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want to know if red wine is a major cause of gout. I have spoken to Doctors but all I get is a shrug of the shoulder and eyebrows lifted which I think….they dont know..Can you send me anything on diet
Red wine can increase uric acid, as can any alcoholic drink.
If you are taking allopurinol, or other uric acid lowering medicine, then the effect of the odd glass or two is minimal.
On the other hand, two bottles might cause a problem, but this is true of any significant alcohol intake – red wine is not significantly different.
Unless replying to specific points in this topic, please start a new topic. See new topic link above, or gout forum guidelines. Current gout status in my profile.
1:30 pm May 5, 2009
zip2play
Member
posts 1278
3
I think it's the DIURETIC effect of alcohol that is the precipiitating cause. After all, with water loss from the bloodstream, the same amount of uric acid will be more concentrated and hence more likely to precipitate.
Personal anecdotal info to be taken with a grain of salt: I find beer the biggest alcoholic offender when it comes to gout. I don't have a clue why.
I would think it's good advice to drink copious water before bedtime after any sizeable alcohol consumption so you don't awaken at 5AM with “THE TOE!”
But to answer the question directly, No, red wine is not a major cause of gout.
I have come to find it is the red wine for me — it linked all 3 of my episodes.
I am 40, 5'9″ 150# and had my first attack about 6 years ago (thought it was a spider bite, haha). In my right big toe. I did my research and preliminiarily narrowed it down to possibly red wine. It was the only variable in my habits during that time period. I preferred vodka or beer for drinking. I never drink red wine, hate the taste so stopped, and it never came back.
I had my second attack last summer 08 and it was during a week of feasting on all you can eat mussels and coq au vin at 2 brunches in a row and yes, having red wine with it (I forgot about the red wine, as I said I never drink it, and forgot about the damn gout).
I play about 15 hours of tennis a week, couple hours every day on average, and I drink Diet Sparks (I will explain that it has to be Diet later) before each session — it helps as an energy drink while still giving focus and high. Never get gout, but my metartarsals in my right foot became swollen last Monday night. It had started a few days prior, from overplaying I thought so I didn't think about it and rested it the rest of the week.
Well I went to a party Friday night 10/14, everyone was asked to bring wine, took my Diet Sparks with me, because of my distaste for wine. The server spilled my Diet Sparks in the cooler. Well, again, I forgot about the red wine problem, and the whites were all closed. So I had a small glass of red wine with my dinner. Within a half hour or hour, my feet were SO sore I couldn't walk. The right foot had gotten worse now to the big toe (the swollen metatarsals were nearly 90% better), and then the left foot started at the big toe and also at the achilles tendon. Oh my god, I left immediately and got myself home to bed and awaken at 5 a.m. in pain.
Putting two and two together, I remembered the small amount of red wine from last night. I then googled and found that spreading to other joints and to the achilles is also secondary point.
Then I started wondering about my right foot and why my metartarsals started hurting the week prior. I remembered that I had to drink the NON-diet Sparks (stores were out of diet) on a couple occasions and thought this may be the cause, because I remember last summer and earlier this summer, drinking it then too and it causing some pain — just figured it was the tennis.
Then just before writing this post, I was reminiscing about a party I went to last weekend, what a great time it was, the weekend before my right metartarsals started being irritated and swollen. Damn! I remembered that all we had to drink there was red sangria! So I am convinced that the regular Sparks started the slight pain in the right metatarsals and gouty twinges, the sangria worsened it and caused the swelling monday to where I couldn't play and then the party with the red wine that friday took it to another level — to both feet and me hobbling all weekend. NO MORE RED WINE for me — not even a small glass.
3:06 pm October 18, 2009
trev
Tophi Terror
England
posts 809
5
Wine is not the worst culprit in the literature for gout causing.
On a report I posted here - it is actually given the 'OK' - compared to Beer & Spirits.
However! – when on the cusp of an attack the fact that you are de- hydrating your body can become a flip point and this, as Zip says, is enough to tip the issue into a full blown event.
I have noticed the niggling effect of a bottle of wine- but nothing kicks gout in like BEER for me, anyway.
We are all different, but at least you know of your definite sensitivity to red wine and reading here further will highlight the fact that as you age, put on weight and increase BP -your gout is likely to increase in frequency and severity.
