Gout

A snowHead

This summer I was diagnosed with gout when my right foot became extremely painful and swollen. In particular the joint behind the big toe.
I can't be the only skier with it?? And regrettably not Port related, but too high a turnover of red blood cells.
I think the issue first appeared in summer 2018 high heat in a middle toe joint.

I'm now on Allopurinol but whilst abroad had to take a half dose on alternate days for a week or so, resulting in another smaller flare up. Two weeks or so on and swelling reducing but the big toe joint protrudes laterally a little more than the other foot.
I don't think it will be an issue with a more spacious telemark boot, but wonder if an anti-inflammatory would be worth it or any other idea??

A snowHead

Have you had an xray to rule out anything else?
Can you get naproxen?
Cherry tablets can be good for gout.

Well, the person's real but it's just a made up name, see?

I'm a sufferer to both Gout and sciatica - sometimes feel like my body hates me. I've taken allo at 100mg/day for several years now ( i think this is about as small a daily dose as is prescribed) . I haven't had any flare-ups for most of that period, although I think the allo just keeps it in abeyance. Unfortunately, I have not been able to find my "trigger foods" but have continued to eat as normal ( I don't really drink much anyway).

you have my sympathies, it's probably one of the most painful afflictions known.

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I knew someone who suffered from Gout. When he was in Spain, it flared up. The Doctor there told him the single most important thing he should do, was drink copious amounts of water - to flush it out. This was more important than medication.

From that moment on, he controlled it by doing exactly that.

I am not medically trained, or have ever suffered from gout - but am passing this on in case it is of use.

Anyway, snowHeads is much more fun if you do.

I am not medically qualified but have / do suffer from gout. It's no joke.
I understand it is like arthritis(?) and is caused by crystals building up in the joint affected. Commonly but not always in the foot / toe. In my case it is my toe. The crystals are caused / can be caused by the food you eat
Mine is controlled by diet. Most of the time it is not there as I avoid "trigger" foods. If it comes on, then lots of water to drink and naproxen. Speak to your friendly GP about how to take naproxen. I absolutely do NOT advise you to follow my example, but I take a double dose on day one to get it into my system and then a normal dose for a day by which time I generally don't need to take any on day three

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Thanks all.
Yes, it is an arthritis caused by crystal build up. I do keep well hydrated and don't eat any of the known trigger foods, eg seafood, in any great quantities but I haven't noticed any specific reaction when I have.
It is now the odd dull ache/twinge from time to time, but I guess foot swelling hasn't completely disappeared since the last flare up.
I have a supply of Colchichine for flare ups and it seems pretty effective in the first day or so, especially when taken with a higher initial dose, as @JHS does with Naproxen. An interesting Crocus derived drug.
Naproxen sounds an interesting alternative to Ibuprofen, which I was thinking of. I'll investigate.

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Naproxen works for me, however I wouldn't take it on a regular basis- it's very bad for the stomach and is normally prescribed with omeprazole or similar to protect the gastric process.

After all it is free

At the risk of peddling “bro-science” I would not increase my dose of allo before a ski trip, it could lead to crystals being released and cause a flair up at exactly the wrong time.

If you’re taking a multi vitamin, check that it doesn’t include iron, vitamins A or B3.

With regards to hydration, we are recommended to drink lots of water permanently or at least until well below 5 mg/dl

Lots of good info here:
https://gouteducation.org/wp-content/uploads/2019/11/Gout_GoFor6_TriFold_May2019_v00_Web.pdf

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I started suffering with gout in my 20s, bad genes as both my dad and sister subsequently had episodes. Dehydration, rather than specific foods, was always a trigger for me (I resisted allopurinol for years as I didn't like the prospect of medication for life from that age, back on it now though), and upping your water intake during a flare up, as has already been suggested, does tend to help ime.

I'm surprised you've not been prescribed an anti-inflammatory; I was started on indomethacin but found that very harsh on my stomach, but I've had no such problems with naproxen. Ibuprofen is in the same class of drugs (NSAIDs) and is of some help; I have used it if I've run out of naproxen, and also in gel form direct to the affected joint. However, your GP would probably prescribe something stronger than ibuprofen for occasional flare ups, and possibly something to take with it to sooth your stomach.

There seems that there is a lot of misinformation floating about, and in the case of my first episode, even with a GP.

I woke up one morning about 15 years ago in agony, my regular GP was on holiday. The Dr that treated me was sure that I must have broken a toe whilst asleep, even sent me for X-rays! My regular GP though it was hilarious and proscribed allo immediately. Had a second episode about 8 years later but I had just stopped taking allo as I assumed all ok.

