8733e5a08613751009c3f

on February 04, 2013
at 03:57 AM

Sounds like a lot of your problem is related to diet, but to be on the safe side I would talk with a doctor who specializes in arthritis (rheumatologist) because gout is a form of arthritis. Here is a link to a good post on how to prepare for a doctor visit and what questions to ask. http://www.goutreliefcures.com/gout-questions-to-ask-your-doctor/

0
Medium avatar

on October 24, 2013
at 08:23 PM

Gout can be caused by excessive phosphate and lack of calcium in the diet. Having a fair amount of milk in your diet protects you from gout, where as a high-meat dairy-free paleo diet predisposes to gout.

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