The upshot is that gout is a slow grower, usually – but is more easily triggered once attacks have started and the urate crystals start to make a home in your joints.
With three attacks in 10 years , you are early days- but your sports hobby will make it imperative you get blood tests for Serum UA soon -to see which way you're heading and monitoring any repeat attacks.
If they're higher than the oft quoted 6+mg/dL level then the option of UA lowering drug therapy is always there.
Diet can make a difference and lets hope you can stay on the right side of this. Yes, avoiding wine and other alcohol will surely help , if you want this route.
5:56 pm October 18, 2009
Utubelite
Tophi Terror
California, USA
posts 273
6
I will also vote for the wine as culprit…..though in my case, it is the sweet wine. I have been taking white and red wine generally in the weekend. I am a low drinker with average of 100 -150 ml of wine 4-5 times a month. That is less than a bottle of wine in a month. In last 10 years, I never had gout attack though my Uric Acid reading were always around 8….
My recent attack( after more than 10 years I had my first attack) was triggered by toe injury and other possible culprit -wine. I had red wine and sweet wine 2 nights before the attack was triggered( 3 days after toe injury). I never had wine at 2 am but this time, I had sweet wine at 2 am after watching a late night movie. At 6 am, I had pain in my toe. I did not have even remote thought of gout in my mind.
So, for me also, a combination of red wine and sweet wine is possible culprit though sweet wine is what I had for the first time in my life.
Thanks trev for the advice, yep, still relatively early. I am hoping to take more preventive measures now that the frequency has increased. I haven't been to the drs for tests, so I know its time to do so. Regarding the alcohols, I do know that the red does it, white doesn't, white sweet doesn't (I do like dessert wines), dark beers slightly do but that doesn't really botherme because light beers are my drinks of preference, and so far I have never had it trigger any attacks, mild or otherwise.
True, the unfortunate thing is that everyone is different and triggers are different. My dad has it too, and the only thing in common we have as a trigger is the red wine. He has a lot more triggers, even apples, pears, nearly all shellfish, etc. so perhaps that is a guide for me somewhat. Being from hawaii, I cannot imagine being away from seafood, and I eat at least a can of either tuna or salmon each and every day. Luckily, the only seafood that bothers me is mussels if eaten in abundance (I do love mussles, ugh). I think I'd die if tuna or salmon became a trigger for me.
Update on my gout from yesterday and today — right foot almost 100% and left foot about 60%. I haven't tried the bbb solution yet, am anxious to do so, but really didn't feel like walking in the store. Been drinking acv, eating a bunch of maraschino cherries, didn't have any ibuprofen, but luckily have some prednisone for my asthma bouts. I took about 2 mg every 12 hours and its helped the swelling immensely. I don't like to take meds of any kind, even NSAIDS or Tylenol, so I hope I will wake up and have my left foot back. I am going through tennis withdrawals and its killing me.
oh and now that you mention it, i think you are right in that the dehydration issue may exacerbate things. I do find that my mouth is often dry and I don't drink nearly enough water through the day (always been a problem for me), but instead a lot of coffee, diet soda and then the water diluted diet sparks for tennis/gym.
5:59 am October 19, 2009
trev
Tophi Terror
England
posts 809
8
Hi Kepa- I would definitely get prepared to modify your diet substantially if you want to stay well and avoid meds 'for sure'- as I suspect you might.
A lot of dealing with pain is like lifestyle changing- the sooner you deal with it the better ! ;)
Basically- Mentally be prepared to reduce seafoods and extra protein to a minimum [we need just the equivalent of a handful of nuts a day] and establish/stabilise your UA level.
Then you can add in extras when you know where you are on the UA scale, otherwise- be assured you are laying down trouble, even as you type on here!
You have the classic genetic background in your parent to see and your diet has been on the edge 'since forever' on that account.
40 is relatively young for gout- so you must get a grip as to the best lifestyle choice- diet+ meds, maybe.
Drinking fluids also gets harder with age- apparently out bodies mistake thirst for hunger pangs.
I think this is a leftover element of our increased lifespans today – previously the risk of foul water causing death was higher than getting dehydrated during the 'time left to play' on the planet!
