Gout question

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I'm not the one with gout (thankfully), my husband is. He had a flare this past spring that lasted a terribly long (like two months) time. He quit drinking alcohol - that didn't make it go away. He finally saw a doctor who put him on Allopurinol and that seems to be helping. He states he drinks lots of water during the day, but only drinks cranberry juice (mixed with sparkling water) in the evening.

He told me a couple months ago that we can't eat pork or beef anymore, as he claims those are two of the worst things for gout. So I'm left with chicken, eggs, and turkey for protein. He also doesn't believe in the LCHF thing. He eats what I cook but asks me to not use much fat. I don't mind making a side of rice or quinoa for him, like last night when I made a ground turkey curry in coconut milk sauce with veggies - it worked for me without the rice and for him with it.

So my questions are:

1) does anyone have any experience with LCHF and gout?
2) what do I do to not get sick of chicken?
3) how to deal with a spouse who isn't on board with your WOE?

Replies

  • anglyn1
    anglyn1 Posts: 1,803 Member
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    From what I've read pork and beef are only moderately high in purines. It's mostly organ meats like liver that is recommended to be avoided. My friend with gout eats plenty of beef and pork with no issues. He is on medicine however.

    Is your husband willing to read any books or watch any videos about the diet? That might help him understand the science behind it and how the science behind high carb diets is really shady.
  • CJ0821
    CJ0821 Posts: 51 Member
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    I was blessed at a young age with gout. :D Thanks a lot Dad. Anywho, I believe my onset was because of beer, wheat, something provoking the inflammation... That was in September last year, I started LCHF the next month and haven't had any issues since. I have the occasional Michelob Ultra when I am craving a beer, but I usually drink red wine. Also... I couldn't give up red meat or pork... man... no bacon? WHAAAAAAT? no ribeye?! oh lord. no. lol.

    I would get so sick of chicken, but if that is the only option I had, i would just season it or cover it in some type of goooooood fatty sauce. Sour cream, cheese, bacon?... avocado and salsa... anything. Lemon pepper, buffalo sauce, ranch... I am getting hungry.

    I have probably bored my husband to death with the science behind this WOE. I do the same type of thing you do for my boys, I make steak, chicken, pork chops, etc, but usually add a veggie I don't normally eat to our meal. I will have double broccoli, while they have corn and broccoli. I usually use corn, it is their favorite. I do not know if any of that helped.... gout is a trial and error type issue that you have to eliminate one thing at a time to figure out what it really is...
  • wabmester
    wabmester Posts: 2,748 Member
    edited October 2015
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    Surprisingly controversial. This article seems pretty good:
    http://www.medscape.com/viewarticle/524766_6

    Prior to these recent prospective studies, patients were advised on a relatively unpalatable low-purine, low-protein and alcohol-restricted diet. When compliant, this type of diet is expected to decrease serum uric acid by ~15% (~1-2 mg/dl or 60-120 µmol/l) at a maximum.[10] With the strong association between gout and insulin resistance and less with the amount of total daily protein intake, however, the dietary recommendation has shifted to focus more on weight reduction, with moderate carbohydrate restriction and an increased proportion of protein and unsaturated fats.

    So, if he's overweight and/or insulin resistant, LCHF may help his gout. A pretty good proxy for insulin resistance is the combo of high triglycerides and low HDL. If that's him, he'll definitely benefit from your diet. :)
  • mountainrun73
    mountainrun73 Posts: 155 Member
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    Cool responses, thanks!
    Unfortunately, he doesn't like to read (surprising for someone with a great vocabulary). Maybe I could just leave my books like Wheat Belly and Keto Clarity laying around. Maybe he'd ask me about them.

    I suspect he has some insulin resistance. Like me, he's athletic (rides his bike to work every day, does ridiculously long rides most weekends), but still has a pretty high body fat percentage and could stand to lose 10lbs (like me). I don't know what his triglycerides or HDL are - he only told me that his doctor said his cholesterol and blood pressure are "good."

    He no longer eats wheat unless out for a special occasion (burrito or pizza). Eats salads with beans for lunch. My guess it's the large amount of fruit, fruit juice, and his love of snacking on granola bars that are the real culprit. However, I shut up about fructose when, last time I suggested fructose was more of a trigger than beef or pork, he got mad and said that had nothing to do with it. Maybe if I had an MD rather than a JD he'd listen to me. I also recall reading somewhere (and I can't find it) that vegans have much higher serum uric acid levels than meat eaters, and that some vegetarian sources of protein have higher purine levels than either beef or pork.

    I'll get to saucing that chicken. (and turkey, and chicken sausage, and turkey sausage) And maybe buying pork and bacon for myself. :)
  • JodehFoster
    JodehFoster Posts: 419 Member
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    It doesn't sound like you are much of seafood eaters, but I know besides avoiding organ meats, shelfish should be avoided like the plague. Shrimp, crab, lobster, etc.

    My dad's gout will flare like crazy if he touches an ounce of the stuff.
  • KnitOrMiss
    KnitOrMiss Posts: 10,104 Member
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    My friend and coworker has been on a Ketogenic diet here for the last 3 months or so, and he has a terrible case of gout. Prior to the diet, he was getting a bad flare up about once every 3 months or so, bad enough to require medication AND pain meds. It will be interesting to see how the cold weather hits him. He does not restrict from anything (except the higher carb trigger foods), eats beef and pork regularly (4+ pieces of bacon for breakfast daily), and doesn't take any medication to prevent flare ups... I'll keep you up to date if anything changes, and if it doesn't!

