Gout Pal Interactive

I am healthy 51 year old man and exercise regularly.  My body weight is in line with the norm and I eat well (Japanese diet).  I have limited my beer intake since I was diagnosed with gout two years ago and also have kept things in check with diet, exercise and ample water.  As a side note – here in Japan there is a beer brewed especially for gout sufferers and is commonly available in convenience stores.  It is made by Asahi and has 60% fewer calories and 99% reduced purines. 

I decided to “push the envelope” one night and drank 3 beers (1 lager, 1 ale and 1 Guinness).  Talk about a quick lesson.  I woke up the next morning and my joints were screaming.  In retrospect, I should have had more water that night but I think the ale and the Guinness sent me over the edge.  I love Guinness but it's something I will have to leave behind.  Onward!

I take drinking “vacation” perhaps 4 or 5 times a year. Other than those 40 days I teetotal. At those times I drink rather heavily.

I havent more than one or two serious joint pain attacks for YEARS that I could call a “gout attack” becasue for me, 300 mg. allopurinol has worked very well for about 2 decades.

When I drink it is usually martinis or Manhattans, sometimes red wine, occasionally white. This November, around Thanksgiving  I thought I'd try something different, pretty much just beer, maybe 9 bottles a day for 10 days. My thighs started screaming at me and then the pain localized to the tendons at the top of the right  kneecap and a bit under the kneecap. This within DAYS of starting the beer. There is occasional involvement of the left kneecap, same area, but that comes and goes on a daily basis. I did a day of colchicine (like 6 pills) and the pain went away but came back a day later.Unfortunately I took another vacation around Xmas and things just kept gettin worse.

600 mg.Aleve (as generic naproxyn…I'm a cheapskate) worked well but caused huge water retention, weight gain and BP increase. I am now trying a uricosuric dose of aspirin (10 x 325mg.day…4th day now.) I HOPE that's a uricosuric dose. I have ceased my daily Lasix and my BP is hanging gust around the hypertension cut-off.

Anyway, to cut my already long story shortER, I think I have proven to myself that beer is a far greater offender than the hard stuff or wine…I won't try the beer experiment again.

(No booze til April 1.)

Just had my first attack of acute gout and could not believe the pain. Doctor put me on arcoxia to relieve symptoms and then I have to get my uric acid levels tested. Been trawling the inernet all day and sadly all I see is how bad alcohol is for gout. Do I have to give it up. Surely not. I drink cider, does this count? Please help me.

The whole point of taking allopurinol is that it helps you lead a “normal” life. I.e., you can eat and drink whatever you like. Of course, there may be other health risks associated with poor diet, but there is no reason to see daily allopurinol as such a big issue.

I'm still new to all this gout stuff. Still havin' my first attack ( 5 days now). I like a drink and I would usually consume maybe 15 pints of cider in a week. Will I still be able to keep this up or will i have to cut down drastically? I know i will have to change lifestyle but can't face givin up cider altogether.

Guys,  just remember that it is not only the attacks you need to worry about, even when talking about potential triggers.  Alcohol doesn't magically deposit crystals that cause an attack; there has to be an underlying condition where when alcohol is consumed, the problem goes from bad to worse.

To put it another way, you need to be monitoring your uric acid levels and you likely need to be on allopurinol.  Hyperuricemia can help promote other conditions, such as heart disease, renal failure, obesity, adult onset diabetes, etc.  You can't just ignore hypereuricemia, even if you are able to limit the amount of attacks that you experience.  Thats like a diabetic saying 'well if my hands arent numb and im not having other symptoms, I can just ignore my blood sugar.'   The problem is the damage is being done in the background, and by the time you turn your attention to it, it might be too late.

If your uric acid level is at 5mg or below, then its likely that occasional beer drinking or other beverages is not going to be enough to bring on an attack.   Naturally if you consume 10 beers a day for an extended period of time, then all those purines converted into uric acid is going to cause problem.   However there is no reason why occasional drinking should be avoided as long as you are smart about it.

So make sure you are in a good place before you experiment with what drinking does to you and your gout.   This is all about lifestyle and changing habits, but you need to develop good habits first.  That means monitoring uric acid levels and keeping it at or below 5mg.

Good luck :)

seansouth said:

Thanks for all the advice, I really appreciate it. One more thing I'd like to know?, how to I measure my uric acid levels. Do I have to get blood tests all the time or is there some other method that I would be able to do myself?

I think it is important to get tested professionally, and get medical advice on what the results mean. You can support this with home uric acid testing.