Wow! Thanks for all that information, William. It’s going to take me a while to go through that list of supplements. I’ll be as quick as I can, but I have to point out I’m on short hours this week, as I have some fatherly duties to perform.
There’s one important thing that I should have mentioned. When we seek gout control through herbal medicine and lifestyle adjustments, a 24-hour urine test is important. That measures uric acid excretion in a day. It tells us if we are an under-excreter or over-producer. It’s not so important for allopurinol or febuxostat users. Those drugs are so effective at limiting uric acid production, they usually help under-excreters as well as over producers. Herbal medicines are less potent, so it helps to know the baseline.
It’s your choice. It isn’t a deal-breaker, but it makes treatment targeting easier.
Whatever you’ve been reading – stop it now!
Purines and proteins are completely different. Also, you should only ever worry about purines when you are certain you do not carry excess weight. My reason for saying that is the purine content of a few pounds of excess human flesh makes any food intake savings unimportant.
Protein is a wonderful natural uricosuric (i.e. it promotes uric acid excretion). However, balance is crucial. We cannot take a bad diet and make it good by adding low-animal-purine protein sources. We need to take a fundamentally healthy diet, and tweak it for better gout control. That means, I need more information.
I need to know your height, weight, and activity levels. Do you exercise regularly? If so, how many hours per week? I also need to understand what you eat. It’s fantastic you avoid chemical additives. I know that it can be tedious keeping a food diary, but analysis of your current diet is vital to me. One option would be to send me photos of your food bills. Whatever is easiest for you. I plan to create a specific sub-forum for this project, so maybe you can just post what you eat there each day.
Whoever wrote “They say pseudogout pain strikes knee first. They say gout pain attacks toe first.” doesn’t understand.
Statistically, pseudogout tends to start in larger joints. Gout tends to start in smaller joints. But, the reasons are not fully understood. We know more about gout. We know that temperature is an important factor. That is a combination of external temperature and blood circulation. Poor circulation in some joints can cause internal temperature to be low. That encourages uric acid crystals to form there first. But, they will spread to every joint.
The only way to distinguish gout and pseudogout is to analyze joint fluid. There are improvements to scanning technologies that will make this easier. But, few gout sufferers have access to DECT. Ultrasound is more accessible, but it relies on people having the right training to distinguish urate crystal patterns from calcium crystal patterns.
Dissolving uric acid crystals
“does this cause symptoms to get worse and for how long”
It’s a personal process that depends on your gout history, and current uric acid levels. In theory, gout attacks caused by lowering uric acid should be less in herbal medicine/lifestyle. I say this because levels during treatment are unlikely to drop as quickly as they would with allopurinol. Just as with gout attacks from high uric acid, it’s a numbers game.
As uric acid crystals dissolve, the immune system coating tends to drop. This reveals partially dissolved crystals. If the coatings of a few hundred uric acid crystals drop, we are unlikely to notice symptoms. If several thousand become exposed, we get a gout attack. That is made more complicated if dissolving uric acid crystals raise blood uric acid levels. New crystals forming might also trigger attacks. Blood test results are critical to understanding this process.
So, it’s impossible to say how long.
I have a very loose guideline that says recovery should take one month for every year you have had gout. There are lots of personal factors that will affect that. But, in your case William, we’re a million miles from that. The truth is, no matter how much we both believe you have gout, you don’t actually have a diagnosis. I’m going to stick my neck out and match your opening:
“I have an uncommon type of gout. Mine started gradually. i think it started 5 or 10 years ago.”
We have started an uncommon approach to gout control. We’ve started gradually. I think I can be confident we’ll resolve the problem within 5 to 10 years.
It should be sooner than 5 years, but my confidence in that depends on our progress. Ask me again in a month or so.
Uric Acid Test Timing
It’s important to be consistent. Choose the most convenient time of day. Always eat at the same time before test time. Most convenient would be to test after you wake, before breakfast. But, do you tend to have regular sleeping/eating patterns? This is just one of many factors why I said you need to be meticulous.
In some respects, it doesn’t matter. That’s because you are best to measure averages. I.e. test every day, but focus on weekly average. The average should ignore any abnormally high, or low, results. The average is the truest picture you will get. It must be below 6mg/dL. In reality, I might accept an occasional 6.1 or 6.2, if the average is below 6.
What you must never do is associate your test result with something you consumed the previous day. If you suspect an association, it needs fastidious, scientific testing.
I have to say, William, you will be my first project for gout control by herbal/lifestyle adjustments, if we are successful. I tried it myself, and could not maintain the discipline. Daily allopurinol is the easy option for someone like me. Also, I trust allopurinol manufactured by controlled labs in my own country. At least, I trust that far more than untested supplements promoted using unreliable pseudoscience from the backstreets of Hyderabad. (Just being honest, so you understand me better).
Other gout forum members have tried natural gout treatment, and given up. You seem very committed, so there is hope. If I’m to help, we need to continue an almost daily conversation. You’ll have to get used to my tendency to analyze everything in great detail. Are you up for it?
Whatever becomes of this, William, thank you for some interesting thoughts and a great discussion. 🙂