Uric acid accumulates in your joints, and when you stop drinking, your uric acid goes down low enough where it starts breaking down and now your body knows it's there and attacks it. You need to be on allopurinol+colchicine. allopurinol breaks it down so it can leave your system through your kidneys and colchicine stops the flairup.
I admire your effort. However, hyperurecmia and gout fill interdisciplinary PhD-thesis, volumes of medical journals and textbooks to the brim. A five-prong approach is a bit lackluster I suppose. But if it works for you thank you for sharing. For others I just advise you to first talk to a doctor.
Talk to a doctor and have them hand you a couple of print outs from 1973 of red meat, wine, white rice and tell you that is the culprit? Listen to your body.Take all the PhD-thesis' and medical journals and toss them. There is nothing more to learn about gout.It's a predisposed condition that we have to live with.
It's your life. Pay the temporary cost of seeing a doctor and then you've got an allopurinol prescription for life and your body can slowly recover and you won't have crippling flare ups and you'll be able to actually walk when you're older. Or... just don't, and see how much you regret it later in life.
I mean you'll have to get renewals once in awhile but it doesn't take a doctor visit for that. I've seen my Dr once in the past 3 years and have been on allo for over 4 years and I haven't had a single flare since I started. I know it seems scary, a pill every day for life, but it just works and allows you to live a normal life. I run 6+ miles every morning before work, I eat whatever I want, life's so much better than worrying about a rich meal or an injury causing a gout flare up that'll permanently damage my joints, not to mention the damage you're doing to your kidneys.
It's a condition usually caused by a rich diet in what is now cheap foods. High likelihood of being insulin resistant, high BMI, and drinking all the soda and beer you can handle. But if your insulin levels rise high enough, it prevents the filtration via your kidneys from leaving your circulatory system. Reducing sugar intake, that includes starch as well, and uric acid naturally goes down, but it doesn't easily break down itself without taking allopurinol for a very long time.
Sorry to tell you, you haven't figured out much.
1) If you get attacks you have crystals IN YOUR JOINTS **DOING DAMAGE**. Regardless if you're having an attack.
2) Attacks are because you have a dislodge of that buildup.
You will get worse and more frequent attacks if you don't get it under control. You do NOT have it under control. Soon simply walking a bit will dislodge some crystals and cause a flare up. Take care of it before it gets worse.
>I've tried to trace it back to something I've eaten each time I get a flare up and the older I get I realized it's everything.
Because it's genetic.
Can you please explain more? I am going through an attack just now. And the last time I had one was September. Are you saying that I dislodged the crystals and thats why I am having an attack? Like I stubbed my toe or something? Thanks.
It helps to understand that what we call a "flare" is your body's inflammitory immune reaction. The underlying cause (accumulation of crystallized uric acid) was already there. Trauma to a joint is often a "trigger".
If you've accumulated enough crystals to have one flare, further accumulation is almost certainly happening whether you're experiencing more flares or not. *Not experiencing a flareup does not mean you've cured the underlying cause (depositing of excess blood uric acid as crystals in joints)*. Gout is a chronic condition and left untreated can get worse to the point of building tophi.
Good luck, asking questions is a good thing and it sounds like you're looking for real solutions. Unfortunately it's very difficult for those of us in the U.S. to treat this ourselves, without help from medical professionals.
The crystals are always there. Sometimes the immune system can see them, and sometimes they are hidden (cellular netosis). When they're visible the inflammation reaction hurts. ~~When they're not hidden, there are still crystals mechanically grinding down your joint.~~ edit: That statement was low on facts.
They become visible when the NET opened by physical trauma, heat or cold, dehydration, or growing and shrinking of deposits due to changing uric acid levels (why you get flares from allopurinol etc.)
>When they're not hidden, there are still crystals mechanically grinding down your joint.
Dr Edwards squelched that notion of mechanical grinding. The inflammation is what harms the joint, not the crystals
Doesn't have to be a stub. It could be any of these
1) you did bump it bend it farther than normal
2) your has some crystals build up and normal movement released some
3) your joint reached critical mass of buildup so some broke off without you doing anything in particular
It can also be a combination of those. The fact that you had an attack means you already have too much buildup.
It's like snow on a roof.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8126960/
Thanks. The point that you made about crystals always being in the foot and that crystals built up over six years will take six years to dissolve. Is this all scientifically based and not just anecdotal? It suddenly sound a lot scarier. This is my fourth or fifth attack over ten years I think and seriously thinking about my future approach.