I sometimes get the odd tingle or pain which fills me with dread, however, touch wood seems so far to be a reminder that I need to drink more water - as confirmed by the colour of my urine

You know it makes sense.

I don’t want to get into a discussion about vitamins, my first post was based on my circumstances, and understanding.

The opposite to fitness, where you can’t out train a bad diet, with gout, even with a very strict diet, is seems difficult to lower your mg/dl significantly without allo, at least in the short term

Otherwise you'll just go on seeing the one name:

A snowHead

@Roguevfr,

Ahh OK, My GP told me to take Naproxen with food & not on an empty stomach. Ive not had any issues with them.
Had Omezprazole a few years ago & it turned my guts into washing machine on a spin cycle. DGL sorted me out in a week what the GP tablets failed to do in 6 months.

A snowHead

Top leaflet here https://www.versusarthritis.org/media/23086/gout-information-booklet.pdf

GPs are often happy to treat to get the urate in the normal range, but to prevent other problems (Blood pressure, kidney, maybe diabetes and heart) it probably needs to go lower, effectively flushing the system of urate. Its good to know your numbers - and get an annual blood tests. Drug doses can go up or down annually, often paralleling weight.

Preventing flares better than treating as Naproxen is a pretty toxic drug long term.

Good luck and hope all is quiet when you ski. Bear in mind cold feet = more gout crystals, so new boots may be in order Toofy Grin

Well, the person's real but it's just a made up name, see?

@Mountain Haddock, Thanks for the leaflet link which reinforced most info previously gleaned.
Urate last week was 327 in range 210 - 420. I have a blood test every monthish, so easy to track. Main issue is Medial Cuneiform area residual swelling is slow to reduce. I'll be skiing for a few hours tomorrow, but boots should have enough space to side of foot in billows area and they are warm.

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Anyone have flare ups in the knees? I've had creaky knee problems on and off for years, and begin to notice a correlation with diet. Last night we had an enormous beef rib roast, washed down with plentiful Burgundy, and followed by cheese.

I was in absolute agony by this afternoon, could barely get up the stairs unaided. In the past, light cycling seem to have done the trick, but I'd be keen to hear thoughts? I suppose some sort of blood test would also be a good idea?

Anyway, snowHeads is much more fun if you do.

I used get gout in my foot from time to time which, whilst amusing my wife and work colleagues, is intensely annoying and could be quite painful.

To combat it I drink loads of water (at least 2 litres per day), exercise to keep the weight down, hardly touch red meat or salty foods and eat a lot of oranges (as I've been told that vitamin C helps to break the acid down). The best painkiller I found was a bucket of ice cold water to dunk my foot in until the pain went away.

However, since changing jobs I've noticed that I haven't had a gout attack at all so I think that stress may well have been a contributing factor.

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I have on occasion suffered from gout. Initially I took colchicine and Narproxen when I had my fairly regular flare ups… but since then I’ve found that in my case it’s almost uniquely related to my hydration levels… so I drink at least 2 litres of water a day normally, and when skiing I’ll easily consume 4 litres when factoring my camelbak. Since I’ve been drinking this much water (no drugs, no other changes) gout hasn’t reared its ugly head… and we’re talking years.

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After all it is free

In gout Uric acid over accumulates in cooler ( usually ) joints it can happen because of too
Much production ie breakdown of cells in your case, eating a diet too high in purines eg oily fish beer etc
It can happen because if slow excretion ( alcohol slows your body from getting rid of it )
It could also be because you are dehydrated
So keep well hydrated, caution on alcohol and bea aware of what you eat and drink.

Having said that
GP can prescribe anti inflammatory eg naprosyn, Indomethacin.
An attack can be aborted with colchicine so you could have those available
Allopurinol is not to treat an attack but more to prevent it

Jonathan Bell

Reading this thread with interest as a gout sufferer. Mostly I get it in feet / ankles but occasionally in the wrist which is easily the most painful. I've had a ski trip curtailed by gout before. Lack of activity and not drinking enough water are my biggest issues (gout is mostly a winter issue for me). Both of those causing the build up of crystals and then something like skiing can dislodge them. I don't take allin - prefer to try to manage it. I like a pinch of bicarb soda in water before going to bed. Also Ibuprofen usually does the trick for me when I can feel an attack coming on (the tingling is a giveaway). But once it's set it can be very difficult to shift

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I have found too much sugar and dehydration are the worst, having run a marathon and guzzled loads of lucozade style drinks and gels. Followed up with a couple of beers gave me a month long flare up. I now go low carb high fat and properly rehydrate with low sugar electrolytes, haven’t had one now for over 2 years. at first sign, usually in middle of night, I would drink 2 pints of water and take cherry and stinging nettle tablets.

Help!!

Gout

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