Has Taking Colchicine Cured My Intolerance To Nuts
Q) As a long-term gout sufferer, I’ve been prescribed allopurinol at a hospital but it has tended to promote bouts of gout. The quick-fire cure I’ve found is colchicine, as the side-effects are not too dire. From being very young to the age of 30 I couldn’t tolerate eating peanuts or ground nuts as they caused violent stomach ache. I’ve had gout since the age of 30 and from then to my present age, 64, I’ve enjoyed eating nuts again with no traumas to my digestion. I’ve had no bouts of gout for nearly two years and wondered if this was anything to do with being able to successfully ingest nuts? Food for thought?
Bob, West Totton – 2008
A) A fascinating observation. There are two important points to come out of your letter. Firstly, when people who have gout first start allopurinol there’s a tendency for them to get acute attacks of gout. This happens during the first three months of treatment. Therefore, rheumatologists recommend taking something to help prevent these attacks . Usually that something is an anti-inflammatory drug such as ibuprofen but it could equally be colchicine or even steroids if the other two drugs couldn’t be tolerated. Not giving this prophylaxis is the single most important reason why people don’t persist with allopurinol treatment. And allopurinol is currently the best way of preventing gout attacks.
This answer was provided by Dr Philip Helliwell in 2008, and was correct at the time of publication.
Orange Juice And Gout Risk
Many sugar-sweetened juices can increase your risk for gout, but naturally-sweetened juices like orange juice may also be a gout risk trigger. “In the last 10 years, there has been some evidence from some studies that high fructose in fruit juices may be associated with a higher risk of gout,” says Dr. Freeman. Fructose is a sugar that is added to soft drinks, but it occurs naturally in orange juice, so drinking too much OJ could be as risky as drinking a sugary soft drink.
Beer And Gout Can Beer Cause Gout
Generally speaking, a drink a day is safe for women, while men can easily do with a couple of drinks daily. But then, there are certain situations when alcohol could be a problem. Particular affections such as gout could be influenced by alcohol. This is one of the main reasons wherefore the dietary changes required to keep gout flareups under control tend to contraindicate alcohol.
Now, the thing is there are more types of alcohol out there and each of them is unique. Some types of alcohol have a higher strength and could be harmful, while others are relatively mild you could probably take a few drinks without feeling dizzy. This is when beer kicks in. When diagnosed with gout, lots of people ask themselves are beer and gout connected in one way or another?
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Best & Worst Types Of Alcohol For Gout
A study published in The American Journal of Medicine reported that the consumption of beer or spirits can increase ones risk for gout.7 A 12-year study conducted by Harvard Medical School assessed the potential differences in risk of gout posed by different alcoholic beverages. The researchers found that beer consumption conferred a larger risk than spirits, while wine consumption was not associated with a risk of gout.8
The risk of gout depends on the type of alcohol, the amount of alcohol consumed, and the frequency of consumption. For example, one study determined that the consumption of 2 or more beers per day increases the risk of gout by more than 2.5 times.6
Foods Ok To Eat With Gout
- Purine-rich veggies like beans or lentils, asparagus, cauliflower, spinach, peas or mushrooms
- Cherries, especially fresh cherries not packed in sugary syrup, or fresh cherry juice.Note: Cherry juice is a popular alternative therapy for gout management, but its not clear whether or not drinking cherry juice helps gout. In some research on healthy volunteers, cherry juice mildly lowered urate levels, but it failed to lower urate levels in people with gout. Even strong proponents of cherry juice acknowledge that its effects on urate level are small, so cherry juice does not replace a medication to lower your urate.
- Moderate amounts of coffee
- Vitamin C, preferably in fresh, whole fruits, but ask your doctor if you should take a supplement
Read Also: Side Effects Of Allopurinol And Alcohol
Alcohol And The Untreated Gout Sufferer
Just because you are not taking treatment to lower uric acid, you should still get a uric acid test at least once a year, and know your uric acid number. Forget about meaningless labels like high, normal or low it is the number that is important.
You need this, because the only thing that matters about gout and alcohol is how it affects you. There are hundreds of investigations into links between alcohol consumption and gout, but almost all of them are statistical studies that do little or nothing to explain how alcohol affects gout. They certainly do not, and cannot, explain how alcohol affects your gout.
If you want to test these theories, you should get a first get uric acid test. Then change your amount or type of consumption for 4 weeks, then get another test and compare results. One test is not enough, so you have to keep testing different combinations until a pattern arises.
