Gout And Alcohol Debate

August 15, 2011 in What Are Purines? Gout Diet Forum

Arguments about gout and alcohol continue, and I have summarized my thoughts on the main gout information site. I am sure I need to add more detail in some areas when I have a clearer idea about the real issues that affect gout sufferers. I have recently introduced a debate about uric acid lowering treatment and alcohol, and this debate runs alongside it, as I do not want to dilute the treatment debate with remarks about alcohol consumption and gout in general.

There is never a single simple answer to stopping gout. Every gout sufferer needs to understand their own personal circumstances with respect to gout, and develop their own personal plan to deal with it. At GoutPal, we use the forums to start a plan. Then we can discuss the things that really matter with our doctors, and get the right treatment.

Alcohol And The Treated Gout Patient

The first consideration is if you are taking uric acid lowering medicine or not. So if you are taking allopurinol, febuxostat (sold under the Uloric brand in the States, and Adenuric elsewhere), probenecid or any other treatment designed to lower uric acid, please see the debate about uric acid lowering treatment and alcohol.

Alcohol And The Untreated Gout Sufferer

Just because you are not taking treatment to lower uric acid, you should still get a uric acid test at least once a year, and know your uric acid number. Forget about meaningless labels like high, normal or low – it is the number that is important.

You need this, because the only thing that matters about gout and alcohol is how it affects you. There are hundreds of investigations into links between alcohol consumption and gout, but almost all of them are statistical studies that do little or nothing to explain how alcohol affects gout. They certainly do not, and cannot, explain how alcohol affects your gout.

By all means, use the statistical studies to give yourself hints about how different types of alcohol might affect your gout. For instance, switching from beer to wine or cider might improve your gout. Total abstinence may make it better or worse, depending on who you believe.

If you want to test these theories, you should get a first get uric acid test. Then change your amount or type of consumption for 4 weeks, then get another test and compare results. One test is not enough, so you have to keep testing different combinations until a pattern arises.

You should not measure results based on the number of gout flares, as this is no indication of how your gout is progressing.

I have added some clarification about the best way to ask about gout and alcohol. Also, I have summarized the latest advice and best practice in the Gout and Alcohol guidelines.

Leave the Gout And Alcohol Debate to browse the Gout and Alcohol guidelines.


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37 responses to Gout And Alcohol Debate

  1. I would suggest not all forms of alcohol pose the same level of risk to the gout sufferer, whether on a gout medication, or not. My personal experience, for instance, is that some beers and deep red wines can cause me problems in short order, whereas white wines such as chardonnay have never precipitated a gout attack. Perhaps it is not alcohol per se that causes the problems, but rather other things that alcoholic beverages contain?

    • I do believe that other substances, especially in red wine, can affect gout. And I have a theory that uric acid is more soluble in alcohol enriched blood than in normal blood. But these are mere beliefs, and do not really mean much, except to me.

      My main point is that you cannot attribute good or bad status to alcohol, or anything else, based on whether it causes a gout flare or not. We know from our experience with uric acid lowering treatments that gout attacks can be induced from old crystals dissolving just as they can from new crystals forming.

      Without precise knowledge of your uric acid level, you can never be certain if your gout flare is good or bad.

  2. I have suffered from Gout for over 25 years, I also have been drinking Beer and wine and Liquor all those years, Until recently I have given up on all Alcohol, and Meats ! I’m also having allot of trouble right now with my gout, I have been on Allopurinol for almost three years, I was just diagnosed with gout three years ago, But I had it for many years without problems a few flareups here and there, I take 300mg a day! this is no miracle drug by far, but does help some. My whole body is in pain all the time, I cannot sleep well, and it keeps me grouchy from the pain. I have tried so many pain pills, they only help a little. but never stop the pain. even Morphine did not stop the pain. A friend who also suffers advised me that his doctor told him that liquor wasn’t near as bad as Beer and Wine and he drinks that. I’m told that beer and wine are not good for gout. I know red meat isn’t I can eat a steak and it’s not good! So I gave up meats, pork is bad also. I’m interested to know if anyone has filed for Disability for there Gout, I did last year and was turned down,but only because I haven’t worked long enough so they say. I have an Attny now who is fighting for my Disability. I have lost several jobs over gout. Have been out of work now for a couple of weeks again because of gout. Life just isn’t good with this Gout.  Thank you and try to have a good day!  A.J Johnson

    • You have my sympathies. Gout pain is terrible if allopurinol is not managed properly. It is very easy to allow alcohol, or more specifically attitudes to alcohol to cloud the judgment, but that is exactly what happens in most cases.