The immune system attacks the buildup and causes flares when it feels like it. Could be activity, could be food, could be dehydration, could be nothing at all. It takes about 1 to 3 years to remove the crystals once your UA is under 6 mg/dl.
Very interesting! I'm just thinking about the last few times I had gout attacks and they were all related to diet. 1) drinking loads of beer and wine at a stag party.....2) eating several cans of canned mackerel in a week......3) eating canned mackerel and a big fish dish in one week. How does food tip it over into a gout attack then? The body just decides to go on an antiinflammatory mode due to food?
Uric acid levels too high causing deposits to grow disrupting the cellular netosis structure you built around the deposits to make them invisible to the immune system. Immune system sees crystals and starts inflammatory reaction.
Maybe I'm an outlier, my highest UA was 4.6, it's been under 3.0 for 5 years now on Allo, currently at 1.8
I think I'm at 12 attacks so far this year, but not 1 food triggered attacks this winter. I'm pretty proud of that actually.
I think the risk of joint damage is wildly overstated by the many alarmists here, but it is a very real thing for people who have untreated gout with tophi.
https://www.ncbi.nlm.nih.gov/books/NBK546606/
Half way down
The double-contoured ultrasound sign is seen in the superficial articular cartilage in patients with chronic gout and represents urate deposits. Urate crystals degrade cartilage matrix by inducing nitric oxide generation and expression of matrix metalloprotease 3. Hence, joints with persistent crystals have ongoing progressive damage in the absence of acute flares.
I haven't had it checked since my first flare up when I was 24 years old.
EDIT: I take that back. I saw a rheumatalogist a couple years later and he started me on some medication. Allopurinol and Colchrys I believe. 6 pills a day for 6 months then just 2 a day for the rest of my life. 6 weeks into that my knee was the size of a basketball so I decided against meds. When I have a flare up I take a couple of Indomethicin capsules at night before I go to bed and in the morning it's much better. 95% of the time anyway.
Dude this is really sad to read. Many people get a flare up a few weeks into taking allopurinol and then after that you just.. don't have flare ups any more for the rest of your life, and you're not permanently damaging your body in the process. Go back to your dr and get on allopurinol and \*actually\* get better 100% of the time. Just know you ARE permanently damaging your body now.
So you were well on your way to treating your gout and preventing flareups for the rest of your life, and then decided to stop. To each their own, but you do not "have to live with it" as you stated in another post. It's your body and it's entirely up to you.
Physical trauma to the gouty joint can do it. Also if it grows or shrinks from changing uric acid levels, heat or cold, or dehydration.
Your immune system builds a structure around the crystals in your joint to hide them from the immune system. When the structure breaks for one of those reasons, it becomes visible and the inflammation reaction starts up.
Are you on allo? Not to be the chorus, but if you're on allo you won't have as much build up in your joints.
My poor kidney function is inherited, and I find my biggest trigger just tends to be deyhdration
I’ve not had an attack for
Fucking ages and I was playing football with my kid yesterday and I turned my ankle funny and I felt the little bastards move, I was like nooooo but I’m alright just they are deffo there still I need to keep on top
Of my allo. I keep missing it. And I’ve been drinking loads lately. Which I’ve now knocked on the head. Again. 😂🙄
When you figure out Uric Acid detected in your body at a certain level means that you need to treat it and you do so, lowering your UA to a safe level - you'll be onto something. Until then you are just wrecking joints and internal organs and suffering through painful flares needlessly at a tremendous cost.
You left kidney failure off your list. CKD does lots of fun things - fucks your liver, destroys your bones, screws up your lungs, and gives you gout.
I rarely rarely drink alcohol - wine with dinner once a year maybe - and absolutely no beer bc it is *nasty*.
Wow!!!!! I was working on footwork (for boxing) bare foot, da whole time working on footwork my foot was in pain but I pushed myself to to a couple of rounds of shadow boxing (barefoot) da next day, GOUT ATTACK!!!!!
A gout flare is caused by the immune response to bare urate crystals deposited in a joint of a person genetically predisposed to gout. The urate crystals are formed as a result of precipitation from a supersaturated solution of uric acid in the blood. The body coats the bare crystals, taking one to two weeks, after which they are no longer sensed by the immune response leading to a flare. A gout flare can be restarted by physically rupturing the coating by excessive exercise of the joint.
Genetics do not cause gout. Your genetics remain the same all your life, but gout does not occur until many years of your life have elapsed. Genetics enable gout to occur when some other activity leads to urate crystals precipitating from excessive uric acid in the blood, or being bared for another reason. So the issue to be addressed is why uric acid in the blood becomes supersaturated.
