January 19, 2014 at 12:01 pm #15973
1st, real quickly I read somewhere on this site not to worry about foods… let me explain why I am ignoring that article: I was told a few weeks ago by the Chiropractor I had gout. I ignored him. Within a few weeks of that I had a pain in my side–mucsle or rib. Nope… gall bladder… go to Doc NOW. Ok I went to Doc. It seems the Uric Acid is in my joints (gout), kidneys (kidney stones) and gall bladder (gall stones). IF I eat the wrong thing, I’m doubled over in pain within an hour–usually before I even finish eating, so for me, finding low purine foods is VERY IMPORTANT. One thing that article hit the nail on the head with was–there is a LOT of conflicting data out there.
I have several questions that if someone can point me in the right direction–stuff that I’ve found exactly ZERO data on:
Is the purine levels of the following considered high, medium, or low
1) Serrano Peppers
2) table salt
3) table pepper
4) sea salt
Any help would be appreciated. I have hypoglycemia too, and need to keep blood sugars up–protien has been my savior…. and now is my enemy? I feel doomed…January 19, 2014 at 11:00 pm #15975Keith Taylor (GoutPal Admin)Keymaster
I’d like to explain why sometimes it is important for gout sufferers not to worry about food, but without a link to the specific article, I’m struggling to explain in ways that might be meaningful to you.
I’ll try to address some of your other points.
1. Don’t get gout advice from a chiropractor unless they have some specialist knowledge. Just because he was right, does not mean he knows about treatment.
2. Family doctor is usually OK with gout, but rheumatologist is better if there are complications. I have heard of many doctors, including some rheumatologists who are unaware of latest professional guidelines. Therefore, you must take responsibility for your uric acid levels and never allow it to go above 5mg/dL.
3. I do not think gall stones are anything to do with uric acid or gout. It is perfectly possible to have gout at the same time as gall bladder problems. As far as I am aware these are two different health problems requiring different treatments. I am not a doctor, and even if I were, it would be immoral to diagnose you online. Go and get a proper diagnosis. If your doctor has told you that gall stones and gout are linked, please can you supply me with some facts, as this is news to me.
4. ” IF I eat the wrong thing, I?m doubled over in pain within an hour” I don’t know what you mean by the wrong thing. Fatty foods are bad for gallbladder pain. They’re also bad for gout, but for different reasons. You seriously do need to worry about food, but you need to worry about your total diet, worry about exactly what you mean by “wrong food”, and worry about the relationship of food to the 3 different diseases you mention (gout, gallstones, and hypoglycemia).
5. A low purine diet can often reduce uric acid by one or two points. I have no idea what your uric acid level is. You should know exactly what your number is. If it is over 7, a low purine diet is unlikely to be enough. If you do not get uric acid down to 5, gout will get worse causing progressive joint damage and organ disease.
6. If you want me to help you resolve conflicting data, you have to give me links to the data that conflicts. I cannot guarantee that I can explain the conflict, but I can guarantee that without the data I cannot explain the problem.
7. The reason why you cannot find purine data for the items you list is because they have no purines.
8. Again, I have no idea where you read that protein was your enemy, but it is definitely a friend to gout sufferers. Do not confuse purine and protein. Animal purines are bad for gout. All protein is good for gout, but if high protein food also contains high purines, then gout sufferers should avoid them, or take steps to minimize the effects of animal purines.
On balance, I wouldn’t say you were doomed, but I’m alarmed by three separate health problems and the problems in managing them together. Gout has to be managed on a case-by-case basis, so I’m loathe to generalize and guess at some likely solutions. I’m happy to try and help you find a path out of this, though I don’t understand why your doctor can’t help.
In complicated cases like these, I’d much rather comment on specific advice from your doctor/rheumatologist. I can also help you determine what questions to ask. The first question is “What is my uric acid exact number, and is there anything unusual about my kidney function or liver function test results?”January 20, 2014 at 7:05 am #15977
Delete comment if possible this was ramblings of a grumpy old man.. I’m a little more awake now.January 20, 2014 at 7:08 am #15979
Delete comment if possible this was ramblings of a grumpy old man.. I’m a little more awake now.January 20, 2014 at 7:21 am #15981
Maybe I should repost, in step by step how this thing went down:
1) I went to a chiropractor how told me I had Gout. I ignored him.
2) I got sick with the flu and went to a Medical Doctor… I was given medication for the flu… like that was going to help.
3) I thought the coughing caused me to pull a rib or a muscle, I went back to the Chiropractor.
4) Chiropractor told me that he thought it was my Gall Bladder and said I needed to go to a Medical Doctor right away. I ignored him again.
5) I got over the flu, and was feeling better. I went out for Mexican food. By the time I got home I was double over in pain. So much so that I thought about going to the Emergency Room.
6) I stopped ignoring the Chiropractor that night and looked up Gall Bladder isses, and found that Uric Acid CAN INDEED cause major problems with NOT ONLY the Gall Bladder, but once it moves to that organ, the next organ typically affected is the Pancrease–both of my Parents died painful deaths from malfunctioning pancrease, and they both had gout.
7) That scared me enough to go back to the Medical Doctor. I did… he confirmed ALL of the above. He (THE MEDICAL DOCTOR) told me to eat a low purine diet between now and when I get my Gall Bladder removed… I asked him what that meant; he told me to google it.