      The fact that you have not mentioned your uric acid level speaks volumes. If it is not kept at, or below, 5mg/dL (0.30mmol/L) then you are simply not doing enough to help your gout in the long term, and you may be causing more gout pain in the short term.

      As I wrote in the article that started this debate about gout and alcohol, you must get your treatment right BEFORE you start worrying about alcohol. If you cannot get uric acid to low enough levels, then you should consider reducing alcohol, and switching from beer to a couple of glasses of wine per day.

      The disability is a whole different debate, but why even consider it when gout is so easy to treat. Of course, I say easy to treat, but if you do not control uric acid levels properly, then you will never control gout. My choice is controlling uric acid effectively, and enjoying my life without disability handouts and misery. I cannot understand why anyone would accept less than this, unless they have gout with other problems that prevent proper gout control.

      The most likely thing that prevents controlling gout properly, is having a doctor who does not understand the importance of getting uric acid to 5mg/dL (and much less for at least six months to speed up dissolving old crystals). If this is your situation, let us move the discussion to a more fitting debate area, and work out a plan to get doctor and patient working together to fix gout properly.

      Finally, you must realize that allopurinol works on the cause of gout by controlling production of new uric acid. It does absolutely nothing for the existing crystals that have built up throughout your body, except that it can create an environment where these can dissolve. It is essential that you do dissolve old crystals, but you must also be prepared for pain during the time these crystals are dissolving. The lower you get uric acid levels, the faster crystals will dissolve. Depending on your levels, it might be a few months to several years, but you must have pain relief either as a preventative, or as you require it. A combination treatment is best, including colchicine to stop inflammation increasing, NSAIDs to lower inflammation, and analgesics to block the pain. If you are not getting that, then I’d look at medical negligence before you look at disability claims.

  3. I first had an attack of gout three years ago, and the only thing the Doctor reccomended was cuting out or cutting down on alcohol, ( I would drink beer mostly, and maybe wine on occasions) since then i have associated Gout attacks with too much alcohol, after the last attack I cut alcohol to a minimum, but my gout has just flared up again.

    I am now looking at my diet , and I think my trigger food is Duck, I feel if the Doctor had not told me that alcohol was the problem I could have had a wider view of things , instead of putting it all down to alcohol.

    Thanks for a great website

    Regards

    Frank

     

    • I’m sorry Frank, but your doctor is a fool. Gout is not an alcohol disorder, nor is it an eating disorder. It is an arthritic condition caused by excess uric acid. Now some people believe that alcohol, duck, fructose, vitamin C and thousands of other random substances cause gout. That is nonsense, only excess uric acid causes gout.

      Now, the follow-on argument is that alcohol causes excess uric acid. If that is the case, then the only thing to do as a competent doctor is to measure uric acid, then stop alcohol, then measure uric acid again. This applies also to duck, and any thing else you care to think of.

      By failing to measure uric acid, your doctor is wasting your time. Alcohol, or any other change to your diet is irrelevant unless it is compared to uric acid levels in your blood. Once you have had a gout attack, then you must get uric acid down to 5mg/dL (0.30mmol/L), or below.

  4. Dear gout pal,
    Thank you for your prompt and informative reply, I have spent a good part of the day learning from your excellent website , I have ordered a uric acid tester and intend to monitor closely the reaction to my diet (beer included) and try and control it this way I dont want to be immobile fir another week if its in my power to change this, cheers frank

    • That’s good, Frank.

      It is in your power, and together we will beat it. Once you get your meter, if there is anything you are not sure about, please come back and we can discuss your uric acid numbers.

  5. Firstly, good site!
    I live in the tropics and, at times, tend to neglect my water intake. During the week I my job requires me to socialize so my beer intake is usually high. My diet is balanced and I eat red meat once a week max. During the week I never have an attack, however, at weekends I cut right back on the beer and try to hydrate with water, tea etc. My weekend diet would be all fresh, home cooked food. Nothing processed. Yet all my attacks happen at the weekend or during holidays! and are becoming more frequent. Clearly, alcohol is not a factor, not that I can see.