You should not measure results based on the number of gout flares, as this is no indication of how your gout is progressing.
I have added some clarification about the best way to ask about gout and alcohol. Also, I have summarized the latest advice and best practice in the Gout and Alcohol guidelines.
What Kinds Of Alcohol Cause Gout
Studies have shown that all kinds of alcohol cause gout flares. Doctors used to think that beer and liquor were more likely than wine to cause gout flare-ups, but recent research shows that all alcohol forms can cause gout.
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Does Alcohol Increase The Risk Of Gout
Alcohol is a major source of purines, the chemical compounds that are broken down by the body to produce uric acid. Different types of alcohol vary in the amount of purines they contain, with regular beer having the highest purine content and spirits the lowest.3 Research has shown that drinking alcohol leads to increased uric acid levels in the blood,4 and evidence from several studies have shown that alcohol consumption is a major risk factor for gout.5-6
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What Is The Recommended Diet For Gout Sufferers
There are no foods that can completely prevent the symptoms of gout, but a diet low in purines may help to reduce the frequency of attacks. Following a nutritionally balanced, healthy diet that is low in saturated and trans fats and rich in unprocessed foods can help to reduce the risk of gout attacks. Care needs to be taken with certain vegetables such as asparagus, beans, cauliflower, lentils, mushrooms and spinach as these contain medium levels of purines.
While these dont need to be avoided completely, portion size is important a moderate intake should not increase the risks of gout. All other vegetables should be eaten freely. There is also evidence to suggest that a high consumption of low-fat dairy products , limiting sugary drinks and having a daily vitamin C supplement of 500mg may reduce the risk of gout. Speak to your GP before starting new supplements or altering your diet to manage gout.
It is important to note that it is the quantity of purine-rich food consumed that is more important than the purine content in each food. However, if a patient is keen to measure quantities of food, a maximum total daily purine intake of around 200mg is recommended.
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Ascertainment Of Risk Factors
Subjects were queried about the frequency and quantity of a set of putative risk factors during the 24-hours prior to that gout attack ., The same questions were also asked over a 24-hour period when they were attack-free at study entry , and at 3, 6, 9, and 12 months of follow-up.
Standardized questions regarding alcohol intake included the number of servings of wine, beer , or liquor consumed during the prior 24-hour period for control and hazard periods. Explanation and pictorial depiction of standard serving sizes were provided with color images. Information on potential confounders, such as diuretic use, food and beverage intake from which purine consumption could be calculated, and gout-related medication were also collected during the control and hazard periods.
Which Other Lifestyle Factors Can Affect Gout
While there are no controlled studies or evidence on the effect of lifestyle changes on the incidence of gout, expert opinion is that positive changes in lifestyle can be beneficial to the management of gout. Being overweight is not recommended for gout suffers and the available evidence indicates that losing weight may helpful. Dietary modifications to achieve a healthy body weight are recommended, however the use of crash, high-protein and low-carbohydrate diets should be avoided. Slow and steady weight loss is ideal and support from a dietitian should be sought to help develop a sustainable and balanced weight loss plan. Rapid weight loss is not recommended as it can increase the amount of uric acid in the body leading to an increased chance of a gout attack.
Regular exercise such as swimming or walking is also recommended as it may help reduce the frequency of gout attacks. In addition, it may have a beneficial effect on associated co-morbidities such as type 2 diabetes, hypertension and insulin resistance.
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The Relationship Between Alcohol & Gout
Gout is a type of arthritis. Gout does not flare up and cause pain all the time but will occur only occasionally, and months or years can pass between attacks. It usually affects one joint at a time, most often the big toe. A gout attack can happen quickly, and its incredibly painful for most people.
The pain of gout leads most people to want to avoid gout in any possible way. One of the best ways to prevent gout starts with diet, especially monitoring alcohol use. Drinking alcohol can cause gout flare-ups.
What Alcohol Is Best To Drink With Gout: What You Should Know
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How Can I Prevent Gout Flares If I Still Drink Alcohol
Drinking any amount of alcohol can lead to gout flares, even if its just a few drinks. The more you drink, the more you increase your risk. The frequency of alcohol intake can also make a difference. More drinks in a short period of time increases your risk more than if they are spread out.
