Understanding Purines for Gout

If you suffer from Gout, chances are you have done some research on it. If you have done any research, you have probably read about purines. There seems to be an unlimited supply of websites attempting to define what is safe to eat and what should be avoided.

Purines are found naturally in the cells of our body and in the food we eat. As much as 85-90% of the purines (Adenine and Guanine) in our body come naturally from our DNA. The remaining 10-15% of purines (Hypoxanthine and Xanthine) come from the food and beverages we consume. Either way, the purines make their way to the liver where it is metabolized in to Uric Acid. The uric acid then travels to the kidneys where most is removed from the body as waste in urine. Some of the uric acid is deposited in the bloodstream. When too much Uric Acid enters the kidney's more is deposited into the bloodstream. It is the excess uric acid in the bloodstream that crystallizes in joints to create what we all know as Gout.

Low Purine Diet Guide

Since up to 85% of the purines come from DNA, that means the remaining 15% can be controlled by what we eat. There seems to be unlimited supply of websites telling us what we should eat and what we should avoid. Generally, you want to maintain a low purine diet and limit consumption of high purine foods. I found this chart at Primary Care Specialists. This chart is a good guide on what to eat and what not to eat. High purines eats, red meats, seafood and alcoholic beverages among many other things. I have listed a few sites I like to reference when I need to find out about a particular food or food group.

Please share with me your favorite website for looking up the purines list.

Purines Food Lists
http://www.dietaryfiberfood.com/purine-and-uric-acid/purines-food-and-gout.php
http://www.webmd.com/arthritis/tc/diet-and-gout-topic-overview
http://goutcuresandremedies.blogspot.com/2012/05/comprehensive-list-of-purine-containing.html
http://www.goutpal.com/gout-diet/purine-rich-foods/

Information Sources
http://library.med.utah.edu/NetBiochem/pupyr/pp.htm
http://www.ehow.com/about_5047849_purines-pyrimidines.html

Uric Acid Meter Accuracy

Easy Touch GU Log

I bought my Easy Touch GU, Uric Acid Meter several years ago. Although, I do not believe it is as accurate and reliable as a test performed at the doctor’s office, I still believe it is a reliable guide that helps in planning menus and activities. 

I purchased my meter from a vendor in Florida a few years ago before they were available on Amazon. Read my previous post on my Uric Acid Monitor. When it first arrived, I used it several times a day. I tested my blood when I woke up, before going to bed, before / after meals, before / after known trigger foods, and randomly during the day. I noticed that my uric acid levels varied through-out the day. It changed depending on, not just what I ate, but what I was doing such as relaxed vs doing sometime of strenuous activity. 

During gout attacks, I observed variances in my levels as well. Although, my levels were higher than normal, they still varied through-out the day. What I found most interesting was that as my gout attack wore on, my uric acid levels went back to the normal range, but I was still in pain. This helped me realize once the uric acid crystals developed in my toe, I had to maintain a low uric acid level for days sometimes weeks for the uric acid crystal to dissolve. If I ate any moderate / high purine foods, it didn't allow the crystals to dissolve as quickly.

I use my meter as a guide. If I think I might be at risk of having gout, I check my blood. If the meter reads that my uric acid is greater than 7mg, I avoid the steak and beer, and have chicken and water instead. If it is within range, particularly below 5mg, I might have a couple of shrimp or a steak but I do not over-indulge. Since Allopurinol does not work for me, I watch my diet and monitor my blood levels. You can read my post on my experience with Allopurinol at Is Allopurinol Good . 

Male : 3 ~ 7.2 mg/dL (179 ~ 428 umol/L)

Female : 2 ~ 6 mg/dL (119 ~ 357 umol/L)

I believe the uric acid meter is worth the investment. I learned a lot about how uric acid works in my blood. My doctor confirmed that uric acid levels can fluctuate. When I compared the results from the meter to the result from the lab, they were not exact but close enough. I purchase my refills through Amazon and find them a bit expensive so I do not test as much as I did in the beginning. There is a bit of a wait to receive the refills so I hopefully that will improve in the future. 

I would enjoy hearing experiences with your Uric Acid Meter. 

Gout Medication

When someone is suffering from a gout attack, the only thing they want is for the pain to stop. Many gout sufferer turn to medication for relief. There are three types of medication to considering for gout sufferers: Steroid drugs, Non-steroidal anti-inflammatory Drugs (NSAID) and Gout Prevention Medication.

When someone goes to the doctor for a gout attack, many times the doctor will prescribe a steroidal prednisone dose pack to help eliminate the pain. This can be an effective method of helping with a gout attack. However, it is common for the need for longer dose and sometimes this may not help. Prednisone can also be addictive and should be tapered off with the help of a doctor.

Gout attacks can be accompanied with tremendous pain that can be controlled using the proper NSAID medication. Powerful NSAID medications can be prescribed by the doctor like Voltarol, Arcoxia, Indomethacin, and Zipsor. Over-the-counter medications like Naproxen, Ibuprofen, or Aspirin. These medications can be used to control the pain associated with a gout attack however they do not remove the uric acid causing the gout attack. As with any medication, one medication may work better for different people. Side effects can also be associated with any medication.