    • Thank you for that, B Goodenough. You make some interesting points. Watch out for that increased frequency – it is a sure sign that your gout is progressing to more serious stages, as it always does if left untreated. I agree that alcohol probably does not have much to do with it, or if it does, the actions are complicated and difficult to understand. Irrespective of your feelings on gout and alcohol, it would be good to get a handle on your uric acid number.

  6. I have added some clarification about the best way to ask about gout and alcohol. Before you contribute to this debate, please explain your personal circumstances and be clear about what you are asking. Is your contribution relating to gout causes, gout treatment, gout diet, or something else?

    • Has anyone noticed how, as soon as I ask for a better debate by clarifying the issues between gout causes, gout treatment, or gout diet, I am immediately ignored? I guess alcohol just promotes indistinct discussion even when writing in a forum. I’m off back to the bar to ramble incoherently about gout to anyone daft enough to listen. :-)

      • My boyfriend is a 31year-old filipino and has had gout for more than 3 years and is on 3 meds for it.He has been told part of his having gout is ethnic background. I hate when we go to the dr about a flare-up and most of them tell him to quit drinking(like he’s an alcholic) HE DOESN’T even drink; really maybe in a year he will have 4 drinks. His really big triggers are butter, steak and hamburger. I know that there is more not so nice food for him; but not sure who to believe on what foods,dr’s say google it but everyone has an opinion. So my question is we are going on holidays in a few wks and we might try and I say try to drink one night as its been 3 yrs since I have had a drunken night and we have never been drunk together, we want to know if he is to drink anything what should it be?

    • I guess we are a little defensive Keith. I drink a lot of red wine and it has never caused a gout flair. If I succumb to a beer, however, I have spectacularly debilitating, multi body part, gout flares, that last for weeks. People who learn I suffer from gout make the automatic assumption that all alcohol is bad and I am effectively getting my just deserts. My wife never stops riding her hobby horse on this and my arguments are all in vain. I just figure that beer is high in purines and that it is nothing to do with the alcohol content.

      • Hi James,

        All good points, but missing the most important one – uric acid levels. If you get a gout flare, and you do not know your uric acid level, how can you tell if alcohol is helping or hindering gout? We know, from the endless discussions about gout pain while taking uric acid lowering treatment, that gout flares can be caused by good things like falling uric acid levels.

        As a second consideration, I’ve heard that there are some companies who follow the sacrilegious process of de-alcoholizing wines and beers. If the stories about different types of alcohol having different affects on gout, then surely this would follow through to the de-alcoholized versions?

        Whenever we discuss alcohol and gout, we never really seem to get to the real issues. As you note, drinkers get defensive. Other people speak without any real knowledge about gout. The resulting confusion gets us nowhere, so we end up with “just desserts” and “hobby horses.” I’m not having a go here – just exploring the context of many gout and alcohol discussions, which almost never focus on facts.

        The real issue for me is first getting a clear picture of how alcohol affects gout. Then, if it is shown that abstention from alcohol cures gout, the choice is clear. Unfortunately, most people start judging based on gout flares, but the only true measure is uric acid levels.

  7. Keith, in essence, I do agree with YOU. However, let me add my twist on the story of ALCOHOL and GOUT:

    1) Alcohol per SE and its relationship to gout is a bunch of hogwash.
    2) Alcohol has its affects on body and mind, regardless of gout.
    3) An alcohol-dependent, or plain, alcoholic (goutie or not) is just looking for an excuse for another drink when s/he comes here to find out which alcohol is good or not for gout.
    4) A whole year (2010) without a drop of alcohol, except ONCE (1/2 half a bottle of Crown Royal after having been sick of myself, others, and my gout and it didn’t hurt me and my gout) I went through the worst hellish gouty year of my life. And today, 2 years later, I drink beer, wine, hard liquor almost every day (but in moderation) and I haven’t had an attack in more than a year. However, I do have my gout (SUA) under control: ~3 mg/dL)
    5) Alcohol, food, possessions. activities, anything in excessive supply or not enough supply, will be detrimental to any one’s mind and body, GOUT or NOT GOUT.