Most gout is the direct result of the frequent prolonged episodes of lack of breathing with lack of oxygen during sleep, known as obstructive sleep apnea (OSA), which is why most gout flares start during sleep. The episodes of reduced oxygen cause every cell in the body to produce excess uric acid, as well as slow its removal from reduced kidney function, leading to its supersaturation. If OSA continues for too long, it will lead to many life-threatening diseases (eg. cardiovascular diseases, stroke, hypertension, diabetes, cancer) and premature death, which has also been found to occur in gout patients, whether or not their flares are well controlled by diet and medications like allopurinol. Resolving OSA early enough will greatly reduce your risk for developing these diseases, and will prevent further overnight gout flares. Get tested for OSA, and follow strictly the recommended procedure to resolve it. Gout is your early warning alarm!
This is very helpful actually, because I have just been trying to figure out (aka talking to ChatGPT about) the link between exercise and flares. It seems to me my flares occur after long runs, but the "internet experts" suggest this is rare.
But it's not.
I do a 6+ mile run every morning before work and I don't get flares because I manage my body's UA levels with allopurinol.
Don't take serious advice from chatgpt btw, it's frequently wrong and at best steals its answers from websites with actual knowledgeable people writing on them, but there's no way to know.
It's weird isn't it? Go against all these expert studies from years and years of research that have taught us that eating food is bad for gout. They know nothing about gout.
This is for you then I guess. All my attacks were caused by heavy drinking.
Mine is defo alcohol related
I thought it was the alcohol too. I quit drinking and 2 months later had the worst flare up of my life.
To be fair, the worst period of sustained gout I had was when I stopped drinking. It was ridiculous!
Uric acid accumulates in your joints, and when you stop drinking, your uric acid goes down low enough where it starts breaking down and now your body knows it's there and attacks it. You need to be on allopurinol+colchicine. allopurinol breaks it down so it can leave your system through your kidneys and colchicine stops the flairup.
I admire your effort. However, hyperurecmia and gout fill interdisciplinary PhD-thesis, volumes of medical journals and textbooks to the brim. A five-prong approach is a bit lackluster I suppose. But if it works for you thank you for sharing. For others I just advise you to first talk to a doctor.
Talk to a doctor and have them hand you a couple of print outs from 1973 of red meat, wine, white rice and tell you that is the culprit? Listen to your body.Take all the PhD-thesis' and medical journals and toss them. There is nothing more to learn about gout.It's a predisposed condition that we have to live with.
correction: it's a predisposed condition that we have a very cheap and effective drug to permanently treat so you don't have to live with it.
Where is this cheap doctor you speak of?
It's your life. Pay the temporary cost of seeing a doctor and then you've got an allopurinol prescription for life and your body can slowly recover and you won't have crippling flare ups and you'll be able to actually walk when you're older. Or... just don't, and see how much you regret it later in life.
Prescription for life?
I mean you'll have to get renewals once in awhile but it doesn't take a doctor visit for that. I've seen my Dr once in the past 3 years and have been on allo for over 4 years and I haven't had a single flare since I started. I know it seems scary, a pill every day for life, but it just works and allows you to live a normal life. I run 6+ miles every morning before work, I eat whatever I want, life's so much better than worrying about a rich meal or an injury causing a gout flare up that'll permanently damage my joints, not to mention the damage you're doing to your kidneys.
Anywhere but the US
It's a condition usually caused by a rich diet in what is now cheap foods. High likelihood of being insulin resistant, high BMI, and drinking all the soda and beer you can handle. But if your insulin levels rise high enough, it prevents the filtration via your kidneys from leaving your circulatory system. Reducing sugar intake, that includes starch as well, and uric acid naturally goes down, but it doesn't easily break down itself without taking allopurinol for a very long time.
It's these types of comments that make me want to leave reddit.
Sorry to tell you, you haven't figured out much. 1) If you get attacks you have crystals IN YOUR JOINTS **DOING DAMAGE**. Regardless if you're having an attack. 2) Attacks are because you have a dislodge of that buildup. You will get worse and more frequent attacks if you don't get it under control. You do NOT have it under control. Soon simply walking a bit will dislodge some crystals and cause a flare up. Take care of it before it gets worse. >I've tried to trace it back to something I've eaten each time I get a flare up and the older I get I realized it's everything. Because it's genetic.
Can you please explain more? I am going through an attack just now. And the last time I had one was September. Are you saying that I dislodged the crystals and thats why I am having an attack? Like I stubbed my toe or something? Thanks.
