So Confused…

This topic contains 12 replies, has 4 voices, and was last updated by  Austin Dixon 3 years, 3 months ago.

Viewing 13 posts - 1 through 13 (of 13 total)
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  • #22114

    Austin Dixon
    Participant

    I’ve been having gout attacks for 3 or 4 years, but I was only diagnosed this year. My doctor’s only advice was to avoid fatty meats and to google for gout diets. When I asked her about medications, she said that the side-affects of the meds were worse than the gout, and advised me to “just live with it” instead. So I have been.

    I get really confused when it comes to the diet though. I have been all over the web and no two articles say the same thing. Some say eat lean meat like chicken instead of read meat. Others say beef is a better choice than chicken. Some say no poultry at all. Some say eat fish instead of meat, others say avoid all seafood.

    I tried eating a diet of only chicken and vegetables and still had flare ups. So at this point, I’m basically a vegetarian and hating it, but I don’t know what I can eat. Any advice?

    #22117

    Yakpi
    Participant

    No offence but I think your doctor is ignorant of the facts. Controlling gout through diet alone will be tough.

    I used to suffer from excruciating gout attacks 4 or 5 time a year. Three years ago I started Allopurinol and have never had an attack since. I can eat and drink whatever I like. It is a very clean drug so I have zero side effects. Simply prevents the over production of uric acid.

    My doctor says I am simply an over producer of uric acid and it runs in my family. So I took care of it. Now I am fine.

    Good luck!

    Yakpi

    #22118

    Paul
    Participant

    Hi Austin,
    You have been badly advised I’m afraid. Probably best if I leave it up to the forums expert Keith to answer, but needless to say ‘just live with it’ is possibly the worst advice concerning gout that I’ve ever heard. The meds do work and not all side affects will show themselves to everyone.
    Diet is very confusing and still confusing to me. In essence you need to lower your uric acid levels to avoid gout attacks. The process can take a while but as most here will agree is definitely worth doing. For my story read ‘my gout story’ on this forum. I still suffer now but this forum has been of great help. I just hope, Keith or Ron will get back to you soon. If not I will endeavour to help but I’m definitely no expert.
    You do not need to suffer as much as you are currently suffering and I feel your pain, we all do. It can be cured and you’re in the right place to start, just hang in there.
    Paul.

    #22121

    Keith Taylor
    Participant

    Hi Austin, and thank you for posting in the gout forum. It’s very confusing when you get such poor quality advice from your doctor. I’ll go through your points, but first I’d like to thank Yakpi and Paul for their wise advice.

    1. gout attacks for 3 or 4 years
    This is unacceptable and dangerous. Gout is a progressive disease that destroys joints, and damages organs. Though your diagnosis is relatively recent, uric acid crystals have been building up for years. Those crystals must be treated urgently, by reducing uric acid to safe levels.

    2. avoid fatty meats
    Sound advice, but I bet your doctor cannot explain why.

    3. google for gout diets
    Please don’t. You will get reams and reams of misleading crap. Gout diet must be planned personally, to match individual needs. Gout diets are a long term part of an effective gout treatment plan. The best gout diet in the world takes many months to contribute. Diet might contribute to prevention, but it will never lower uric acid enough to treat existing crystals in a safe way.

    4. side-affects of the meds were worse than the gout
    Dangerous, negligent, nonsense. The side effects of a doctor who prescribes ineffective treatment might be worse than no treatment, but that is not the same thing.

    Ignore diet for now, until you have an effective treatment plan. Without a treatment plan, it is logically impossible to have an effective gout diet. However, if you do want the best starting point for diet improvements, think about alkalizing or Mediterranean diets. Don’t google them – just go to Foodary.com for facts, and Foodary.org for personal eating advice.

    Austin, I’m throwing this back at you now. I can help, but I have absolutely no idea about you, or your goals. Tell me what you need to achieve, and I’ll help you achieve it. Ultimately, we all need personal gout management plans. But, we all have different ways of managing our unique situation.

    I’ll end by asking if my responses so far make sense to you. If not, tell me and I’ll try to clarify. To avoid being taken in by the rubbish that purports to be gout advice on the Internet, I’m also happy to explain why (almost) everything you read is wrong. Just don’t ask why some say one thing, and others say different. Give me the links to whatever you are reading, and I’ll explain why it’s right or wrong.