    • 1) Thank you for your incisive scientific contribution to the gout and alcohol debate.
      2) Ditto.
      3) Totally agree.
      4) How dare you do that without offering me the other half?
      5) Oh yes. For gout and alcohol, or gout and anything, we’ve said it before *moderation in all things*

      Gimme an alcoholic beverage and let me toast the 3mg/dL :cheers:

  8. I say I am a 36 yr. gout sufferer, (71yr old) confirmed only 2 yrs. ago. Now on 400mg Alop.& 1.2 Colch. per day. Everything now under complete control,.3mm and running up to (in spring/summer) 100 miles per month. (extreme athl. stuff) I cannot touch Alcohol. One drink and bang I am down with .3mm reading during the attacks. Live two blocks from clinic and have ready access to blood tests. This is the only consumption (alcohol) item I have been able to prove up in 36 years and its 100% of the time. I am shocked there is not more gouties with this alcohol experience coming foreword on this site. Why would that be ???

    Gerry Wilson

    • Hi Gerry
      When you say .3mm, do you mean a blood uric acid test result of 0.30mmol/L? If so, this is the safe level that proves your allopurinol dose is correct, but I cannot see what it has got to do with the effects of alcohol on gout. What does “One drink and bang I am down with .3mm reading during the attacks” mean? That is the same figure, and it is perfectly safe. This implies that alcohol has no effect on your uric acid levels, which is what I have always believed. If you are saying that alcohol is giving you pain, then that is a different thing entirely. Chances are that the pain has nothing to do with gout if it only occurs with alcohol.

  9. I see, thank you Keith for, something more to think about.

    For your info., the blood uric acid level test taken during the attack registered .30mmol/l. This is also the third time I have had the same uric acid reading from a self-inflicted alcohol incident. I have had many others (alcohol related) in my life but no immediate uric acid test to go with it. If it isn’t gout it has exactly the same results and if not attended to will flare like a red balloon. My Ruemy. says it’s gout, as he has attended to one of these happenings,taken neddle samples and looked at it under his newest latest microscope and declared “Chrystal fragmentation” (old broken down chrystals) which my body happens to be sensitive about even at the acceptable blood uric acid (.30mml/l). His advice, “alcohol predisposes you gout/like attacks, remove it from your diet”.

    I know I have other gout causers, as I purposely live on the edge of pain and stiffness through extreme exercise/Hot-cold pool/etc.etc. Ruemy. laughes as he thinks I am wingieee (which is probably the truth) but is interested in the results. He has trainees around in his office and also teaches this stuff at UBC.

    Regards;
    Gerry

    • The good thing is that your uric acid level is remaining at 0.30 mmol/L. This is safe, and the crystals will go eventually – it just takes time.

      I have also noticed, after alcohol, that stiff joints and aches are common, and of course, I put this down to gout. However, talking to a non-gouty friend, who drinks alcohol almost every day, he informs me that he gets the same. He takes a day or two off the alcohol, and the stiffness goes. After drinking days, he feels stiff, especially in the morning. Could this be an explanation?

      We probably will never know, but here’s hoping that you get clear of this once all the old crystals have gone.

  10. Thank you again Keith for your point form comments. This type of communication is all new to me and I think I need the following clarifications ::

    1/ Are you implying “not scientific enough to be acceptable, or say creditable” ??

    4/ What is “the other 1/2 please” ??

    5/ I do not get the point here. For further information though, I have not been what I would call a Drinker since the age of 36 (now 71). I imbibe anyways on odd occations.

    Please, do enjoy your toast. I just wish we were close enough to allow me buy.

    Respectfully and light;
    Gerry Wilson.

  11. I found alcoholic drinks like rum and liqueur to have no effect on gout. If anything I felt better. The key here is to drink a lot of water before and after having alcohol.
    I found watermelon to be quite effective and I have a feeling that betel leaves (eaten i India after meals) are beneficial, but I still need to try these out over an extended period of time. I also wish to try out the beneficial effect of cod liver oil tablets which are claimed to be goo for gout prevention.

    A vigorous game or workout helps especially in case of Continuous exposure to AC environment.

    • From my article above: “You should not measure results based on the number of gout flares, as this is no indication of how your gout is progressing.”

      Staying hydrated is a golden rule for all gout sufferers, and has little to do with the gout and alcohol debate.

      I have removed some other comments about supplements and exercise. These are not necessarily wrong, just not relevant to a debate about gout and alcohol. Why not use the new gout forum?

