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No!
It’s dangerous for gout sufferers. Baking soda is mostly dangerous for everyone, except under medical supervision.Hi Donald.milotte and Richielyons76
Alcohol is part of gout diet. Gout diet is part of gout treatment. There’s no point in discussing gout treatment without relevant information about uric acid levels, and plans to contain them.
Anyway, your question summaries are:
Is there any beer safe for gout
and
Is there any alcohol which is not as bad as the others
I put the 2 specific questions into the gout search engine. That’s the box labeled ‘Google Custom Search’ that sits top-right of every GoutPal page. At the top of the results is the same result for both questions:
What Is The Best Alcoholic Beverage To Drink With Gout?I suggest you read that. Then, start a new topic about alcohol, uric acid, and your gout. Include information about the part that alcohol plays in your diet. Include information about your uric acid, and what you are doing to control it.
Since writing that article about alcohol and gout, I’ve refined the personal gout management plan that I mentioned. Now, I call gout management plans Structured Gout Help. If you want structured gout help, you must first start a GoutPal Gout Diary.
Again, I can’t add much to Patrick’s advice.
Bob, please post your uric acid numbers. Then I can be happy with sharing safe beef recipes. ๐
Thanks Patrick, for some very interesting information.
All I can add, is to ask for more facts. I’ve heard low blood pressure is harder to treat than high blood pressure. But, most important are the numbers. I say this, because I’ve heard people say “low blood pressure” when they actually mean “not high”.
Anyway, we’re not professional medics here. I think if gout is complicated by other conditions, it has to be managed by a professional. The dangers of giving someone un-prescribed allopurinol in normal gout are bad enough. I shudder to think what the dangers might be when the situation is compounded by hypotension and malnutrition.
Pamela, I urge you to get your partner to a doctor. It might be inconvenient and expensive. But, what’s a life worth?
Patrick, your final sentence reminds me of the FDA extra warning notice from July last year:
FDA is strengthening an existing warning in prescription drug labels and over-the-counter (OTC) Drug Facts labels to indicate that nonsteroidal anti-inflammatory drugs (NSAIDs) can increase the chance of a heart attack or stroke, either of which can lead to death. Those serious side effects can occur as early as the first few weeks of using an NSAID, and the risk might rise the longer people take NSAIDs. (Although aspirin is also an NSAID, this revised warning doesnโt apply to aspirin.)
The OTC drugs in this group are used for the temporary relief of pain and fever. […] Prescription NSAIDs are an important treatment for the symptoms of many debilitating conditions, including osteoarthritis, rheumatoid arthritisโ, gout and other rheumatological and painful conditions.
The consumer notice specifically mentions ibuprofen (Motrin, Advil) and naproxen (Aleve). We commonly discuss diclofenac (Voltaren) and indomethacin (Indocin). There are others, and NSAIDs are often active in many medicines such as cold and flu relief.
All that, combined with the destructive effects of uric acid crystals, should persuade every gout sufferer to get uric acid safe as soon as possible. I hope Paul can get his uric acid under control soon.
C’mon Paul – we’re here to help.
Bloody hell, Paul! How has your doctor let you get in this mess? ๐
I’m sure we can find a way out of it, but I need more information from you. I also need to explain some facts about gout. Because, reading between the lines of some of your statements, I think you’ve been misled. That’s not too important for now. 2 things are vital:
Gout Pain Control
As you’ve fallen foul of the naproxen/tinnitus problem, we need to find a way to get your pain under control. Giving up exercise is a bad thing, though sometimes with gout, we need to slow it down to a gentler pace. So, we need to find a tinnitus-free alternative to naproxen that will allow you to get back to your cycling. Have you discussed alternatives to naproxen with your doctor? You mention gout drugs as if you’ve tried more than one.Can you give details of all the drugs that you’ve tried, together with dose. I hope I can suggest some alternatives, if your doctor can’t.
