[azasadny]

I'm no expert but I have learned a great deal about gout. The closest analogy I can use is diabetes, which is another metabolic disorder. Both diseases (diabetes and gout) require monitoring, diet modification, activity modification and MEDICATION to control and prevent acute attacks and permanent damage. Diet alone will not do it. Serum Uric Acid is the key and getting the level down as low as possible is the MOST IMPORTANT thing to do if you have gout. Some do this with Allopurinol or other newer meds (Uloric, etc...). You have to find the right dose of Allopurinol to lower your SUA, for me it's 600mg a day. I eat a semi-vegetarian diet (no red meat, only chicken or fish once or twice a week, no alcohol of any kind, no high fructose corn syrup, etc...), I drink tart cherry juice and water (1/2 to 1 gallon every day) and I keep my weight down, but this isn't enough to lower my SUA by more than 10% or so, so I MUST TAKE ALLOPURINOL for the rest of my life, which is something I've resigned myself to. The Allopurinol doesn't raise my liver enzymes (I have liver disease, so I have to be very careful) and I take Vitamins C, D and E every day.

Again, gout has to be actively managed, just like diabetes. Too many people ignore it until they have a flare-up and they are oblivious to the fact that the uric acid is constantly building up in their joints, causing a deterioration of the joints that cannot be undone. My rheumatologist told me that I most likely had gout for 10 years before I has my 1st attack, so the damage done was significant and wouldn't go away. When I drive a car with a clutch or play the drums, my feet are sore for a time afterwards. I take 220mg of Aleve (naproxen) twice a day, as needed for that chronic pain cause by the after-effects of gout. The Dr told me that osteoarthritis moves into the joint that is affected by gout because the gout sets up an inflammatory process that causes osteoarthritis to continue even after the gout is under control and not active in the joint.

This is why it's so important to keep your SUA under control (as low as possible, 6-7 is way too high!) because once the osteoarthritis sets in, you have permanently damaged the joint and will have to live with pain. I talk to people with gout all the time and they say things like "I don't worry about my gout until I have a flare-up, then I go to the Dr"), which is bad because they are not treating the disease, just ignoring it until the damage has been done....

Sorry about getting on my soapbox.... This is a very sensitive subject for me....