Matthew's Gout

In 2015, I had my first gout attack in my foot. At that time, I didn't know it was gout. My foot was swollen. I was limping and eventually had to walk around on crutches. I went to my doctor. They took an X-ray of my foot and didn't see any broken bones. For the next several years, I had a gout attack every year. It got worse. Eventually, I would get a gout attack two to three times a year. I still didn't know it was gout. I went to a foot doctor. I had X-rays on my feet at three different times over several years. 

In 2022,  for the first time, I showed the same symptoms in my knee. I went to a new doctor. He had the wisdom to do some blood tests and check my uric acid levels. I had significantly high levels of uric acid and he told me I had gout.

If you don't know what gout is, you can read about it on Wikipedia.

When I refuse sugary treats or insist on other dietary restrictions, I sometimes get questions. Sometimes, people know someone with gout and are familiar with their treatment plan. Yet, everyone is different and everyone's treatment plan is different. I've put together this blog post to answer the most common questions I get about my gout and to address the most common concerns I hear. I link to peer-reviewed research and other reputable sources. If you have serious questions about gout, talk to a doctor or medical expert. Everyone with gout may handle things differently in consultation with their doctor based on what's best for them.

Why do you avoid certain foods, like sugary desserts?

Gout is caused by high levels of uric acid. Someone's uric acid levels may be high due to various factors: diet, hereditary/genetic factors, or kidney issues. What is clear from the research is that diet does have an impact. Even if someone's genes are the main cause of their high levels of uric acid, eating certain foods will also increase uric acid levels. I think Cleveland Clinic has the best summary of the gout diet based on my own research and my own conversations with my doctor. You can find the gout diet repeated on multiple reputable websites, but if you want to dig into the actual research yourself (like I did), you can go to Google Scholar and read the peer-reviewed studies yourself.

Isn't there medicine that just cures gout?

There is medication that lowers uric acid levels in someone's blood. Allopurinol helps limit the amount of uric acid that gets into someone's blood. Probenecid helps people's bodies better get rid of the uric acid they have. 

Cleveland Clinic's website says, "Diet is not as effective as medication for managing gout, and it’s not supposed to replace it. But paying attention to your diet may help minimize your need for medications."

Mayo Clinic's website says, "People with gout who follow a gout diet generally still need medication to manage pain and to lower levels of uric acid."

Yes, medication is better at helping manage gout than diet. However, diet still makes a difference. The dosage of medication a doctor prescribes is based on how much uric acid someone has. If someone can do anything to lower the amount of uric acid in their blood naturally, they will need less medication than they would need otherwise. 

As someone's gout gets worse (which often happens over time with age), the dosage of medication they need to take increases. But, someone who decreases their uric acid levels naturally will likely not need to increase their dosage as high as someone who doesn't.

Let's imagine that my genes are 90% of my problem and only the medicine will help with that. Let's imagine that my diet only helps with 10% of my problem with high levels of uric acid. Personally, I'd rather do everything I can to solve the problem, addressing both factors. If that means that my diet is only making a 10% impact in comparison to the medication, I'd still rather do everything within my control to make a difference. I also enjoy the overall health benefits of the gout diet on other aspects of my health.

Do you have to take medicine your whole life?

The medication usually takes a few weeks to start working. You cannot typically expect to take the medication only when you need it. Most doctors prescribe a dosage to be taken daily. This medication is usually taken long term, for the rest of someone's life.