    Sometimes, it’s just a matter of context. What is right for one gout sufferer might be wrong for another. I prefer to start with the gout sufferer, not the gout. I’m sure that we can train your doctor to give you the safe care you need.

    #22124

    Austin Dixon
    Participant

    Thanks for the advice. Makes sense to me. I will look into the mentioned diets. I suppose I should try to get my doctor to prescribe something, but I’m doubtful now if she would know the right thing to prescribe…

    My goals though are:
    1.) Get rid of the 2-3 gout attacks I have each year.
    2.) Avoid foods that might make my Gout worse.
    3.) Loose about 40 pounds.
    4.) Not live on a boring diet like I’m currently doing.

    #22125

    Austin Dixon
    Participant

    I went to a different doctor this morning and requested to be put on a gout medication.

    They decided to run a full blood-work to check my kidneys and liver; I should have the results this afternoon. They said that if everything looks good, then they will start me on 50 something of Allopurinol. I asked what my Uric acid levels were earlier this year when I was diagnosed, and they said 9mg. I’ll find out what they are now when the blood-work comes back.

    #22126

    Austin Dixon
    Participant

    Correction, levels were 9.8 last December, 9.1 now. Kidneys and liver are good; picking up prescription this afternoon.

    #22128

    Keith Taylor
    Participant

    Thank you for your information, Austin. I’m really pleased that you’re starting on 50mg allopurinol. It’s the first step in reaching your first goal. Before I discuss your other goals. I’d like to make a few points about allopurinol treatment.

    It’s best practice to start on 50mg, as that will determine if you can tolerate it. Most people can, but better safe than sorry. You will need to be tested again to get the dose right. The best time is every 2 weeks, as that is how long it takes for results to stabilize after an allopurinol dose change. It’s good to include kidney function and liver function tests. The maximum safe level for uric acid is 5mg/dL, but it is best to go lower for your first year of treatment to get rid of old uric acid crystals as soon as possible.

    As crystals dissolve, they can trigger a gout attack. This is good, as it shows you are recovering, but obviously not pleasant. The way to deal with this is through good pain control. I’ve just described good gout pain control to Paul. The colchicine is optional but useful. The key to success is a combination of anti-inflammatory and pain-blocking meds. When your doctor starts the allopurinol, ask for maximum strength scripts for an anti-inflammatory and a compatible pain-killer. If you decide to include colchicine, remember the maximum is 2 per day.

    3.) Loose about 40 pounds.
    Weight loss is best done slowly, as rapid weight loss can trigger gout attacks. 2 pounds a week is good, and in 20 weeks, it’s much more likely to stay off than if you lose it quickly. Which brings me to…

    2.) Avoid foods that might make my Gout worse.
    4.) Not live on a boring diet like I’m currently doing.
    Rather than thinking about specific foods to avoid, it is far better to think about total diet. It has to be balanced so that you get an adequate amount of all the nutrients you need. In that respect, the main thing to avoid is excess calories. When you overeat, there’s more of the meat that is the biggest source of uric acid – your own flesh.

    The easy way is: Eat Food. Sufficient. Especially Plants.

    Eat food means avoiding highly processed food-like substances. We all love junk food, but it really isn’t good for gout. Mostly, it’s high-calorie, which I’ve mentioned. But also, junk food tends to be high in Free Fatty Acids (FFAs). Recent research suggests that FFAs are the main cause of gout attacks, as they seem to be the catalyst that provokes our immune response to uric acid crystals. Therefore, it’s far better to eat whole foods, and prepare your own food rather than rely on ready meals and takeaways.

    Sufficient. The excess weight issue again.

    Especially Plants means that most of your food should be plant based. This does not mean you have to become vegetarian. Rather, see meat as a treat. Or follow the traditional Chinese way of using meat as a flavoring in vegetable based dishes. Please note that the Chinese food we see in most restaurants is a Westernized misinterpretation of healthy food. Far better to find old traditional recipes, and make your own. Similarly, traditional Mediterranean meals are mainly vegetable-based. With oily fish as the weekly animal protein, and monthly treats of meat. If you prefer a more scientific approach, alkalizing diets are always high in fruit and vegetables. They’ve also been shown to be useful at lowering uric acid.

