In the early hours of this morning, my gout re-appeared after just over a week of absence, this time at my left Achilles tendon. Now I thought I had this all beat but not so as I lay in pain thinking of what I ate and drank the day before that could have triggered this episode off.
Because I was running late, I started yesterday off without breakfast but with the first of my two cups of coffee for the day. That is one cup in the morning and one in the evening. Although I drank a litre of kiwi and pear juice throughout the day and about mid afternoon a few mixed nuts to see me through. I am trying to lose weight okay. After arriving home I cracked open a beer and with some cheese as company I sat on my patio and watched the sun go down while some vegetable lasagna was slowly baked for my supper later.
Now I have had all of the above except the lasagna in the week before with no gout attacks. So that narrowed it down to the vegetable lasagna. What was in the lasagna that I didn't eat in the previous weeks? The broccoli and baby marrows were eaten before so it must be either the carrots, cauliflower or pea pods. Then it dawned on me, a friend a sent me a list of foods that are have known links to purines which cause uric acid that develops gout and on that list was beans. Yes beans and I am sure pea pods are close enough to beans. So the culprit for my gout this time was the vegetable lasagna. You can now see how I deduced that vegetables are evil. Oh and with that I will leave you with a photograph of my office in Parktown while I go off and slowly appreciate a glass of red wine to celebrate my Dr Watson moment.
Since the last century, when all purines were held to blame for gout, things have moved on. Current experts believe that vegetable purines do not readily break down to uric acid.
ReplyDeleteEven more important, is the knowledge that most gout is genetic, or caused by meds for other health problems. Food can make gout worse, but it can also make gout better. The only way you can be certain is to test your uric acid level.
The values change according to temperature and other factors, but basically, anything much above 6.5mg/dL will cause new crystals to form with the chance (not certainty) of a gout attack. Anything much below 6.5mg/dL will cause old crystals to dissolve, with the chance (not certainty) of a gout attack from partially dissolved crystals. That is why people who control gout with allopurinol or other uric acid lowering treatment need pain relief during the first few months of treatment.
There is good evidence that tomatoes lower uric acid, so the chances are that the tomatoes in your veg lasagna lowered your uric acid to the point where crystals started to dissolve and triggered your gout attack.
Of course, without a blood test, you never know for certain. That is why, whether you chose diet changes or medication to treat gout, you must have regular blood tests and make sure your level never rises above 5mg/dL - 5 is important because it gives a safety margin to cover natural fluctuations in uric acid and in temperature.
Never use pain to measure the success or failure of gout management. As I've explained, it might be a sign that you are getting better. Also, uric acid deposits can build up so slowly that you do not notice them, but they eat into your joints, leaving you permanently crippled in later life.