4 ms·

This is not entirely true. Gout is caused by excessive levels of uric acid, which is an end-product of purine metabolism. You can get uric acid via two pathoph

by t-0 6y ago

This is not entirely true. Gout is caused by excessive levels of uric acid, which is an end-product of purine metabolism. You can get uric acid via two pathophysiologic mechanisms: under-excretion of uric acid, or over-production. Under-excretion is by far and away the most common cause of gout (think ~90% of cases). Causes for this include things like chronic kidney disease or an inborne/hereditary problem (like you mentioned), but can also be caused by extrinsic factors such as some medications (common ones include cyclosporine, most diuretics, a few of the TB drugs) as well as more general problems (alcohol decreases UA excretion by itself, dehydration can contribute) Over-production is a whole other kettle of fish. This is most commonly secondary to some problem of increased cell turnover (think leukaemia, lymphoma, haemolytic anaemia etc.), Again alcohol and obesity can contribute. You'll note alcohol was in both groups. Alcohol excess (especailly beer) can lead to gout without any other contributing factor. Excess alcohol + excess red meat is an especially bad combo which can lead to gout without any other contributing health issues. So, gout can certainly be caused by what you eat. It's not the ONLY cause of gout, though.

HighlandSpring 6y ago
Wait a minute, how did red meat make its way into this post?
- ciceryadam 6y ago
  Red meats (beef, venison, bison) in general are higher in purines than white meats and should be eaten only occasionally. https://www.arthritis.org/health-wellness/healthy-living/nutrition/healthy-eating/gout-diet-dos-and-donts https://www.arthritis.org/health-wellness/healthy-living/nut...
- C19is20 6y ago
  Red meat (especially rare-medium) for me is a no. I can feel the low-level gouty effects for days after in my left foot, and I have to back off the beer to compensate.
- Tuna-Fish 6y ago
  Red meats contain a lot of purines, which often metabolize into uric acid. They are on the list of products whose consumption gout sufferers should minimize.
- wil421 6y ago
  From the Mayo Clinic: >Purines are also found in certain foods, such as steak, organ meats and seafood. Other foods also promote higher levels of uric acid, such as alcoholic beverages, especially beer, and drinks sweetened with fruit sugar (fructose).
ben_w 6y ago
> most diuretics Does that include caffeine and phenylalanine?
- bmcahren 6y ago
  Phenylketonurics - this comment contains phenylalanine
ciceryadam 6y ago
>Excess alcohol + excess red meat is an especially bad combo My buddy was a beer drinker and had an almost 100% beef diet, on his bi-yearly checkup they found out that the uric acid levels were too high. He switched to turkey/chicken meat and wine, got rid of the occasional brawn (as in meat jelly), and he is pretty much okay now.
LeCow 6y ago
Gout cannot be caused by your diet. You can temporarily increase your uric acid levels by eating purine rich food/drink beer etc. But if your body is excreting it, as it should be - the levels won't remain high enough to build up crystals. It takes years of persistent high levels, it's always caused by your body. But you can reduce attacks by changing diet, loosing weight or taking medication. If your body was functioning properly it wouldn't matter how terrible your diet was.
- darkerside 6y ago
  Bad analogy, but you can run your car without an oil change for a damn long time. The eventual breakdown isn't just an innate action taken by your car.
vagrantJin 6y ago
Not to disagree but can you define nebulous terms like excess and put those in context for us who may not be professionals with underlying knowledge of quantity of what acceptable levels and excess are. Anecdotally, I drink a lot of beer but only twice a week. The rest of the week I may very well be a monk. Not a drop. Does the quantity I consume on weekends count as excess? On what scale or timeline?
- darkerside 6y ago
  Not OP, but his description lines up with my experience. Short answer is, probably imo. Long answer is, every person is different, and if you don't have gout, you may never get it. In my case, I had what I thought was a persistent toe sprain for years and only later realized it was gout. I'm sure alcohol contributed, as did dehydration, poor running form, the keto diet I was on, and sudden weight loss.

by t-0 6y ago

HighlandSpring 6y ago

Wait a minute, how did red meat make its way into this post?

ciceryadam 6y ago
Red meats (beef, venison, bison) in general are higher in purines than white meats and should be eaten only occasionally. https://www.arthritis.org/health-wellness/healthy-living/nutrition/healthy-eating/gout-diet-dos-and-donts https://www.arthritis.org/health-wellness/healthy-living/nut...
C19is20 6y ago
Red meat (especially rare-medium) for me is a no. I can feel the low-level gouty effects for days after in my left foot, and I have to back off the beer to compensate.
Tuna-Fish 6y ago
Red meats contain a lot of purines, which often metabolize into uric acid. They are on the list of products whose consumption gout sufferers should minimize.
wil421 6y ago
From the Mayo Clinic: >Purines are also found in certain foods, such as steak, organ meats and seafood. Other foods also promote higher levels of uric acid, such as alcoholic beverages, especially beer, and drinks sweetened with fruit sugar (fructose).

ben_w 6y ago

> most diuretics Does that include caffeine and phenylalanine?

bmcahren 6y ago
Phenylketonurics - this comment contains phenylalanine

ciceryadam 6y ago

>Excess alcohol + excess red meat is an especially bad combo My buddy was a beer drinker and had an almost 100% beef diet, on his bi-yearly checkup they found out that the uric acid levels were too high. He switched to turkey/chicken meat and wine, got rid of the occasional brawn (as in meat jelly), and he is pretty much okay now.

LeCow 6y ago

Gout cannot be caused by your diet. You can temporarily increase your uric acid levels by eating purine rich food/drink beer etc. But if your body is excreting it, as it should be - the levels won't remain high enough to build up crystals. It takes years of persistent high levels, it's always caused by your body. But you can reduce attacks by changing diet, loosing weight or taking medication. If your body was functioning properly it wouldn't matter how terrible your diet was.

darkerside 6y ago
Bad analogy, but you can run your car without an oil change for a damn long time. The eventual breakdown isn't just an innate action taken by your car.

vagrantJin 6y ago

Not to disagree but can you define nebulous terms like excess and put those in context for us who may not be professionals with underlying knowledge of quantity of what acceptable levels and excess are. Anecdotally, I drink a lot of beer but only twice a week. The rest of the week I may very well be a monk. Not a drop. Does the quantity I consume on weekends count as excess? On what scale or timeline?

darkerside 6y ago
Not OP, but his description lines up with my experience. Short answer is, probably imo. Long answer is, every person is different, and if you don't have gout, you may never get it. In my case, I had what I thought was a persistent toe sprain for years and only later realized it was gout. I'm sure alcohol contributed, as did dehydration, poor running form, the keto diet I was on, and sudden weight loss.