This needs to be a short term solution. As you’ve experienced – long term pain relief for gout causes more problems than it solves. I put pain control first. But, most important is…
Uric Acid Control
You need to get your uric acid safe. Then, the need for pain control goes away. It’s usually very easy to do this. The starting point is always your uric acid level. Get a blood test and post your uric acid test result here. Please be sure to include all the test result details. Including, date (at least month and year), scale used (mg/dL, mmol/L, or μmol/L), and the number. I recommend getting a 24-hour urine test for uric acid excretion rate. It’s not essential, but it does help you make the best choice of uric acid lowering treatment.Paul, it’s a shame that you’ve had to endure this needless suffering. And, a greater shame that it will get worse unless we act now. Let’s work together to get your gout under control, for good.
Thanks, Dave, for the clarification.
In my view, you are well on track to becoming gout free. ๐
Your plan is certainly above average. Whether you want to make more effort to get rid of gout quicker, is up to you. Here’s my thoughts on your progress:Allopurinol Dose
This sounds right to me. You’ve increased allopurinol dose inline with blood test results. 267 is a perfectly acceptable target. It allows the uric acid burden that has built up over several years to dissolve. Most people would regard this as ideal. But, if you have visible tophi, or if you want to get rid of your uric acid burden quicker, talk to your doctor about further increases in allopurinol. Once the burden is significantly reduced, you should be able to slowly reduce allopurinol dose to maintain uric acid below 300 μmol/L.Because our bodies change with age, I strongly recommend all gout sufferers get a uric acid test at least once a year. That way, you can make sure it never creeps above 300, which might allow uric acid crystals to start building again.
Gout Diet
Your diet sounds good, as long as you are happy with it. Personally, since controlling uric acid, I’ve focused on trying to eat healthily. That’s usually the best thing for uric acid, as well as general health. If you are happy with your diet, all seems good to me. If not, we can chat some more.Hydration for Gout
Hydration is always important for gout sufferers. This does not change on allopurinol. Some people might argue hydration is more important when on allopurinol. I won’t bore you with the details.
If urine is darker than a pale straw color, drink more fluids. Water in all drinks and foods is part of your fluid intake. It does not need to be plain water all the time.Pain control during early allopurinol treatment
As I mentioned, you have a uric acid burden from crystals that have formed over many years. It takes at least six months to get rid of that burden. Usually longer. During that time, naproxen as required is usually a very good strategy. But, don’t be surprised when old crystals dissolving cause a little discomfort. Take the naproxen at the first twinge, and try to stay mobile. I recommend a dance of celebration – gout pain when uric acid has fallen below 300μmol/L is a sure sign that you are recovering from gout! ๐Hi David, it’s good to see your uric acid is now safely below 300 μmol/L. That should mean that your need for pain control will diminish. It’s really great to see some clear uric acid test result data. Thank you for that, but I have a question. You say: “Currently taking 400mg of Allopurinol per day.”
When did that dose start, David? Is it an increase between the last 2 tests, that finally got your uric acid safe?
“I donโt fit into a group”
I just spotted this. I feel it’s important that I explain my view. Every GoutPal reader needs to know this. So, it’s not a personal message to Andrew. It’s a message for all gout sufferers.
I rely on GoutPal Gout Groups to organize my gout facts. Increasingly, I’m using them to improve my personal responses to casual gout help. I absolutely need them to focus my structured help plans. So, I feel it is very important that all my readers can identify with one of the groups.
Maybe I should use a better word than
Group? โAnyway, they are groups of GoutPal readers. If I’ve got the logic right, every gout sufferer must fit into one of the GoutPal Gout Groups. If gout diagnosis is uncertain, then you’re in the Arthritis Sufferer Group.
Actually, I didn’t quite get the logic right in Which Gout Group Am I In. But, I’m actively working on putting that right. Hopefully, I’ll have it finished today (see Questions for Gout Sufferers). But, I’m also adding individual guides for each group. They will point each gout sufferer in the right direction. With 9 individual group pages, plus a new group summary, 10 pages a day will be a new record for me.
Sorry for the interruption. Gout Groups are playing on my mind at the moment.
I’m really pleased your gout flare has almost gone, Mark.
I hate to be the bearer of bad news. But, chances are, it will come back.
Worse, as you’ve never had a uric acid test result below 5.Every sentence of your latest message resonates with me. I have lived your gout life! You are doing many things right. But, you have some fundamentals wrong.
