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No hero that's understood
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Discussion Starter · #1 ·
I think I have it, I know I hate it.

For the better part of the last 10 years, I have been having periodic (semi-annual) flare ups in the large knuckle of the big toe of my right foot. Sometimes it moves to other toes or even to the other foot. All of the physical symptoms point to gout, but none of the blood tests ever show an elevated level of uric acid.

For this reason, I have never been prescribed the daily dose medicine (alapurinal sp?) that is said to prevent this. On Saturday night, I got another attack which generally means treat with prescription anti inflammatories and return to normal in a week or two.

Diet is generally a leading cause of the flare ups, but I have no idea I have eaten recently to cause this. My diet does not vary greatly and I have not been drinking any more than normal.

I am officially fed up. Anyone else have it and is there anything that I can do that I'm not already doing to prevent it?
 

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Proud luddite
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When you mentioned that your uric acid levels were normal, that caught my attention. I had very similar symptoms years ago and while they thought I had gout, my uric acid levels were also normal and I didn't fit the profile of a typical person with gout. After my primary physican couldn't figure out what was going on I was referred to an orthopedic doctor, who also couldn't figure it out. Eventually I made my way to a rheumatologist who diagnosed me with psoriatic arthritis. Turns out that even though I have a relatively minor case of psoriasis, it led to this arthritic condition in several of my toes. Psoriatic arthritis comes and goes, and mine resolved about 7 years ago. But for a while, they had me on azulfidine (arthritis med) and feldene (anti-inflammatory). Not sure if that is what you have, but I just wanted to throw this out there because it took a couple years for them to figure out what my problem was and maybe this will save you the trouble.
 

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banned from the museum
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My doctor thought I had gout, or perhaps arthritis. It turned out to be a shellfish allergy. Once I stopped eating shrimp, everything was OK. How's that for strange?
 

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No hero that's understood
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Discussion Starter · #5 ·
azpeterb said:
When you mentioned that your uric acid levels were normal, that caught my attention. I had very similar symptoms years ago and while they thought I had gout, my uric acid levels were also normal and I didn't fit the profile of a typical person with gout. After my primary physican couldn't figure out what was going on I was referred to an orthopedic doctor, who also couldn't figure it out. Eventually I made my way to a rheumatologist who diagnosed me with psoriatic arthritis. Turns out that even though I have a relatively minor case of psoriasis, it led to this arthritic condition in several of my toes. Psoriatic arthritis comes and goes, and mine resolved about 7 years ago. But for a while, they had me on azulfidine (arthritis med) and feldene (anti-inflammatory). Not sure if that is what you have, but I just wanted to throw this out there because it took a couple years for them to figure out what my problem was and maybe this will save you the trouble.
Thanks, I've been to all these docs as well. The rheumaologist didn't think it was psoriatric arthritis based on the blood tests. I got really tired of going to the doctor and not having them be able to tell me what it is. I even had fluid drawn from the joint with a 6" needle. The lab tech screwed up the sample and we were unable to get the results. I'm just tired of trying to get this straightened out.
 

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Just Plain Bitter
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My Own Private Idaho said:
My doctor thought I had gout, or perhaps arthritis. It turned out to be a shellfish allergy. Once I stopped eating shrimp, everything was OK. How's that for strange?
This is a good possibility as suddenly I have developed allergies I had thought I had outgrown in my childhood. It is possible that you have developed a new allergy to something you had not been previously allergic to,
 

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No hero that's understood
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Discussion Starter · #7 ·
rward325 said:
This is a good possibility as suddenly I have developed allergies I had thought I had outgrown in my childhood. It is possible that you have developed a new allergy to something you had not been previously allergic to,
I've considered this as well. 6 months ago before after my last attack, I thought it was related to eating shell fis, shrimp clams and the like. I stopped eating them and thought I had found the solution, then it came back again.

If it is beer that is triggering it, then screw it, I have something that cannot be cured and I'll just have to HTFU.
 