I think with your positive attitude, better diet , more water and LESS sucrose you will better face your UA figures with confidence.
6:08 am October 19, 2009
trev
Tophi Terror
England
posts 809
9
Utube-
I think wine is much more dehydrating than beer as it's typically 3X the alcohol per unit of fluid taken- whatever other components may be involved in gout.
Hangovers on wine (and fortified versions like Port) , taken to excess are terrible, in my limited experience for this very reason. [Blush]
Couple this 'drying out' with another trigger, like injury in a vulnerable area ,and you have the classic setup for a bout of the 'screaming nadgers' !
6:04 am October 20, 2009
zip2play
Member
posts 1278
10
Post edited 11:07 am – October 20, 2009 by zip2play
THe proper treatment for gout is NOT pain management but uric acid lowering to a point where crystallization does not occur.
Trying to find food triggers and use old nostrums is NOT a substitute for going to a doctor and getting uric acid measured. The first goal of ALL medicine is a proper diagnosis and the second is treatment of the CAUSE. The CAUSE of gout is high uric acid in susceptible individuals.
I'm confused, are you saying there is a cure for gout? or a controlling of gout? And does it “require” medicine? I'd rather not take medicines if I don't have to.
Its pretty clear that I have gout and it was because my levels were too high. I don't need to go to the doctor to see if I my uric levels are too high if I have gout. Its already too late to see if my uric acid levels are too high — they already are. I thought treating the cause included controlling your diet. How else can you control gout (or I should say uric acid level control) if you don't want to take medicines for the rest of your life. I can't change the physiology of the way my body processes food — any other options? Or other than food, is gout caused by any other factors?
Going to the doctor, sure to get regular feedback on how well I'm doing as a function of how I've been eating, but if not through diet (identifying and controlling triggers) and meds (which I'd rather not take for the rest of my life), what else is there?
In the US, in some areas, there is an alcoholic beverage called Sparks, its a malt beverage, a cross between a beer and Red Bull, tastes like Red Bull with just as much sugar and such, the diet is just the no sugar version and actually looks like a Diet Red Bull. Targeted to younger or active adults looking for a pick up, its packaging resembles that of a duracell battery.
zip i read that article you posted earlier (great article by the way) and am I correct in concluding that diet modification is just a minor role and that medication plays an integral role, and a necessity? So no matter what you do you, since its a result of your body's synthesis of foods and drink, you cannot get away from high ua levels without medication? I did note the term “current therapeutic agents” as being more useful — what exactly are these, prescribed medicines?
9:42 pm October 20, 2009
trev
Tophi Terror
England
posts 809
13
The key as to why some people, and not others, suffer from gout at higher SUA levels is that of genetic predisposition.
If you have Arthritis is your family then this is a high risk factor.
Taking diuretics long term is acknowledged as a factor in gout- even by the medicine producers- therefore what you take in does affect the equation.
Resetting the balance is somewhat harder to do though, as discussed on this forum, due to the immune system packaging the unwanted joint depositions in a rather crafty way.
This works for a while until the balance gets disturbed. This can be many things, but physical shock & age deterioration to joints are the obvious ones and alcohol, in my opinion, has a part here- mainly as it's a solvent and nicely placed in the bloodstream.
I am of the 'natural approach tendency' on avoiding high SUA but realise there's only so much that can be done over, what is essentially, a failing of sufferers' metabolisms.
I hiope I'm right in estimating that a 1 to 2 mg/dL of blood UA can be knocked back by diet and avoiding meds that worsen it, as much as possible; followed by another 0.5mg/dL due to keeping joints supple and warm (esp. feet at nights).
As the digestion shuts down during sleep- I see this as a big factor in early morning pick up on gout twinges & attacks.
This would allow someone in the danger zone of 6-8 mg/dL to scrape this figure back to some measure of safety.
It does mean restrictions to lifestyle however- esp. on the heavier use of alcohol ,so many will prefer to take meds that, if luck holds, produce no marked bad side effects- whilst allowing an attack free life.
There are, however other negative health factors, as GP and Zip stress, to do with higher SUA- but whether being 'attack free' is a good indicator for safety here is still an open question in my mind.