    As far as your hubby not wanting to read, there was a recent thread with a ton of video links. My guy refuses to buy into the LCHF concept, despite proof that it is working for him too, despite his constant drinking of Pepsi and eating bread/starch with every meal and his pants literally falling off him without a belt... I just don't argue. I do keep the foods with less fat than I would if he weren't eating them, but I always add some back in to mine. Like last night, I roasted a beef rump roast with a thickish fat layer on top and beautiful marbling. After I sliced it, I dredged mine through the pan drippings/broth in the pan and I left his "dry." I had broccoli with butter and cheese, as did he, but he also had mashed potatoes and biscuits.

    I make a meat/main course and a LC friendly veggie if I want something. I'll then add a side for him and bread is available. That's pretty much how I operate across the board. Last night for a snack, I had ham with cheese and pickles. He actually asked for pepperoni, cheese, and pickles. I was amused. I think he thought I'd been eating pepperoni, not ham. He still eats leaded desserts, but he'll embrace my fat bombs too... As long as I don't spring cauliflower or brussels sprouts on him without warning, we're good! I do the rice for him with stir fry, etc. too.

    As for the naysaying, he's seen the proof, so the voice has toned down some, but the rest I ignore. I know what is working for me, and my doctors and bloodwork agree. So until it doesn't work anymore, I'm keeping with the program, and he can stuff his objections in his ear, because I'm not hearing them! LOL
  • mountainrun73
    mountainrun73 Posts: 155 Member
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    @JodehFoster - I love seafood, hubby doesn't very much. And where we just moved, even frozen seafood is really expensive, so I haven't bought any (I used to keep bags of frozen shrimp around for variety on my salads).

    @KnitOrMiss - thanks for the tips, I hope that my own experience (as it unfolds) will speak for itself and he'll ask questions. Love that LCHF is working for your guy despite his not buying into it! And yes, I do want to know how your friend does with gout and LCHF!
  • V_Keto_V
    V_Keto_V Posts: 342 Member
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    wabmester wrote: »
    Surprisingly controversial. This article seems pretty good:
    http://www.medscape.com/viewarticle/524766_6

    Prior to these recent prospective studies, patients were advised on a relatively unpalatable low-purine, low-protein and alcohol-restricted diet. When compliant, this type of diet is expected to decrease serum uric acid by ~15% (~1-2 mg/dl or 60-120 µmol/l) at a maximum.[10] With the strong association between gout and insulin resistance and less with the amount of total daily protein intake, however, the dietary recommendation has shifted to focus more on weight reduction, with moderate carbohydrate restriction and an increased proportion of protein and unsaturated fats.

    So, if he's overweight and/or insulin resistant, LCHF may help his gout. A pretty good proxy for insulin resistance is the combo of high triglycerides and low HDL. If that's him, he'll definitely benefit from your diet. :)
    I concur with this. Dietary intervention has little if any effect on serum Uric acid levels (obviously though avoiding binge beer is a wise decision...wine apparently is less concentrated with purines...not that it's okay to get plastered on wine).

    Prophylaxis with Allopurinol or Febuxostat is generally good enough, as long as he remains compliant. A general goal is serum Uric acid < 7.0 mg/dL in men for prophylaxis. Although Uric acid levels don't always correlate with gout flares or disease severity. Prophylaxis is best as more frequent flares generally equate to greater severity.
  • KarlaYP
    KarlaYP Posts: 4,439 Member
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    It's also called "Rich man's disease" since the sources of uric acid tend to be higher priced foods.
  • V_Keto_V
    V_Keto_V Posts: 342 Member
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    Karlottap wrote: »
    It's also called "Rich man's disease" since the sources of uric acid tend to be higher priced foods.

    Originated with pharaohs interestingly enough...a truly ancient disease
  • Standsfast
    Standsfast Posts: 77 Member
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    Look for an article or post by Tim Ferriss
    fourhourworkweek.com/2009/10/05/gout

    Gout: The Missing Chapter from Good Calories, Bad Calories

    Interesting reading!
  • KeithF6250
    KeithF6250 Posts: 321 Member
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    About 5 years ago I had an acute gout flair, the worst pain I've ever had in my life. At the time I found a lot of support and advice in the forums at this site:
    http://www.goutpal.com/

    Like diabetes gout is a very individual disease and different people have different triggers. I have corresponded with people to whom chicken was an immediate and painful trigger and a woman who was a young, skinny vegan and still a gout sufferer.

    There are two characteristics of gout, uric acid deposits in the joints and an inflammatory response to those deposits. Deposits occur because your body makes too much uric acid or excretes too little. Allopurinol addresses either of these and causes deposits to stop growing or reduce. In a cruel twist, deposits which are breaking down can also produce an inflammatory response.

    For the intense pain of the inflammatory response, colchicine has been drug of choice for a long time. There are reliable reports of its use 1500 years ago, less well documented reports date back 2500 years. Unfortunately, that was long before the FDA did testing. Sometime in the past 5 years the FDA has started a program to allow companies to test these ancient drugs and gain some limited patent protection. Colchicine is one of those drugs and it is now available as a brand name at 10 times the price and a dosage level of half that which I found to be effective.

    Since I have reduced my weight from 220 to 150 over the past year, I have effectively increased my allopurinol dosage substantially. Last month I had a flair from a deposit in my wrist which I assume was breaking down. Fortunately, I was able to quiet the flair with a single dose of naproxin sodium.