Do endurance athletes get gout?

Question

Having had foot "attacks" as my training for marathons and triathlons peaked, it wasn't until a foot specialist mentioned gout that caused me to consider gout. Everything that I was using for a foot injury (aspirin, compression, beer and ice) was making the foot worse. Everything that I have learned on Goutpal reduces the symptoms. Plus, I know longer train beyond the two hour point where the body eats it's own protein (catabolic metabolism). While I did not have gout toe, there was itching, redness, night fever, and the walking on glass feeling that required crutches, especially upon waking up. X-rays showed nothing and in the emergency room they said I was too healthy to have gout. Do endurance athletes get gout? PS love your website and have been following it for months.

Answer 1

You have gout - but are basically hovering right below the "attack" threshhold. Tha crunchy glass feeling in many ways is worse than having an attack. Far more damage is being done to your tissues.

In general, sports are one of the easist ways to activate the triggers that increase gout symptoms.

• Heat - As the body warms up, crystals dissolve and reform when the body cools.
• Increased Blood Pressure- Increasing the amount of blood flow through areas of the body during exercise hat do not normally see high levels (such as the feet) and joints can increase uric acid in those regions.
• Dehydration - As your hydration level during training, the uric acid concentration within the blood stream can increase.
• Movement and Impact- Flexing joints and the impact with pavement can break loose existing crystal structures causing them to shift positions to a location that is more irritating to the body.
• Beer - Beer will still increase gout regardless of any other benifits you receive (its proven to reduce muscle recovery time by helping expel lactic acid from the body)
• Weight Loss - As your body losing mass, the uric acid levels in your body fluctuate and can cause symptoms.
• (there are others, but you get the idea that everything affects your uric acid levels)

As GoutPal said in his answer, knowing your personal uric acid level and managing that number until it lowers is the best solution. I am a long distance cyclist (100+ miles regularly) and gout is still a big part of my physical life. Managing my diet to include fewer gout increasers (red meat, beer, etc) is still a critical part of my health maintenance.

Answer 2

Endurance athletes certainly do get gout, but that is not to say that exercise causes gout. You just need to be aware of the issues.

The first thing that is vital is to keep measuring uric acid in your blood. Exercise can affect this in different ways. Most reports that I have looked at seem to suggest an increase during exercise, with a fall to lower levels when not exercising and rested. I'll try and summarize some specific investigations to get a clearer overall picture. However, the only view that matters is your own personal uric acid level.

I copied your question into the search box in my menubar at the top of the page. It shows a few discussions about exercise and gout, but nothing much on the main reference site, so I made a start.

Thank you for your kind comments, and for prompting me to write an article about Gout & Exercise.

P.S. please go back to ER and shoot whoever said you were too healthy to get gout - or at least persuade them to join in here, where our collective minds can educate them.