10:52 pm October 20, 2009
Utubelite
Tophi Terror
California, USA
posts 273
14
I think finding the trigger is the key like Trev said. I have read in one of the topic in this forum where people have got Gout by eating apple, carbonated drink etc. while other gout sufferers do not.
I have got 2 attacks of Gout so far in my life. First was 10 years back due to acute cold conditions( temps of -25F). The second was 5 months back, triggered by direct blow(injury) of big toe in right foot( caused a fracture), and probably sweet wine.
Where as it is logical to say that we should keep UA level less than 6, I think there is more to it than UA level only.
In my case, for the 10 years of gout free period, my SUA level was around 8 all these years, including at-least one reading of >9( it is important to note these levels after first gout attack) I did not take any medicatication for lowering UA levels and ate whatever I wanted to. Unknowingly, I did all the things that can trigger Gout – heavy exercise where I lost 25 lbs in 3 months, high purine food like legumes, lentils, meat, wine, scotch, beer, very low water intake etc. Nothing triggered gout in me in the 10 years though my UA levels were high.
It was the toe injury that triggered the second one 5 months back( though my doctor still has doubt that I had gout and puts it 50%)
Because crystals can be formed if UA levels are above 6, it does mean the crystals would be formed at >6 all the times. It is that “something extra – the trigger” that I think plays an important role as well. Otherwise how can someone explain that I was gout free for 10 years till I got the trigger – toe injury.
But as finding the trigger is very tough, and there may be many triggers, it becomes easier to manage the levels below 6 with medication than managing the triggers.
4:27 am October 21, 2009
trev
Tophi Terror
England
posts 809
15
Post edited 6:57 pm – October 21, 2009 by trev
Whatever the genetic factors affecting gout tendency- the research shows that women are protected by their hormones by getting on for 1mg/dl SUA [including older samples to age 70]. Seeing that the median level in the sample was 4.64 then it's a wonder any got it given the levels men run around at!
What the above does show is one certain element in the UA transport equation is hormonal -and that is a whole new barrel of fish.
Take the issue of Thyroid function, which alone is commonly a source of problems in todays Iodine low food supply chain, for just one element. This can severly affect metabolism and many other functions.
Serum uric acid concentration (sUA) and hyperthyroidism have been reported to positively correlate with each other
Serum uric acid was significantly decreased in patients with hypothyroidism. Renal excretion of uric acid clearly increased in hyperthyroid patients, …
says ” In hyperthyroidism the hyperuricemia is due to the increased urate production, while in hypothyroidism the hyperuricemia * is secondary to a decreased renal plasma flow and impaired glomerular filtration”
[My asterix- this is opposite result to the earlier differently based study]
* What this says to me is-, in just one area, contra-indicated results can co-mingle easily- depending on hormones, metabolism and organ malfunctions.
Is it any wonder , if one throws in the gender angle- things can get even more blurred?
Just tried to post, but doesn't appear to have worked.
Utubelite, you seem to be now on Allipurinol after 2 attacks in 10 years. I'm in much the same situation, though still deciding which way to go.
Have you had any flares since starting the meds and, if so, how severe have they been ?
9:47 am October 21, 2009
Utubelite
Tophi Terror
California, USA
posts 273
17
I am on Allopurinol for almost 3 months( a week less) and started with 150 mg for first 4 weeks, then increased by 50 mg every 2 weeks to reach 300 mg in 2 months. I am on 300 mg for 3 and half weeks now.
In addition to Allop, I am taking Colchicine 0.6 mg once a day for first 2 months and 1 every other day for last 3 weeks now.
I do get some sensations in the right and left toe( I never had gout in left toe), more so in the evening and on some days they are little bit bothersome. However, there is no flare up till now.
My current Uric Acid levels are 3.5 to 4.0 in last 2 weeks.
4:08 pm October 21, 2009
zip2play
Member
posts 1278
18
kepagk said:
zip i read that article you posted earlier (great article by the way) and am I correct in concluding that diet modification is just a minor role and that medication plays an integral role, and a necessity? So no matter what you do you, since its a result of your body's synthesis of foods and drink, you cannot get away from high ua levels without medication? I did note the term “current therapeutic agents” as being more useful — what exactly are these, prescribed medicines?