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I have it

Never had a problem until about seven years ago and it cropped up in London. Then about a year later it happened on a trip in Mallorca. I couldn't figure it out until my wife mentioned it to a doctor friend at her gym. She thought the symptons were gout so I went up to her clinic for some bloodwork which showed some of the symptons which one associates with gout. I mentioned it to my mother on a phone call and she told me my father had gout for years and was on allopurinol. Then my sister the the doctor indicated that it can be hereditary. Lol, the stuff they don't tell you!!!

By now you've researched allopurinol and it's not the answer if avoidable. Diet change can work if your case is not that extreme. Like you, the idea of coming off beer, wine, ie any alcoholic beverage, was not attractive. Most of my attacks have come during periods of high work-related stress, lack of sleep, high alcohol intake and eating unbalanced meals, in other words, when traveling for business. Shellfish is extremely high in purines so despite my love for the stuff, I've laid off and indulge infrequently and in moderation. Historically I've been a meat and potatoes person so I've radically changed that, decreasing red meat intake significantly and increasing veggie intake. Being outside of the States has helped as red meat intake in Europe and Asia is significantly less than the States and the dishes are such that you don't notice and eventually don't care about the difference. You can download lots of charts showing what foods are high and low in purines. I've had one attack in the last four years and again, another road trip and I just got careless with the diet so do some more research as I've not had to alter my drinking habits at all.


q_and_a said:
I think I have it, I know I hate it.

For the better part of the last 10 years, I have been having periodic (semi-annual) flare ups in the large knuckle of the big toe of my right foot. Sometimes it moves to other toes or even to the other foot. All of the physical symptoms point to gout, but none of the blood tests ever show an elevated level of uric acid.

For this reason, I have never been prescribed the daily dose medicine (alapurinal sp?) that is said to prevent this. On Saturday night, I got another attack which generally means treat with prescription anti inflammatories and return to normal in a week or two.

Diet is generally a leading cause of the flare ups, but I have no idea I have eaten recently to cause this. My diet does not vary greatly and I have not been drinking any more than normal.

I am officially fed up. Anyone else have it and is there anything that I can do that I'm not already doing to prevent it?
 

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No hero that's understood
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Discussion Starter · #9 ·
Boneman, thanks for the info and stress and business travel definitely are contributing factors. The reason this attack is so frustrating is that I have neither of those right now.
 

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RoadBikeCrusader
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I had a really bad time with gout in both of my knees about 8 years ago. Some of the attacks almost literally crippled me. I never knew of such pain and discomfort and I feel what you're going through. I met with several doctors and followed their advice (laying off foods with high purines, alcohol - especially beer, drinking gallons of water, yadda, yadda). It helped somewhat but it sure was not the cure all.

At that time I was going through a very bad time at work and my boss was really stressing me out. Make a long story short, after 2 years of hell with her I got ****-canned and a few weeks later I started a new job where no-one rode my ass. The gout eventually just disappeared and I have been pain free the last 6 years. I can drink beer, eat shrimp & steak and I even indulge in my local butcher shop's delectable smoked bacon once in a while. In my case it was stress. Funny what it can do to a person.
 

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My wife would get what appeared to be gout every summer in her toes + ankles. We figured out that it might be related to bacon in BLT sandwiches. Switched to turkey bacon and she hasn't had the symptoms again.
 

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smell my finger
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When I was in the Coast Guard my diet was rich in seafood and I drank a bit more alcohol than I do now. I had gout flare-ups in my right great toe joint 2x per year and they were really painful. I was on allipurinol daily to try and control uric acid levels. I retired and my diet in seafood was reduced because no one in the family really cares for it, my stress level came down when I started riding my bike more and the amount of alcohol consumed has been reduced also. I have had no gout flare ups in 3-4 years now and have stopped the meds altogether. I hate taking meds so I'm thrilled with the results. I never had gout in any other area other than my great right toe joint.
 

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25.806975801127
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I haz gout.

Things you wouldn't suspect can trigger an episode.

Spinach, for instance.

Drink 'natural' cherry juice (not the cocktail stuff) or each cherries. A few a day will make it go away. Keep eating the cherries after it's gone and you shouldn't have any more problems.
 
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