Of course, its best to cut back or completely avoid alcohol whenever possible. If you are worried about your ability to cut back on alcohol, consider looking into some resources that can help, or talk to your healthcare provider.
You can also consider starting medication for gout, like . This can help prevent gout flares by stopping your body from making uric acid.
How To Safely Stop Drinking Alcohol
Although it may sound simple to limit or altogether quit drinking alcohol, it can be difficult for those whove developed a physical dependence on alcohol or those struggling with alcoholism. When a person can one can no longer control their drinking, compulsively abuses alcohol despite its negative ramifications, and/or experiences emotional distress when they are not drinking, they may have an alcohol use disorder .8
Acute alcohol withdrawal can occur when a consistently heavy drinker suddenly stops after a period of time.9 Left unmanaged, users may experience uncomfortable and potentially severe symptoms when attempting to quit.9 Some symptoms may develop as soon as 8 hours after the last time alcohol is consumed.9
Additional withdrawal symptoms, depending on the magnitude of physical dependence, may continue to arise beyond 24 hours, with some potentially severe effects emerging in the range of 2 to 4 days after abstinence.9
Symptoms may include:9,10
- Delirium tremens.
Severe withdrawal symptoms may include cardiac rhythm disturbances, markedly altered mental status, psychomotor agitation, and continuous grand mal seizures.9 A professionally supervised medical detox can help minimize the risk of severe complications and discomfort associated with acute alcohol withdrawal.9
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What Is The Best Alcohol To Drink With Gout
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How Much Alcohol Is Safe To Drink If You Have Gout
People with gout should limit their intake of alcohol, especially in the first six months after starting a uric acid-lowering medication such as allopurinol to manage it, suggests Dr. Fields. Once a person is on allopurinol and hasnt had any gout flares for six months, often they can liberalize their alcohol intake, at least a little, and not get flares, he says. This seems to be because the allopurinol has led to uric acid being pulled out the joints, so that there isnt an overflow situation when the uric acid suddenly rises due to alcohol.
That aforementioned American Journal of Medicine study mentioned above found that when people were on allopurinol, it helped mitigate the effects of their alcohol intake. Taking colchicine, a medicine used to treat gout flares, also helped decrease the effects of alcohol, but to a lesser extent.
If youve been diagnosed with gout and are managing it with medication for the long term, occasional intake of high-purine foods, like red meat and shellfish, and a small amount of alcohol is generally okay, says Dr. Fields. High quantities of any of these have a good chance of setting off gout flares, especially in the untreated patient or the patient early-on in the use of a medication such as allopurinol.
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How Does Drinking Alcohol Affect Gout
Alcoholic drinks tend to be high in purines and consuming more than the recommended amount can increase the risk of a gout attack. It is therefore recommended to limit alcohol intake, avoid binge drinking and avoid all alcohol if you have painful gout or are having a gout attack. Try limiting alcohol to a maximum of 14 units per week for both men and women and 1-2 units per day with a minimum of two alcohol-free days a week. Beer, stout, port and fortified wines tend to be higher in purines and should be restricted. Moderate consumption of wine is not associated with a significant increased risk.
Why Gout Flares Up When You Stop Drinking
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All Alcohol Even Wine Raises Risk Of Gout Flare
By Ronnie Cohen, Reuters Health
5 Min Read
NEW YORK – Bad news for gout sufferers who enjoy drinking the fruit of the vine – new research finds that all types of alcohol, even previously exempt wine, can bring on attacks of the painful condition.
I dont want to sound too dogmatic and say, You must stop drinking, lead author Dr. Tuhina Neogi told Reuters Health. But, the Boston University rheumatologist said, based on this study, I would counsel patients that any type of alcohol may trigger an attack.
Its not just beer or hard liquor that can trigger attacks, but also wine, she said.
Gout is a potentially debilitating form of arthritis that afflicts more than 8 million American adults, and the number is rising, Neogis team writes in The American Journal of Medicine.
The so-called disease of kings causes joints to swell and redden. It most often strikes overweight mens big toes but also claims feet, ankles, knees, hands and wrists. A link between intoxicating beverages and gout has been suspected since ancient times.
A 2004 landmark study of more than 47,000 men found that drinking beer and hard liquor – but not wine – increased the risk of developing gout.
Neither has wine been shown in other studies to bring on attacks in people who already have gout, the way beer and liquor have.
Nonetheless, Neogi said, some of her patients report they cant even sniff wine without having a gout attack.