8) I’ve been googling it for several days now. Most sites say nuts are fine for low purine diets, but I know from experience that I can’t have nuts anymore.
Please, any advice given, please provide references… I’m not the type that will just take anybody’s advice. I have an elaborate spreadsheet started with the references listed, that actually documents the conflicting datum I’ve received and the sources thereof. I would like to continue this and see if I can actually balance out the conflicting dataum.
Oh, and BTW, Keith, While researching low purine diets I have found several sites that suggest that Uric acid can affect “other organs” besides the joints, kidneys, gall bladder, and pancrease. Those “other organs” go unnamed, and I haven’t been back to either the Doctor or the Chiropractor to ask about this–and I’ll probably forget it when I do go back. I’ll be nervouse enough about what’s comming next… but yes, I do want referenced knowledge, not opinions. Thanks…January 20, 2014 at 8:03 am #15983
Ok, Keith, I know my original post was clumsy at best, so I appologize for that. I can’t blame you for not seeing the info in that post, and I apologize for being full of “Uric acid” in the comments I obliterated. Now, with that said, I was never told what my uric acid level or cholestorol level was, just that I needed to lower both. Well–I’ve been concentrating on uric acid, since I knew so much less about it. I have learned so much in the past 2 days–I’m brighter than a lot of Doctor’s on this topic. There I go rambling again. Let’s do this step by step again:
1) I don’t know my Uric acid levels, I’ll try to find out for you.
2) Is there some way I send you that spreadsheet that I have, it lists the links and what the links said about specific things. I put a 0 for stay away from, a 1 for not a problem if taken in moderation and blank for foods they didn’t even mention. I have a tally box at the top, but it’s not “weighted” so i thought about making a formula to take into account the percentage of hits/ misses/ and such, but yeah… i would spend more time on the spreadsheet than on actual research, so I’ve not done that yet.January 23, 2014 at 1:34 am #16004Keith Taylor (GoutPal Admin)Keymaster
@twidget, I understand your frustration. You’re in the same place as I was when I started GoutPal. Bad advice from the medical profession, and confusing information on the Internet.
I also mistrust most of what I read, so I take most information from PubMed. It isn’t perfect. I know researchers can sometimes get it wrong, but the quality is way beyond the tittle-tattle that forms most gout pages.
Now I understand your context a little better, I am veering towards suggesting you stop worrying about food. I know you won’t do that, and I don’t blame you, but I’m trying to think of a way to change your thought process.
The only thing that causes gout is excess uric acid. There are many causes of excess uric acid, and food is only one of them. If you do not know your uric acid level, you cannot tell if diet changes are making you better or worse. Pain is not a valid indicator. You can get gout attacks when uric acid is falling due to old crystals. That was the turning point for me. It explains why so many people pick on certain foods as being bad, when scientifically they should be good. You eat a food that everyone says is bad, and you get a gout attack. That reconfirms your fear of that food, but it might be wrong. The only way you can tell if a food item is good or bad is to test for uric acid levels. Most people, myself included, do not have the patience or tenacity to self-experiment in this way. There are too many confounding factors.
I can write volumes on all the factors that can affect uric acid. Besides food, other medications, other health conditions, exposure to toxins, can all affect uric acid. The biggest factor is genetics, so I’ll repeat my favorite mantra: No amount of dieting will change who your parents are.
If you want to remain obsessed about food, why only concern yourself with purines? Excess calories and excess iron are both worse causes of gout. There are few specific foods that you should avoid, but daily gout diets that lead to excess calories, excess iron, or excess animal purines are definitely foods to avoid with gout. Bad eating habits such as fasting, bingeing, dehydration, are all worse than purines.
The only thing that matters is uric acid level. Once I know that, I can advise you about diet. If your level is 7 or 8, diet might be possible. Above that, without allopurinol or Uloric, life is going to be a real struggle for you.
As for the spreadsheet, have you tried the Attachments button below the box where you type your forum submissions? Let me know if the 512KB limit is too small, and I’ll increase it. The best way for sharing spreadsheets is via Google, so if you want help with that, please start a new topic in the Using GoutPal forum.
That’s as much as I can say about food really. You have to plan food in the light of your uric acid levels and a gout treatment plan. The “food first” way is just too confusing. Let me move onto stones and organ damage.
Gout is a progressive disease caused by uric acid crystals. At first, they tend to collect around joints, particularly extremities such as fingers and toes, because these are at lower temperatures. They stop tendons, cartilage and bone repairing itself leading to permanent joint damage (osteoarthritis). They also grow in other tissues. They are usually first noticed in the skin – our largest organ. These clumps of uric acid crystals will eventually spread to all organs. I tend to focus on kidneys and heart, as these bring the highest risk of fatality. I am quite sure that they will eventually affect the gallbladder, though I have not yet seen any specific research on this. Most gallbladder stones are cholesterol (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3216212/). However, you’ve prompted me to look at some new research (thank you), and I can see that uric acid is indeed prevalent in gallstones – http://www.ncbi.nlm.nih.gov/pubmed/24377514.
That last report makes the point that alkalizing is good for uric acid stones. That brings me back to food, and reinforces my belief that, if a gout sufferer needs to have a special diet, then the absolute best starting point is a well-balanced acid-alkaline diet supported by urine pH testing.
Thanks for a great discussion, @twidget.
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