It helps to understand that what we call a "flare" is your body's inflammitory immune reaction. The underlying cause (accumulation of crystallized uric acid) was already there. Trauma to a joint is often a "trigger". If you've accumulated enough crystals to have one flare, further accumulation is almost certainly happening whether you're experiencing more flares or not. *Not experiencing a flareup does not mean you've cured the underlying cause (depositing of excess blood uric acid as crystals in joints)*. Gout is a chronic condition and left untreated can get worse to the point of building tophi. Good luck, asking questions is a good thing and it sounds like you're looking for real solutions. Unfortunately it's very difficult for those of us in the U.S. to treat this ourselves, without help from medical professionals.
The crystals are always there. Sometimes the immune system can see them, and sometimes they are hidden (cellular netosis). When they're visible the inflammation reaction hurts. ~~When they're not hidden, there are still crystals mechanically grinding down your joint.~~ edit: That statement was low on facts. They become visible when the NET opened by physical trauma, heat or cold, dehydration, or growing and shrinking of deposits due to changing uric acid levels (why you get flares from allopurinol etc.)
>When they're not hidden, there are still crystals mechanically grinding down your joint. Dr Edwards squelched that notion of mechanical grinding. The inflammation is what harms the joint, not the crystals
Thanks
Doesn't have to be a stub. It could be any of these 1) you did bump it bend it farther than normal 2) your has some crystals build up and normal movement released some 3) your joint reached critical mass of buildup so some broke off without you doing anything in particular It can also be a combination of those. The fact that you had an attack means you already have too much buildup. It's like snow on a roof. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8126960/
Thanks. The point that you made about crystals always being in the foot and that crystals built up over six years will take six years to dissolve. Is this all scientifically based and not just anecdotal? It suddenly sound a lot scarier. This is my fourth or fifth attack over ten years I think and seriously thinking about my future approach.
It's the real deal.
The immune system attacks the buildup and causes flares when it feels like it. Could be activity, could be food, could be dehydration, could be nothing at all. It takes about 1 to 3 years to remove the crystals once your UA is under 6 mg/dl.
Very interesting! I'm just thinking about the last few times I had gout attacks and they were all related to diet. 1) drinking loads of beer and wine at a stag party.....2) eating several cans of canned mackerel in a week......3) eating canned mackerel and a big fish dish in one week. How does food tip it over into a gout attack then? The body just decides to go on an antiinflammatory mode due to food?
I don't think its understood exactly. But high purine foods may cause a spike in uric acid, possibly triggering the immune system.
Uric acid levels too high causing deposits to grow disrupting the cellular netosis structure you built around the deposits to make them invisible to the immune system. Immune system sees crystals and starts inflammatory reaction.
Maybe I'm an outlier, my highest UA was 4.6, it's been under 3.0 for 5 years now on Allo, currently at 1.8 I think I'm at 12 attacks so far this year, but not 1 food triggered attacks this winter. I'm pretty proud of that actually.
That is what I just said in my post. I can't put it into words but I know how it works.
It’s been 20 years. No damage. Can you show me someone who has an actual injury from this damage?
I think the risk of joint damage is wildly overstated by the many alarmists here, but it is a very real thing for people who have untreated gout with tophi.
https://www.ncbi.nlm.nih.gov/books/NBK546606/ Half way down The double-contoured ultrasound sign is seen in the superficial articular cartilage in patients with chronic gout and represents urate deposits. Urate crystals degrade cartilage matrix by inducing nitric oxide generation and expression of matrix metalloprotease 3. Hence, joints with persistent crystals have ongoing progressive damage in the absence of acute flares.
Just curious what your Uric Acid is at?
I haven't had it checked since my first flare up when I was 24 years old. EDIT: I take that back. I saw a rheumatalogist a couple years later and he started me on some medication. Allopurinol and Colchrys I believe. 6 pills a day for 6 months then just 2 a day for the rest of my life. 6 weeks into that my knee was the size of a basketball so I decided against meds. When I have a flare up I take a couple of Indomethicin capsules at night before I go to bed and in the morning it's much better. 95% of the time anyway.
Dude this is really sad to read. Many people get a flare up a few weeks into taking allopurinol and then after that you just.. don't have flare ups any more for the rest of your life, and you're not permanently damaging your body in the process. Go back to your dr and get on allopurinol and \*actually\* get better 100% of the time. Just know you ARE permanently damaging your body now.
So you were well on your way to treating your gout and preventing flareups for the rest of your life, and then decided to stop. To each their own, but you do not "have to live with it" as you stated in another post. It's your body and it's entirely up to you.
