Gout
The term gout refers the disease that is caused by an overload of uric acid in the body, resulting in painful arthritic attacks and deposits of lumps of uric acid crystals in body tissues.
Gouty arthritis is typically an extremely painful attack with a rapid onset of joint inflammation. The joint inflammation is precipitated by deposits of uric acid crystals in the joint fluid (synovial fluid) and joint lining (synovial lining). Intense joint inflammation occurs as white blood cells engulf the uric acid crystals and chemical messengers of inflammation are released, causing pain, heat, and redness of the joint tissues. Source http://www.medicinenet.com/gout/article.htm
Now this bad boy really does effect training as it impacts on your diet big time.
For me the big triggers are red meat, offal, oily fish and shellfish, which happens to be all my favourite foods – you can’t beat a juicy medium rare rib eye steak or some fresh crab or even some really fresh pan fried herring fillets seasoned well with salt and a twist of lemon.
As you all know protein is a big player in terms of strength training and hyper trophy. As such my main protein sources are chicken breast, white fish, skimmed milk and whey concentrate (funnily some protein powders give me gout, I have settled on muscleforms whey concentrate XV, only £23.99 for 5lbs. I actually feel stronger on it than their ubey whey isolate at twice the price).
If I do have a gout attack, I will drop my protein intake massively to maybe only 50g per day. An attack can last for 3 to 21 days, so during this period my protein intake is relatively low.
I have lost up to 12kg/26.4lbs during some of these gout attacks!!
Drinking plenty of plain water – I aim for 6 to 7 litres spread evenly throughout the day, which I feel really helps in prevention. The big downside is broken sleep as I need to get up 2-3 times a night to go to the toilet.
I have also spent a fortune on cherry juice, not any old cherry juice mind but top of the range Montmorency cherry juice. I have recently stopped after about 9 months of consumption, as I didn’t think it actually made a difference to me. Other natural preventers I have tried include bromelain tablets, ginger extract and devils claw – none of which really helped. Just a quick note – just because they didn’t work for me, doesn’t mean they won’t work on you.
At present I do not take any preventative medications i.e allopurinol as luckily my gout attacks are not frequent enough. I probably average about 8 to 12 attacks per year, mostly minor attacks i.e no longer than 4 to 5 days per attack, which I treat with Naproxen alongside Omeprazole to protect the stomach (1000mg to start, followed by doses of 500mg every 7 hours – please consult your doctor for dosages). I will try and stay away from the preventers as long as possible as they are quite toxic to the body. Saying that, taking Naproxen for extended periods can increase the risk of serious cardiovascular thrombotic events, myocardial infarction, and stroke, hence why I am trying to do more Cardio exercise. It is also not good for the stomach as it causes ulceration.
When I do get these attacks, obviously legs and heavy back are out of the question. If the attack is bad then the gym is competely out of the question. Othertimes I will train my upper body with light weight and depending on how long the attack has lasted start building up the weight again after it has finished.
Currently I try to limit my red meat intake to a maximum of 4 meals a week, which I find very hard as it is so tasty. Shellfish I probably eat 1 meal a week and the same with oily fish. It will probably do more good if I was to half this intake or cut it out altogher but this is near enough impossible as I love my food too much.
Alcohol is meant to bring on a gout attacks but I have not found this is the case for myself. I personally drink lager and vodka. My personal theory is that because I drink lots of water my body doesn’t end up dehydrated through the alcohol (dehyration is a big trigger of gout attacks).
UPDATE – 27th October 2009
Had quite a prolonged gout attack in my right knee. Luckily it wasn’t too intense but it was still painful enough to cause a fair amount of discomfort. What this meant was that I took quite a lot of naproxen, which makes me paranoid about getting a heart attack. Therefore I have started a new preventative measures programme as detailed below:
- Xylitol – 4 teaspoons a day (2 in morning with my cereal and 2 at night mixed with water), the logic here is that xylitol is meant to be alkalizing
- Vitamin C – dosing up with 1500mg-2000mg per day, split into 500mg doses taken throughout the day
- Bicarbonate of Soda – 1 level teaspoon before bed, another alkalizing agent
Will keep you updated on how it goes.
UPDATE – 28th October 2009
Have tweaked my plan outlined above – instead of 2 teaspoons of Xylitol at night, I mix 3 teaspoons of Xylitol with fresh lemon juice (1 lemon) and make a lemonade. Lemons are alkalizing too so am trying to make a more potent formula.
I am also eating 1 banana a day to try and help my kidney function
UPDATE – 23rd December 2009
Got my blood test back – I have been prescribed allopurinol
In 2 minds whether to wait till after xmas period before I start allopurinol course due to the fact that it can cause gout attacks to begin with
UPDATE – 13th May 2011
So I ended up taking allopurinol for about 7 months but kept getting sick i.e. colds, stomach bugs, chest infections etc. Not sure if this was due to the allopurinol or having 2 young kids combined with winter = loads of bugs and viruses but I started to get it in my mind that allopurinol was effecting my immune system. Anyway’s I didn’t really notice much difference in frequency of attacks and didn’t want to increase the dosage, so I stopped taking it.
For the last year, I have been relatively gout free – only maybe a couple of mild attacks. Not sure why, I think it may be because I started taking Vitamin D (1,000 iu twice a day), Rose Hips (5g) and an omega 3 capsule (390mg omega 3, DHA 130mg, EPA 200mg) daily. Funnily with the omega 3, I have to avoid some brands as it can trigger an attack – the exact brand I take is here. Water intake is still high, between 4 to 6 litres a day and diet is relatively clean.