  12. My fathernlaw has had bad gout attacks for the past 20 years and has never and will never drink alcohol. However, he does eat a lot of steak, bacon and other foods high in purins. He is on medication for it. So, alcohol does not seem to be the problem with him. As you say it is the level of uric acid and I believe that some people just have a high level of it and it eventually catches up with them. His son also has gout problems and does not drinl alcohol except many on occasions and it does not seem to be connected to his attacks. I recently had what I think was my first gout attack, swollen big toe and a lot of pain to the touch. Howevre it began after I strained my foot pushing a vehicle so not sure it is gout. It also was after I had drank alcohol about three days before. I need to get a device to start checking my uric acid level. Where can I get one and is it advisable to do it at home? Thank you.

    • Hi Tom, welcome to GoutPal.

      Gout is mostly a hereditary issue. Lifestyle and environment can play a part, but the majority of gout is genetic.

      Doctors cannot be bothered to understand it, or understand how to treat it, so they push loads of bad information about gout being your fault due to bad eating and drinking habits.

      I do not think that you should have bad eating and drinking habits, but neither do I think that changing them will fix gout. You have to control uric acid to control gout. Any discussion of gout without knowing your uric acid number is meaningless.

      Home testing devices are available. I have described how to get them at http://www.goutpal.com/uric-acid/uric-acid-test-kit/

      These work OK if you are absolutely meticulous. Unfortunately, few people have the skills to collect a perfect sample, and place it correctly on the small target area of the test strip. This leads to more problems than it is worth, with unreliable results clouding your judgment about proper treatment. There are situations where a home uric acid meter is useful, but I need to know why you do not take the obvious route of getting uric acid tested by your doctor.

  13. Hello everyone,

    I am a 33-year-old, caucasian, male who was diagnosed with gout in May of 2010. I had my second flare-up in June of 2011, followed by a 3rd in February of 2012, a fourth in April 2012 and finally a fourth (my last) on August 6th. My flares have all been in the big-toe joint of my right foot. I have also noticed painful swelling in my right ankle and knee at random times.

    At the time of my first flare up in 2010, my uric acid levels were 5mg/dl. My uric acid level at the time of my 2nd flare up (almost one year later) was at 5.5mg/dl. At the time of my 3rd flare up, my levels were back down to 5mg/dl. During all exams and upon results from my bloodwork, my doctor explained that my uric levels were below the threshold for gout in men, but that I did in fact have gout.

    I plan on getting another uric acid blood test next week and I will be curious to see the results. I am concerned with the Uric Acid level tests not being accurate or relevant to gout flare-ups since my doctors said I can have a gout flare up without higher than normal uric acid levels.

    I am not on a maintenance medication like allipurinol or cholchicine, however, I take cholchicine at the time of a flare up. (One .6 pill every two hours). I have found that taking the cholchicine does not relieve my pain immediately and almost all my flare ups have lasted 3 complete days.

    I will let you know what the results of my next test will be…

    I drink alcohol, especially beer daily and have done so for the last 4 to 5 years. I have not changed my alcohol consumption between flare ups. My uric acid levels seem to be unchanged and unaffected by alcohol.

    • I’ll work backwards through your points, as the later ones are easier to answer.

      There is no reason why alcohol would affect your uric acid test results.

      Colchicine stops inflammation getting worse. It does not relieve inflammation, and it does not relieve pain. That is why I recommend that colchicine is always supported by an anti-inflammatory such as ibuprofen or naproxen. Sometimes it may also need a compatible analgesic – your pharmacist can best advise which pain killers are suitable to take alongside your other meds.

      Now for the mystery gout with uric acid in the low fives.

      Technically, the only way for this to happen if you are constantly exposed to low temperatures. I’ve heard of this in homeless people, and I guess it could also be possible for people working in cold conditions for long periods of time. Uric acid is soluble above 6.8, but low temperature can bring this down.

      A common reason for low test results in gout sufferers is the tendency to only get tested during, or immediately after a gout attack. In this situation, some uric acid moves from the blood into crystals, and so cannot be measured. The only solution to this is to get tested when you have not had an attack for two weeks.

      A less common, but not unheard of reason, is poor testing procedures. If there is a delay between drawing blood and analyzing it, uric acid can breakdown naturally causing under reporting.

      Finally, though your symptoms are very gout-like, you might actually have something else. A rheumatologist would be the best specialist to examine and advise on this.