    I think food boredom comes from the feeling that you can’t eat what you want. My approach is entirely different. I look forward to a delicious roast dinner once or twice a month. In the meantime I create delicious spicy vegetable dishes that I love. I might be slightly overdoing the mackerel and tuna, but allopurinol fixed my uric acid, so I don’t worry about that.

    I should point out that this is not an instant fix. It’s good that you are starting allopurinol Austin because that puts you back in control. With diet, changes will, and should, take longer. I find the best way to start is with your shopping list. Each week, reduce the animal content. Reduce the processed food-like substances. Increase fresh or frozen fruit and veg.

    Also, you can set me a challenge.

    Tell me your favorite foods that you think you cannot eat, and I’ll try to find ways to incorporate them into a gout-friendly diet. I can’t promise a meat feast, but I’m sure I can avoid boring.

    #22129

    Austin Dixon
    Participant

    Thanks for all the advice.

    Since you ask, my favorite meals are:
    -Steak and potatoes
    -Pot-roast
    -Chicken alfredo
    -Hamburgers
    -Chicken sandwhiches

    #22131

    Keith Taylor
    Participant

    Good meals, Austin – I like a challenge 🙂

    For this to work properly, I really need a recipe, or at least a list of ingredients that I can work with. A very rough example of what I mean is:

    Before: A typical steak-and-potatoes meal
    8-ounce rib-eye steak
    Whole baked potato with sour cream and butter
    1/2 cup steamed broccoli

    After: A Mediterranean-style steak-and-potatoes meal
    3-ounce rib-eye steak
    3/4 cup Garlic and Lemon Roasted Potatoes
    1/2 cup steamed broccoli
    Grilled Fennel
    Mediterranean Steak and Potatoes

    That is courtesy dummies.com but please don’t take nutrition advice from that site. I haven’t reviewed their Mediterranean advice yet, but their alkaline diets advice is truly appalling and very very wrong.

    Please note that this is not an example of a gout-friendly meal, but more an example of the type of approach I would take. This specific example doesn’t include enough information about how it improves your diet. It takes me quite a lot of time to do this, so I don’t want to do it if it isn’t something you would like to do.

    The principles are to reduce meat, increase veg, add other gout-friendly ingredients. Changes are best made gradually. If you cannot envisage lowering meat portion sizes to the ‘after’ recipe, then there’s not much point in considering these improvements.

    As I say, if you think this is something that will help you, please give me a bit more information about your favorite meals. Then I’ll explain how to make the meal healthier.

    #22136

    Austin Dixon
    Participant

    We do need to come up with some healthy new recipes, so thank you for the help! But it would be hard to answer your question, as we don’t really go by any recipes currently. We just buy what’s on sale and my Wife wips it into something. Or we eat out. I’ll put what I can below though and maybe you can work with it, or if not, maybe you can just give me some recipes you like.

    Generally, our diet consists of:

    Meats- Chicken, pork tenderloin, porkchops, ribs, tilapia, steak, or ham. We also eat a lot eggs.

    Veggies- Zucchini (grilled), squash (in a cheesy casserole), greenbeans (both boiled and in “green bean casserole”), onions, peas, carrots, spinach salad.

    Carbs- My wife is doing a low carb diet at the moment, but I sometimes eat rice, potatoes, and pasta (though I’m cutting back on these).

    Fruits- Oranges, apples, bananas, melons, grapes. And tomatoes.

    Misc.- We love cheese. Also alfredo, marinara, pico-de-gallo, garlic, rosemarry, basil, curry, ect.

    *My wife’s favorite foods are all Italian or Mexican. I like “Meat and three” type meals and Chinese the best. I’d like to find more vegetable centric recipes, especially stir-fries.

    #22138

    Keith Taylor
    Participant

    Meat and three is a new thing to me. I’m looking at some stuff now, and salivating.
    Meat and three meal

    The thing that strikes me first is, it’s almost a perfect gout-friendly meal. First, we have to change it to meat and four, or meat and five. Second, we have to adjust the meat portion size, so just one of those tasty ham hocks. Third, this should be an occasional treat rather than an every day meal.

    You’ve given me some great stuff to work with, Austin. I guess I should stop messing around, and come up with some meal plans.

    Stay tuned.

    #22146

    Austin Dixon
    Participant

    Looking forward to the meal plans. Thanks for the help.

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