Gout Preventive medication are used to reduce the uric acid in the blood stream. Medicines like Allopurinol, Uloric, Colcrys, and Colchicine are very popular for gout sufferers attempting to control their gout. They reduce or limit the amount of uric acid that enters the blood stream.

There are also natural alternatives to fighting gout on my Fight Gout Naturally blog post.

Gout Preventive Medicine

• Allopurinol
• Uloric
• Colcrys
• Colchicine

Non-Prescription Gout Pain NSAID

• Naproxen
• Ibuprofen

Prescription Gout Pain NSAID

• Voltarol
• Arcoxia
• Indomethacin
• Zipsor
• Piroxicam

Prescription Steroid for Gout Pain

• Prednisone Dosage Pack

If I have overlooked any medication for helping gout, please add yours to the comments link below this post

Alkaline Water for Gout

Increasing the alkalinity of the body is a good way to reduce your risk of gout. When you add sugary carbonated sodas, candy, beers, sugars, meats, and other acidic foods and beverages the your diet the body as a whole becomes more acidic. This is not good for the body as viruses and bacteria can survive. It is even worse for gout sufferers, it makes it harder for the kidneys to remove the excess uric acid which contribute to more gout.

The human body is naturally alkaline with a pH of around 7.4.

pH < 7 is Acid
pH = 7 is Neutral
pH > 7 is Alkaline



Pool Chemical Test Kit

 There are many different ways to get alkaline water depending on your taste buds and budget. Each method has it's pros and cons. To test the pH of the water, you can get a swimming pool chemical test kit or test strips. There are also test strips used for urinalysis to check the acidity of your urine to track your progress.

Lemon Water - The cheapest way to get alkaline water at home is squeezing lemon juice into regular tap water. Although the lemon water is acid, it is believed to have an alkaline effect on the body.

Baking Soda - Baking Soda (sodium bicarbonate), which has a pH of around 8.0, will alkaline your water also and is very inexpensive. Due to the high sodium content, baking soda can increase your blood pressure. Ask your doctor before trying this remedy. Personally, I did not like the flavor or texture of the baking soda water.

Baking Soda Remedy
- A half teaspoon to 6 to 8 ozs of water.



Alkazone

 Alkaline drops - Alkaline drops can be added to any beverage to increase it's alkalinity. Although, not as inexpensive as lemons or  baking soda, a single bottle is not too expensive and can last for weeks or months. The bottles are small so they travel well and are convenient when out for dinner. There are several brands available through your local health food store or favorite online retailer. Each brand of Alkaline drops I tried each used different minerals to change the pH of the water. This created an after taste in some brand that I did not like. I prefer AlkaZone, but I recommend trying several brands to find the one you like.

Water Alkalizer Machines - Water Alkalizer use electric charges, or electrolysis, to adjust the pH of the water in its tank. Alkalizers can be purchases in small portable bottles, counter-top versions, or systems for an entire house. Some of these systems are very expensive so that are not for everyone.

Caramel and Gout

One of my favorite candies is those soft caramel chews but as a gout sufferer I now eat them in moderation. My favorites are the Cow Tales and Caramel Creams by Goetze. They have the cream centers that are so delicious. I could eat handfuls at a time. That was my mistake. I bought several bags of the Caramel creams and ate them all within a few days. After years of gout attacks, I am generally very good about watching what I eat. Unfortunately, I hadn't considered candy caramels.

The Cow Tales and Caramel Creams from Goetze are made with soy and wheat. Both soy and wheat are considered as moderate in purines. Lots of foods that we eat contain soy or wheat. Foods derived from soybean include tofu, soy sauce, edamame  and soy milk. Wheat, of course, can be found in lots cereals, breads, pastries, and so many other items.

So the question is; did the caramel increase my risk for cause or was it the trigger? 

What do you think?

Gout with Wide Shoes



My Gout Shoes - EEE

 Anyone who has experienced a gout attack in their toes knows that it can be very difficult to walk. This is particular true for those who travel for business or pleasure. Back when I was having frequent gout attack, I would have to travel for work. Although, I didn't travel much, Gout seemed to find me before or during the trip. As with most business travel, you get bigger meals, fast food, and lots of walking.

On one particular gout experience, I had been preparing a presentation that I was to give at this conference for months.  As luck would have it, gout found it's way to my right toe about 4 weeks before I was supposed to attend the conference. I immediately cut my on my trigger foods, limited all red meats, seafood, alcohol, etc. I drank lots of water, cherry juice, and chicken in hopes that I could shake this attack myself. With one week before I left and the gout attack didn't seem to be subsiding. I broke down and went to see my doctor. I was desperate to get this gout attack eliminated before my travel. It was just not to happen. I was in lots of pain with no end in sight and business travel on my mind. I knew there would be lots of walking and my food was not going to be up to it.

With that in mind, I decided to find a larger pair of shoes. I needed shoes that I could walk in that looked professional and would cause the me least about of pain when I walked. So I went out and found me a pair of EEE width dress shoes. They were huge to walk in but as long as I tied them tight, I was able to walk around. It was not the perfect solutions but it helped me get through that week.