      • Thanks Mr. Taylor. I am in the process of finding a Gout specialist or a Rheumatologist that can help me further.

        One other note, when I go on a fast or go on a quarterly detox I seem to have mild flare-ups almost immediately. I wonder if this has anything to do with my body purging the excess uric acid in my body and thus leading to a buildup of crystals in my big toe.

        Thanks again.

        • Cheers Gary,

          I’m a bit surprised by the Mr Taylor – last time I heard that, I was being arrested (only joking, but Keith is just fine).

          I think whenever gout is not straightforward, either in diagnosis or if there are treatment complications, then a rheumatologist is the best option.

          I now nothing about detoxing, but fasting is a well known cause of gout. It is common in cultures where fasting is a regular feature. We know that uric acid can come from the flesh we eat, but much more comes from our own flesh. That is why vegetarians get gout. When fasting, our lean body tissues get broken down for energy very quickly. That releases purines, many of which breakdown to uric acid. Gout attacks are also common in the first few days of crash dieting.

  14. Please could you tell me if low alcohol beer contains purines
    Thanks C Campbell

  15. Hi.

    MY take on this interesting subject:

    Yes, the Medical Profession make lazy assumptions on Gout (I guess they have more important things to research).

    These assumptions contribute to the stigma associated with being a gout suffer (everyone assumes you are a modern day alcoholic Henry VIII)).

    I have had spells of no alcohol for weeks (the last 3 months of my wife’s 2 pregnancies for example) and during these spells I’ve had gout attacks.

    I drink often, not necessarily heavily, just four cans of 5% lager every two days for example, maybe twice that Friday and Saturday night.

    If I have beer or RED wine – no problem (even though you’re lead to believe RED wine is bad for gout) and, to add to what others have said here, those drinks can help relieve both the pain and swelling.

    Eg – had a bad attack yesterday morning (say a 7 out of 10 on the pain threshold) and I drank 5 beers last night – pain is now a 3 or 4; surely if beer was bad for it then I’d have been AT LEAST still at a 7 right?

    BUT…..

    I think WHITE wine can kick it off, as can champagne.

    My last two attacks have been after drinking both of these things (my 40th Birthday and then Christmas Day).

    Anyway, I just wanted to do a +1 to the fight against the lazy assumptions made and throw my two cents worth into the equation as far as white wine is concerned.

    (Also have experience of an attack after a night where I’ve drank vodka and coke but I believe this is to do with the sugars and fizz in the coke rather than the vodka).

    • MJP, I basically agree with your comments, except the one about white wine and champagne. Some other gouties know, I drink my own homebrew, 7% (Hans in New Mexico Stout) 2-3, 12oz bottles and 1-2 glasses of white or red wine (also home-made) with dinner every day/night and I haven’t had a gout attack in nearly two years. Friends and I “celebrated” DOOMSDAY Dec.21, 2012) by drinking, eating and having fun all day. I drank 3 glasses champagne and 3 bloody Mary’s and never had an attack, hang-over or belly ache. (I must confess, though, that I also drink 10g of CA Bentonite Clay in 2oz of water before I go to bed. Why? Read up on Montmorillonite Bentonite Clay and you’ll understand.)
      Now, THAT’S ME/I who has been getting away with it, however, it was Keith who drummed into my head that I have to get my Uric Acid level down to/below 5 mg/dL, which I have done. What I am saying is that the saying: What’s right for the gander ain’t necessarily right for the goose.

      • Hey.

        You having a DOOMSDAY party made me chuckle! I like your style!

        Your post had a profound effect on me.

        I’ve taken the New Year as a chance to re-assess how I’m not managing gout at all, leaving it all to fate to decide when I’ll next suffer from it.

        You’re right, it’s all about getting the Uric level down first, then I guess a particular type of wine/booze won’t matter.

        I’ve now ordered Cherry Capsules (which came highly recommend on this site) and bought a book “Beating Gout: A Sufferer’s Guide to Living Pain Free” – after quite a rough 2012 gout-wise, I am determined to be pain free in 2013.

        PS – Thanks for your reply!