Without being an absolute absolutist, only a minor absolutist, I think that is what I feel precisely…nearly everyone most likely will fail to control UA without meds. Primary gout is a metabolic deficiency resulting from either WAY too much production or WAY too little excretion of urates over a long period of time. Then body hides the excess away over the years until there are so many grams of this poison stored away that the body begins a vicious attack on the deposits.
I think years and years and centuries of treatment BEFORE urate lowering therapy with diet and analgesics (morphine and colchicine and trips to BATH) showed the disease to be progressive, painful and life shortening. I am convinced that nearly EVERYONE who espouses cherries, baking soda, BBB, alkaline fruit, Vitamin C, Lourdes and prayer have just taken the first step towards the eventual purchase of allopurinol. Other agents are febuxostat, probenecid, sulfinpyrazone, benzbromarone (but not in the U.S.) and peg uricase…but probably 90% will probably be the allopurinol proportion for quite a while.
One can rail against a life of meds, and a life of meds DOES suck, but all the railingg in the world will not excrete a single gram of uric acid.
The Kubler Ross model for death acceptance very much applies to gout:
1. DENIAL (I don't have gout)
2. ANGER (DAMMIT, why should I be forced to suffer like this)
3. BARGAINING (Maybe if I eat cherries, give up fish, and stop drinking wine, huh?)
4. DEPRESSION (NOTHING is working…I'm DOOMED)
5. ACCEPTANCE (Alright, I give up. Give me a bottle of allopurinol to treat my gout forever.)
<<apologies to Elizabeth Kubler-Ross>>
9:28 am October 22, 2009
trev
Tophi Terror
England
posts 809
19
Post edited 2:50 pm – October 22, 2009 by trev
Very good Zip ! Gout likes to save you for later,rather than kill you too quickly…
On the 'addendum illness' list btw, as emphasised in that pdf file -YOU- listed- it clearly says that the only CV known hyperurecaemia risk proven is in post menopausal women. the rest is not actually firmly shown by research.
Obesity,alcohol abuse and a high purine diet MAY increase the risk of gout.
By this stage, it is , of course no longer asymptomatic hyperuricaemia, agreed.
We know this well enough here, so these known risks can't be discounted so readily, even if you like AP [lots]
PS: Almost as much as Colch..
8:51 pm October 22, 2009
zip2play
Member
posts 1278
20
HYPERURICEMIA AS A RISK FACTOR OF CORONARY HEARTDISEASE: THE FRAMINGHAM STUDY
F. N. BRAND1,, D. L. MCGEE2, W. B. KANNEL1, J. STOKES, III1and W. P. CASTELLI2
1Boston University School of Medicine, Evans Research Foundation Boston, MA 2Framingham Heart Study, National Heart, Lung, and Blood Institute Framingham, MA
Uric acid values were obtained on subjects of the original Framinghamcohort at their fourth and 13th biennial examinations. The meanuric acid value for men was 5.0 mg/dl at the fourth examinationand 5.7 mg/dl at examination 13 and was 3.9 mg/dl and 4.7 mg/dl,respectively, for women. This secular trend was due to both“laboratory drift” and increasing use of diuretics. Serum uricacid values were consistently higher in subjects of both sexeswho were taking antihypertensive drugs at both examinations.Serum uric acid values correlated with systolic and diastolicblood pressure in both sexes; the relationship was strongerin women than in men and for systolic than for diastolic pressure.Correlations were stronger at examination 4 than at examination13 when more antlhypertensive treatment was used. ExaminatIon4 serum uric acid predicted the subsequent development of coronaryheartdisease, in general, and myocardial infarction, in particular,but not angina pectorts. The uric acid relationship with myocardialinfarction was equally strong in both sexes, even correctingfor antlhypertensive treatment However, in multivarlate analysis,Including age, systolic blood pressure, relative weight, cigarettesmoking, and serum cholesterol, serum uric acid did not addindependently to the prediction of coronary heartdisease.
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I think that is what I feel precisely…nearly everyone most likely will fail to control UA without meds. Primary gout is a metabolic deficiency resulting from either WAY too much production or WAY too little excretion of urates over a long period of time. Then body hides the excess away over the years until there are so many grams of this poison stored away that the body begins a vicious attack on the deposits.
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