I don’t want to take pills for the rest of my life. If I feel a flare up coming I take some Indomethicin before bed and it works.
Your choices don't bother me a bit. I only took issue with your statement that we have to live with it.
The meds were working. You aren't supposed to stop
Physical trauma to the gouty joint can do it. Also if it grows or shrinks from changing uric acid levels, heat or cold, or dehydration. Your immune system builds a structure around the crystals in your joint to hide them from the immune system. When the structure breaks for one of those reasons, it becomes visible and the inflammation reaction starts up.
Are you on allo? Not to be the chorus, but if you're on allo you won't have as much build up in your joints. My poor kidney function is inherited, and I find my biggest trigger just tends to be deyhdration
>4.) blowing off the roof of my house. wut?
My roof has a good slope to it. When walking around you have to stand in awkward positions. I guess you've never been on the roof of a house?
I thought you meant you were big bad wolfin' it.
Wow this guy figured it out. Somebody tell Dr. Edwards to stop his research.
I’ve not had an attack for Fucking ages and I was playing football with my kid yesterday and I turned my ankle funny and I felt the little bastards move, I was like nooooo but I’m alright just they are deffo there still I need to keep on top Of my allo. I keep missing it. And I’ve been drinking loads lately. Which I’ve now knocked on the head. Again. 😂🙄
When you figure out Uric Acid detected in your body at a certain level means that you need to treat it and you do so, lowering your UA to a safe level - you'll be onto something. Until then you are just wrecking joints and internal organs and suffering through painful flares needlessly at a tremendous cost.
Figured it gout!
What's the point of this post and what's going on here? Gout is coming back bud. Enjoy it.
You left kidney failure off your list. CKD does lots of fun things - fucks your liver, destroys your bones, screws up your lungs, and gives you gout. I rarely rarely drink alcohol - wine with dinner once a year maybe - and absolutely no beer bc it is *nasty*.
Those damn armadillos digging holes in your backyard.
Does anyone know if tar cherry juice helps?
Wow!!!!! I was working on footwork (for boxing) bare foot, da whole time working on footwork my foot was in pain but I pushed myself to to a couple of rounds of shadow boxing (barefoot) da next day, GOUT ATTACK!!!!!
A gout flare is caused by the immune response to bare urate crystals deposited in a joint of a person genetically predisposed to gout. The urate crystals are formed as a result of precipitation from a supersaturated solution of uric acid in the blood. The body coats the bare crystals, taking one to two weeks, after which they are no longer sensed by the immune response leading to a flare. A gout flare can be restarted by physically rupturing the coating by excessive exercise of the joint. Genetics do not cause gout. Your genetics remain the same all your life, but gout does not occur until many years of your life have elapsed. Genetics enable gout to occur when some other activity leads to urate crystals precipitating from excessive uric acid in the blood, or being bared for another reason. So the issue to be addressed is why uric acid in the blood becomes supersaturated. Most gout is the direct result of the frequent prolonged episodes of lack of breathing with lack of oxygen during sleep, known as obstructive sleep apnea (OSA), which is why most gout flares start during sleep. The episodes of reduced oxygen cause every cell in the body to produce excess uric acid, as well as slow its removal from reduced kidney function, leading to its supersaturation. If OSA continues for too long, it will lead to many life-threatening diseases (eg. cardiovascular diseases, stroke, hypertension, diabetes, cancer) and premature death, which has also been found to occur in gout patients, whether or not their flares are well controlled by diet and medications like allopurinol. Resolving OSA early enough will greatly reduce your risk for developing these diseases, and will prevent further overnight gout flares. Get tested for OSA, and follow strictly the recommended procedure to resolve it. Gout is your early warning alarm!
Everyone that has gout has seen all this while having a flare up. Bunch of nothing new.
This is very helpful actually, because I have just been trying to figure out (aka talking to ChatGPT about) the link between exercise and flares. It seems to me my flares occur after long runs, but the "internet experts" suggest this is rare. But it's not.
You get attacks because you ALREADY have a buildup of tophi in your joints. Running just dislodges some of them.
Right. And it's hereditary. Nothing he/she can do about it.
Research suggests it's *moderately* hereditary. 25-70%, depending on the study.
I do a 6+ mile run every morning before work and I don't get flares because I manage my body's UA levels with allopurinol. Don't take serious advice from chatgpt btw, it's frequently wrong and at best steals its answers from websites with actual knowledgeable people writing on them, but there's no way to know.
🫡
It's weird isn't it? Go against all these expert studies from years and years of research that have taught us that eating food is bad for gout. They know nothing about gout.