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  • in reply to: New member #18530
    Tomj
    Participant

    Hello,

    It is nice to know that 50 years old, is still considered an early start for something. :).

    Thanks,

    Tom

    in reply to: New member #18494
    Tomj
    Participant

    Hello,

    Just received the results of the uric acid test. After a month of no beer, wine, or any alcohol. Lots of water. My level went from 6.8 up to 8. Drats! I am hoping that some of that increase is due to the weight loss I have had from the removal of beer. I have lost 9 pounds over the course of three weeks. I would lying if I did not admit to some disappointment. From the research I have done there does seem to be a direct relationship to weight loss and uric acid during weight loss. Am I correct in this? My foot is feeling better (knock on wood). I suppose this is a long game, and I should not be disappointed in short term trends, especially in the beginning.

    Thanks,

    Tom

    • This reply was modified 7 years ago by Tomj.
    in reply to: New member #18462
    Tomj
    Participant

    Hello,

    I hope you have been well. I had the blood draw today, and hope to get results tomorrow. I had a bit of a flair just last night. It happened after a moderate workout, so maybe that was the problem. I have colchicine in the house but I am a little hesitant to use it, with the side effects. My appointment with the rheumatologist is coming up in 2 weeks. My foot really has not felt right in 3 weeks.
    Be well.

    Thanks,

    Tom

    in reply to: New member #18376
    Tomj
    Participant

    Hello,

    At this point, my toe is still a little tender but not terrible (knock on wood). I am going to get my next lab this Monday. That will be almost 3 weeks from my initial injury/flair and 2.5 weeks from the last beer. I hope to see an improvement in ua levels, but we will see. I thought that the weight was going to fly off, after the cessation of evening IPA, but alas that is not the case. I am starting to think I have the metabolism of a sloth. I well post, with the results when they are available.

    Thanks,

    Tom

    in reply to: New member #18287
    Tomj
    Participant

    Hello,

    I find the topic of exercise induced hyperuricemia very interesting, as I suspect this may play a part in my gout situation. I found the following article/study of interest. http://www.ncbi.nlm.nih.gov/pubmed/737. A more detailed description of the study can be found here. http://deepblue.lib.umich.edu/bitstream/handle/2027.42/23305/0000243.pdf?sequence=1. Sorry, I am unsure of how to place a proper hyperlink, in this forum. So I can only hope that copy and paste will work.

    I am not a health care professional, thus I can understand only a small fraction of what these guys are talking about, but the discussion/conclusions would indicate the following. First, moderate exercise, at roughly 35% of maximum capacity does not increase uric acid concentrations. Second, high intensity exercise, at 80% of maximum effort does raise the uric acid levels. Specifically, men running 5k had a pre race ua level of 6.9 and post race level of 8.5. By my math that is and increase of 1.6 or a 23% increase. That is significant.

    My hypothesis, for a perfect gout storm, is the following recipe. After a stressful day at work, go for a good long run. Boosting ua levels 23%. When done with the run, have few beers while making dinner and doing chores. Beer increases uric acid levels (http://www.ncbi.nlm.nih.gov/pubmed/6743968), and the alcohol decreases ua elimination. Kick your shoes off and relax. Repeat this process day after day. If ua crystals are only reabsorbed at levels below 6, you get a build up in your joints over time, with the inevitable outcome of an acute gout flare.

    It seems to me that a person who suffers from gout flares, and wants to continue with exercise may want want to adjust their schedule so that they work out earlier in the day. Drinking plenty of water before and after the work out. Of course keeping your ua levels under 5 is very important, so that crystal reabsorption is promoted.

    Does anyone know how volatile ua levels are? Studies such as that above would indicate that they fluctuate greatly over the day, in response to specific inputs. How long should ua levels remain below 5 for a gouty joint to be cleared of the crystals? Days, weeks?

    The au level numbers I have used are in mg/dl units. What ever that is.

    Have a good day,

    Tom

    in reply to: New member #18276
    Tomj
    Participant

    Hello,

    Here are my gout stories. I have always been very active. All the typical activity. Hiking, biking, swimming, etc… I attempt to get a minimum of 45 minutes of strenuous exercise per day. I eat a vegan diet with occasional slip up with a good cheese pizza.

    Last winter I did some cross country skiing for a few days. The equipment, of course, put a fair amount of strain on my big toe joints and they felt sore for a day or two. Being snow bound for about 4 days, with a rare and beautiful winter storm, I probably had more beer (IPA) than was necessary. I woke up in the early A.M. , thinking that a small farm animal was standing on my foot. I did not go back to sleep. I certainly could not walk. I made an appointment and went to the doctor the following day. I of course had spend the night researching Dr. Google and convinced my self I had gout. The examination was pretty quick and I was told it was probably just a strain.

    Three months later I had a twinge in the ankle, the pain increased at night and with rest. Not much swelling but it hurt enough for me to go back to the doctor. This exam was more complete and I think they correctly diagnosed tendonitis. Although, I still have a hunch goat could have been the cause. This one kept me on crutches for about three weeks.

    Then there was last week. I went running (5k), and the next day my big toe joint was sore again. I did not think anything about it and exercised very strenuously. When I dismounted the exercise equipment, I did not “stick” the landing, to say the least. I almost fell off, and in the process, twisted my foot. My toe and arch felt like I had a cramp, that lasted about 10 seconds. That night I had a fair amount of pain in the toe. Certainly enough to wake me up. The following night the farm animal was back and he was not small anymore. Indeed he gained considerable weight and it felt as I’d he was clog dancing, on my foot. The pain was intense, there was swelling. Back to the doctor. Again they thought strain, not gout. But this felt like gout with waves of pain, and I could not press against it without yelping. The area was swollen and red. X rays show that I do have a fair amount of arthritis. Unfortunately, the X-rays where inconclusive for gout, although they thought I had some bone degradation on the outside of the joint that indicated early gout. My ua level on day 6 after onset was 6.8. That was enough for my podiatrist to make a diagnosis of gout, with a referral to a rheumatologist.

    So here is my current situation. The foot feels better but is still somewhat tender to the touch. I am 50 year old. I have bmi of 30.1, which considered obese, but I do much weight lifting so the numbers are not completely indicative of my fitness. That’s not to say I could not trim 30 lbs off. I plan to see the rheumatologist in about one month, and am going to get my ua levels checked 2 times in the interim. My big vice is beer, I love a good cold IPA. Fact is I love several. So I have removed all alcohol from my diet, this has put quite a hole in my evenings, but I figure there is a bright side. I have meant to make this “life style adjustment” for years, but never got around to it. If abstaining from beer is what it takes to keep that beast in the barn and off my foot, and I lose a few stone in the process, then possibly there is a silver lining to this gout thing.

    I will post more as the results come in.

    Thanks for your time,

    Tom

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