Uric Acid Testing
Uric acid testing is a good thing. But, it is only relevant when you have a safe uric acid target. Then, you can test to target, and adjust your regime accordingly. Before I realized that, I’ve played exactly the same games with uric acid meters. In the right circumstances, they are useful. If you are committed to using one, my best general advice is:
Look for trends and averages with uric acid test results from home meters, rather than specific results. If you are home testing more than once a day, keep separate data for each time slot. Analyze moving average of at least three results. Ignore especially high and low results (or record them separately from your trend analysis).General advice is one thing, but much more important is specific advice. Interpretation of results often depends on where you are in the symptoms-diagnosis-treatment-symptoms cycle. And, quality of data depends on the consistency of your testing procedure.
Uric Acid Burden
Plant-based diets and hydration are good. But, current diet changes have limited impact on gout attacks. You can’t ignore that. But, more importantly, you cannot ignore the uric acid crystals in your body that have been building up for years. That uric acid burden is what gives you the foundation for a gout attack. While you have that burden, you have a gout risk.For some reason, I tend to think of fire-fighting analogies for gout, these days. Imagine a buildup of litter in your yard. Passing smokers flicking their butts over your fence keep causing fires. Yes, you can hide by your gate, and shoot the bastards. But, wouldn’t it be better if you cleaned the litter?
Gout Pain Control
When it comes to gout pain, “shooting the bastard” is a very wise strategy. And, you need to get good at this before the overseas trip. Trust me on this one. Those sneaky foreign gout attacks are flicking their butts from directions you never expected.Or, to break my analogy, and put this a more sensible way. Starting uric acid lowering treatment might cause a gout flare. Continuing unsafe uric acid levels will cause a gout flare. Your uric acid burden is highly likely to show itself in the unfamiliar environment of an overseas work trip.
You need an effective gout pain control plan. That takes the worry from your overseas trip. And, when you chose to start your uric acid control therapy, you can tackle that without worries about gout pain.
In your shoes, Mark, I’d see the doctor to get an invincible gout pain control package that will cover you for your overseas trip. Also, start the preparations for uric acid lowering therapy. Time spent now, means you can be prepared to start uric acid control as soon as you return. See what your doc says. I’d start with a 24-hour urine test. Other recommended preparatory tests depend on ethnicity.
Let us know what your doctor says, Mark. Best in a new topic – we’re moving far away from gout triggers.
Andrew, that’s very interesting about the magnesium.
I keep banging on about safe uric acid levels. But, gout pain is very complicated. Scientists are only just starting to understand how gout pain usually needs other factors besides uric acid crystals.
Of course, the bottom line is, if you get rid of the uric acid crystal burden, you cannot get gout attacks. But, until that happens, there’s many things that trigger each attack. So, there’s many things that can help prevent it. The hard bit, is finding the right treatment combination. I guess, I’m lucky, because I respond well to the standard gout pain meds.
As you’ve shown, with some perseverance, it’s often possible to find non-standard ways that work.
The 6.8 crystallization point for uric acid is a lab value at standard human body temperature. But, as well as temperature, there are many other factors that affect crystallization. Anything over 5mg/dL is generally considered bad. But, if you are exposed to prolonged cold, even that could be too high. Just part of the reason why gout management has to be personal. We are all unique!
The shape of uric aid crystals is completely irrelevant (unless you are trying to identify them under a powerful microscope). Gout pain is an immune system reaction. White blood cells exhibit some extremely “clever” properties. But, shape recognition isn’t one of them. They will react to invading foreign bodies irrespective of shape. Volume of crystals is significant. But, most significant is personal status of your immune system. Sometimes you just get a bit of itchy discomfort during a gout attack. Sometimes, you get a slight fever. Sometimes, it’s full-blown agony. Just another part of the reason why gout management has to be personal. We are all unique!
Am I repeating myself? Time for bed!
I love it, Andrew! ๐
I’ve heard of saturnine gout. But, I thought it was part of history, given that lead plumbing has virtually died out.
