Gout is different for different sufferers, and my experience doesn't necessarily apply to other cases.
It's also a stigmatized condition, often associated with excessive eating and drinking alcohol, or old age.
This is not all incorrect, but it is also not correct all of the time, and gout attacks can also be brought on by exercise and dieting.
The common information says that being male puts one at a greater risk, and males also have attacks at a younger age, whereas women largely get it
Some say this is changing however, and the ladies are catching up.
Apparently males at risk start depositing the uric acid crystals after the onset of puberty, and the first attack usually occurs about 20 years
Males that are prone to gout will typically have their first acute attack in their early to mid thirties.
That's exactly what happened to me when I was about 33.
However, it was the last thing I imagined at the time, and the stereotypes of an obese aristocrat, or a hag with claw-like fingers just didn't fit.
I was exercising at the time (doing a lot of skipping in the backyard), hardly drank soft-drinks and followed a vegetarian diet (although I still ate
seafood and drank alcohol).
There was no warning before the first acute attack.
I just woke up one night during winter and it felt like somebody had hit my foot with a sledge-hammer.
Nobody actually knew what it was, and at first I thought it was some kind of insect or snake bite, or that I'd somehow managed to sprain my foot while
To make a long story short, I was only diagnosed with gout during the second attack bout two weeks later.
I was given colchicine and anti-inflammatories to stop the attack, and a day or so later I started allopurinol and drinking Alka-fizz (one of many
cheap powders one can buy over the counter that contains a lot of sodium bicarbonate to make the urine more alkaline).
I was also given a list of high-purine foods to avoid, that went into three classes: never, or very rarely, sometimes and safe.
However, the doctor said that in my case many of those foods weren't applicable (like organ meats), and that I should consult a dietician for more
details if necessary.
He also said (a bit off the record) that by his experience red wine consumption preceded the attacks in many (but not all) patients, and if I had to
drink wine I should try to stick to dry white wine.
Then it occurred to me that a female ancestor of mine always avoided red wine because she said that it gave her arthritis like pains the next day.
And indeed, I recall drinking red wine (the social plonk for winter) before the attack.
That is, I don't think the red wine a night or so before caused the uric acid build up, but it might have pushed something over the edge for me.
A male ancestor of mine considered himself somewhat of a naturopath, and upon his recommendation I ate a potato-based diet for a few months, with a
bake of sliced potatoes, onions and turmeric (the spice supposedly has anti-inflammatory properties).
Although gout was never fully admitted by that side of the family, an ancient packet of Puricos pills I found in the cupboard suggested to me that
somebody did have gout a few decades back.
I must commend that doctor for bringing my uric acid levels back to normal, after they were shockingly high during the attack.
Luckily I never had any side-effects from the allopurinol, although they did frighten me, and after a few symptom-free months I stopped.
I'd also heard of guys who had one or two attacks of gout, and it never came back, so I wasn't keen on being lectured by the doctor for not taking my
pills for the rest of my life.
A new doctor also suggested that I should only take the pills if another attack occurred, or if my uric acid blood test was too high (I test about
twice a year).
Although it has been somewhat high at times, the medication remains untouched in my medicine box.
One shouldn't use the allopurinol during the attack itself, since it can worsen it, but rather to prevent further attacks.
I still get gout-like symptoms in my feet every winter, but over the counter colchicine seems to work when necessary to prevent a full attack.
I used about six tablets over the whole winter.
I also only drink the Alka-fizz when necessary, since it neutralizes the stomach acid, which can lead to other problems over time (another family
member of mine got a severe case of a gut parasite after using antacids daily).
So yes, it can be hereditary, although acute attacks can flare up and die down, and people tend to correlate a lot of causes and cures with such
Another piece of "street wisdom" I picked up is that when the urine is watery and clear the uric acid is OK, but if it goes darker it may be time for
an intervention, such as sticking to water, or drinking Alka-fizz twice daily (unless one ate or drank something that dyes the urine, like
I've even read somewhere on "Dr. Google" that some races are more prone to gout genetically, such as British people and black Americans (but strangely
not black Africans).
I'm not sure there is a genetic test yet, but if one feels one is ancestrally prone perhaps asking for a uric acid test once a year or so couldn't
I'm also not sure who will develop chronic gout (not just a few acute attacks), but I'd monitor the situation if one has known ancestors with gout,
especially as it could lead to secondary problems.
Especially the prospect of a kidney stone is frightening.
I've read of rare chronic gout that doesn't seem to respond to anything, not even the medications, and of people who literally have an acute attack
every few hours.
That must be unimaginably painful.
I was at a birthday party not so long ago in the midst of winter, and people remarked that I was drinking white wine in winter (seemingly a major
social faux pah).
I then explained that I thought red wine brought out gout attacks for me, and the chance of an attack wasn't worth it.
One lady eyed me suspiciously, as if I was a cripple, or raging alcoholic, and said: "Shame, you've already got gout and you're so young!"
That's the kind of ignorance one deals with, and nobody spoke up, although I knew of at least three other people in that room who'd had acute attacks
of gout before!
With the treatments and medication I decided not to take the chronic preventative meds, but to treat the symptoms as they occur with tried and tested,
cheap and over the counter medicines.
There are also other options, like Acoxia, which seems to work in a day, but must be prescribed.
So far so good, although everyone is different.
One surgeon I once consulted about an unrelated minor operation however advised that I should see a specialist on rheumatism if another acute attack
occurred, and that one shouldn't just rely on general practitioners and over the counter medications, because there could be other underlying causes,
or even misdiagnoses.
There's also an awful lot of over-priced snake-oil and diets that claim to cure gout, with no real evidence that they work.
I guess that if I had my life over knowing what I know now, I would have asked for uric acid tests from the moment I turned 30, and perhaps a pattern
could have been found to start a course of preventative meds or lifestyle changes, but that's hindsight, and for most people it will come as a
sledgehammer in the night.
edit on 8-10-2014 by halfoldman because: (no reason given)