In regards to diet, as I need protein for recovery and to build muscle, I get most of it from chicken breast, white fish and eggs. I treat myself to the good stuff once or twice a week i.e. red meat, I do make sure I consume a load of water after consuming the red meat and it seems to help. Whey protein isolate is also quite a good protein to have at hand, I consume quite a lot of this without triggering attacks or upsetting my stomach. I tend to go for an unflavoured isolate, as there are less in the way of harmful colourings, sweetners and flavourings.
Also I have been consuming a lot of brown rice, again not sure if this helps but eating this with plenty of vegetables along with my chicken breast seems to keep me healthy and at the same time fuel the strength training.
Personally I think handling stress is the key factor. If I get really stressed I can guarantee a gout attack in the next couple of days, so for me I now make a conscious effort to manage my stress levels, plenty of self help books out there.
Please consult your Doctor before starting any dietary supplementation.
great blog thank you
I’m sorry to hear you went on allopurinol. I have been going down a similar path and trying to avoid any drugs that I would have to take for the rest of my life. I’m been tweaking my diet and had limited my “real” attacks to a few a year. I have been an avid runner but not much weights and as long as I kept up with the water intake I could manage my gout.
I just added weights back into my routine and now have a pretty bad case of gout in my ankle. I’m going to continue the weights and hope my body will get control of things is I stick to it.
I was wondering if you could provide an update as your post is now a few years old. I am interested to know how things are going with you
Hi Rob
Thanks for the comments, I just updated this page with what I have been up to.
In regards to weights, I agree and think it is a good plan to continue and hope your body adjusts.
I would make sure you do an effective warm down after the weights i.e. light cardio, stretching and maybe some foam rolling. Also make sure you do some active recovery after doing weight training on your lower body i.e. light cardio, stretching and foam rolling a day or two afterwards. Maybe even some really high rep weight training i.e. if your quads are sore from training then a few days afterwards do a couple of sets of 30 reps on the leg press to really flush fresh blood into the muscle which should help recovery. I think getting the blood moving and circulating around your body may help your gout as well.
Also remember to drink plenty of water whilst training. Depending on how hard you are training you will need to increase your protein intake to aid recovery and build new muscle. I suspect this maybe the problem, start off slowly and gradually increase the protein. You will have to find out what protein sources work for you, for me it is chicken breast, white fish, cottage cheese, eggs (mainly whites) and whey protein ISOLATE.
Lastly don’t go too heavy on the protein, you can gauge your body’s own recovery rate and adjust your protein levels as required i.e. if you train chest and you take 130g protein daily and this is enough so you feel fully recovered after 2-3 days then there is no need to overcook it, likewise if you still feel sore after 4-5 days then increase to 150g a day after your next session etc, etc.
Have you tried just using baking soda? I have had great success with it. Mix 1/4 teaspoon with 4-8 oz of water and drink it several times a day on an empty stomach. I will usually do this at the first indication of a flare up and several days after an attack. I haven’t had a full attack in around 2 years. I still do the baking soda a couple of days a year when I feel like a flare up may be coming.
No luck with baking soda – didn’t work for me.
Funny, I’ve been tracking my own gout attacks and have found a pattern.. Looking back at my notes, it seems that I get flare ups when getting back to hitting the weights. During recovery, I normally spend about a month away from weights, I’ll walk with my 1 year old son, and run around the park for exercise. Eight times in the past year, when I felt I was ready to hit the weights, within a week, I get a severe gout attack. I just find it interesting. For you weight lifters, please let me know if you notice similar patterns.
Hi Mike
What I find is that diet and stress are my biggest triggers. In regards to weight lifting, I find if I can balance my volume of training so I can recover without having to eat a boat load of protein I am usually OK.
I have heard that if you haven’t trained for a while, then the trauma from intensive weight lifting can trigger off attacks but if you can persist through it or work around it and get a routine going, your body will get used to it (easier said than done when you have a gout attack and can barely walk). Not sure if this is actually the case though as I have never had to do this myself, could be just a load of internet B.S, plenty of that flying round.
Great blog.
I’m a 27 year old that developed gout when I was 24 and went on allopurinol when I was 25. My uric acid was at 13 and with the medication it went down to 6.2. Make the story short I developed gout after I started to do heavy weight training and regardless still keep going hard at the gym. However its been almost a year that I stopped taking allopurinol and BAM I has my longest gout attack ever. Lasted 6 days tried naproxen and nothing, finally had to get indomiacin to help bring it down. I started the allopurinol and hope I don’t get a gout attack anytime soon. Whats really troubling in my case is the fact that I limit what I eat and also limit what I drink and regardless its as if my body doesn’t want to process the uric acid.
The main reason why I’m writing is because I do isolation workouts with usually one to two body parts a day 5 times a week. To be honest I’ve had the hardest problem in getting up in muscle mass because I have to limit my protein intake. At times it feels as if you just want to stop lifting because you can’t really go up. I’m 5’11″ 215-220 lbs and 16% body fat. I would love to do cardio my my gout has affected severely my ankles (where my gout attacks occur). I’m just like you, I love red meat and seafood but I have to limit what I can and can’t eat. What I found surprising after doing extensive literature review on gout is that fructose is also a contributing factor in developing a gout attack. We really are limited in eating whatever we want. I must admit, after reading your blog I really do need to start drinking water more. I usually notice that before I get gout attacks I develop cramps throughout my body. Oh and that black cherry juice is all non sense hahaha the only thing that $10 bottle does is send me to the bathroom for 3 days non stop.
Is there a possibility that you can give me insight for a meal plan. At this point I’m losing motivation in gaining muscle mass. I use a pre work out take creatine and also hydrobuilder. Please advise.
Hi Manny
Here is my response
http://www.liftingreport.com/2012/02/06/gout-response-to-manny/