There are lots of environmental toxins that can cause secondary gout. I tend to lump them all together, but it might be better if I investigate specific toxins more (?)
The answer, as with all secondary gout causes, is to get rid of the root cause if you can. But, this often takes a long time. So, it’s usually best to take something to lower uric acid, until the root cause can be stopped. Or, in case it can’t be stopped.
Of course it’s gout.
And, who wants uric acid to be normal?? (“Normal Uric Acid? No Thanks!” might be worth a search ๐ )
Normal means average. Average means a 6 in 100 chance that you have gout.
It’s much better to aim for safe, rather than average. Safe means a 0 in 100 chance that you stay with gout.
Your doc might be happy to give you a 6 in 100 chance of gout. I’m not. I will only be happy, Mark, when your uric acid is safe.
It’s nice of you to bookmark me. But, I’d much rather you post here every time you think of anything about gout.
Anything about gout. Or, anything.
Uric Acid Diet
I find ‘careful’ is usually better than ‘strict’ when it comes to uric acid diet. Start with EFSEP (Eat Food. Sufficient. Especially Plants), then tweak. From your post #2044, you seem to tick the ‘Eat Food’ box. That means, you appear to eat real food, and avoid processed food-like substances. I’m with you on that. Just today, I vowed to stop buying any foods that contain ingredients I wouldn’t eat by themselves. Despite my urging people to ‘read the label’ I’ve been getting lazy. I thought I was good switching from an animal burger to a plant burger. Until I read the label, and saw: “Calcium carbonate, added iron, niacin, thiamin, annatto coloring, glucose-fructose syrup, modified maize starch, diphosphates, sodium carbonates”. ๐ฎ I’ll be making my own veggie burgers, in future.As for the other 3 boxes:
*- Sufficient – My bathroom scales tell me, I’m failing that, but improving. I’m now trying to cut down on too much bread & pasta.*- Especially Plants – For me, that’s fish about 5 days a week, and meat about once a week. Or, at least that’s my target! ๐
*- Tweak – This is well overdue for me. I’ve been trying to focus on EFSEP. But now is my time to look more closely at specific food improvements. I haven’t made my gazpacho soup for gout in a long time. I think I need to create a winter version of that, now. Also, I’m thinking about researching quercetin. So, look out for a red onion soup recipe.
You’ve got me thinking there, Andrew. 2 soups is too strict! I’m going to aim for a different plant-based soup for each day of the month. I just need to find a better way to enjoy soup. That is, without 2 slices of thickly buttered bread!
Rheumatoid Arthritis (RA)
It’s a shame about the RA, Andrew. I think lots of gout sufferers also get rheumatoid arthritis. I don’t think there’s a causal connection. There are likely management connections regarding anti-inflammatory pain relief, and low-inflammation diet. But, on balance, I’d say it’s best to get uric acid under control, then that part of the inflammation problem is solved (in at least six months).Moving Gout
Anyone who thinks gout doesn’t move around is ignorant. Best to send them here for some training and enlightenment.Hi John,
I’m sorry to read that you are in pain. But, I’m shocked to see you’ve had gout for 38 years! I would normally tell you to get to the doctor right now, and discuss safe gout treatment.
But, what doctor allows gout to last 38 years without getting it under control?!?
I’m really struggling to know what to suggest, John. There’s obviously a lot more to your story than you are telling me. I want to help you. I just don’t have enough information to tell you the best way to get the right treatment. Do you have any uric acid blood test results?
I’m especially struggling to understand why you are considering prednisone or probenecid. Both of these drugs can play a part in gout treatment. But, they are not the obvious options. Both have very different roles in gout treatment. And, both of these would only be the first choice if you had some specialist tests done.
I’d love to help you better, John. But, I need more information. As well as uric acid test result history, I need to know:
– What has your doctor suggested?
– Why consider prednisone?
– Why consider probenecid?
– Have you used either of those drugs before?
– Have you used any other forms of gout treatment in the past?Sorry about all the questions John. Gout is very easy to manage in most cases. But, it depends absolutely on applying the right treatment for personal circumstances. If gout treatment isn’t matched to your personal situation, it’s a waste of time.