  16. I was diagnosed with gout shortly after I got out of the Military. I was 23, in college, drank heavily, ate poorly when my first flare-up occurred. It was in my ankle and was misdiagnosed by the campus doctor. I played beer league hockey at the time and went into the boards feet first and got my blade caught in between the boards. Went ome after the game, drank with my teammates and woke up with swollen ankle and unable to walk. The doctor gave me an ankle brace and told me to keep it elevated. We all know how physical contact feels with a gout flare-up!!! The pain was terrible and after a couple of days, I started drinking… I drank a lot and my ankle never seemed to get any better. I was down for about a month before I could move around and when I walked, I used crutches. After awhile the pain went away and everything seemed to get back to normal. About a year latter, I went to go see my brother in another state and when I got there my knee swelled up and I was in terrible pain. When I got home, I went to see my doctor, who said I had a torn meniscus. Same thing as with the ankle only more pain all around. When I told my dad about it, he said he used to get pains like that and he was diagnosed with gout. So i went back to my doctor and was finally diagnosed with gout. At the time my UA level was 10.6 and this was back when I was 25 years old. My doctor put me on allopurinal, which didn’t help at all and upset my stomach something fierce. I got off that and decided to control my gout with my diet. Stayed away from red-meats and pork. This worked great and was able to get my UA levels to 5.0. This whole time, I drank like a fish… I drank alot of beer and drank everyday. I went attack-free for almost 3 years until I went to a mexican restuarant and had chorizo. Instant gout attack. So I gave up chorizo… Went another couple of years and would get minor flare-ups but nothing significant. This kept up for like 7 years, my heavy drinking was offset by not consuming red-meats and pork. One weekend, about 3 years ago, I was drinking with some friends and grilled some pork chops. They looked so good and I had to eat one. Woke up the next morning with a flare-up in my knee and ankle. I was down for almost a month. I then gave up all meat and practiced a vegetarian diet. Last year at my annual physical my UA was under 4.0. The diet worked great and I still got to drink whenever and whatever I wanted! people at work would always give crap for eating tofu and vegtables… If they only understood the pain, and I love drinking beer. Last week, it was warm and I got my grill out. I ate a cheeseburger…. Woke up with a flare-up in my left foot. The next day, woke up with a flare-up in my right ankle and pinky toe…. Went to my doctor and UA is currently over 7.0. I am now 38 and for years I have been trying to control my gout by dieting just so I could drink heavily. To mee it seems like controlling your UA levels is like a scale when it comes to diet and alchohol consumption. If you drink moderately, then you can eat the “bad” foods moderately. If you drink heavily, then stay away from meat. This is the route I eventually took but I want the freedom to eat what I want now, so I am going back to my doctor in a couple of days to talk about therapy. I am tired of the pain and discomfort, I am so tired of it that I am going to quit drinking all together. It sucks when my son wants to goto the park and we have to stay in the house because I can’t walk. 15 years of heavy drinking is probably enough…

  17. I think AlexB75 sounds a bit like me. Though 60 now, and got my first gout attack three years ago, I was eating all the wrong things and drinking a lot of beer. When I figured out my swollen toe was gout, I ordered a home test kit and got a reading of 9.0. With no health insurance,I ordered allopurinol online and started at the standard 300mg dose. Within a month my blood levels dropped to 6.3. One month later, 3.4. My flares, though regular, were less painful and i thought by switching from beer to rum and avoiding my favorite shrimp, I was cured.
    Two weeks ago i got tophi bumps behind my ears and the back of my neck and my levels were 4.9.
    I stopped drinking for a week and upped my allopurinol to 375mg. and the tophi nearly disappeared.
    Then, after a couple nights of rum and cherry juice cocktails, the bumps came back full force.
    I’m beginning to believe that gout affects people differently according to a wide range of variables.
    I’ve always reacted badly to stress. I’ve noticed a correlation between stressfull times and gout flares.
    Good luck, Alex with quiting alcohol totally, I know it’s not easy. But, unlike some on this site, I do believe
    alcohol has an effect on the organs responsible for metabolizing and excreting uric acid.
    Each person is unique and, if one has tried medications and diet modification but still has gout flares, perhaps it’s time to entertain the possibilty that alcohol could be a contributing factor.
    For me, eating 25 cherries a day for a week didn’t help at all. Switching from alcohol to water dropped my UA levels dramatically. Sounds like a boring solution but it’s working for me. Maybe you can find a different and more comfortable solution but, compared to the pain and cost of disability, it’s worth trying anything possible.