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Keith Taylor

Hi Steve. It’s great news that you’ve got uric acid down to 3.0

Can I confirm this is 3mg/dL? If so, you are well set to control your gout completely. I can’t say much more, as I don’t know what your uric acid test result history is. I’ll just assume for now that you and your doctor are happy with progress. Let me know if this is not the case, and I can help you with any issues and ensure you get a safe allopurinol treatment plan.

Allopurinol encourages old uric acid crystals to dissolve, as it reduces uric acid levels in your blood. Crystals dissolve faster at lower uric acid levels. This process takes time, and until it is mostly completed, dissolving crystals might trigger a gout flare. This has almost nothing to do with diet.

Today’s gout flares are caused by crystals that formed years ago. Some of that uric acid might be from meat that you ate at that time. Most uric acid comes from meat that is your own human flesh. As your uric acid is low, nothing you eat today will cause new crystals to form. Old crystals dissolving might cause flares – but that is a good thing.

Obviously, it is not good that you are in pain, but the flare is good because it is a sign you are healing. It hurts to get the bullet out, but leaving it in will kill you. The correct approach is a good pain management plan. Your doctor should have arranged this for you. If not, I can advise you on the different components you need. By combining 2 or 3 sensible pain-control meds, we can ensure that any discomfort during this part of your healing process is bearable.

As for diet, just eat a good healthy balance of a wide range of foods. EFSEP!
Eat Food. Sufficient. Especially Plants.

That is:
Food, not highly processed food-like substances. Read the labels, and avoid additives wherever possible.
Sufficient, not over-eating or starvation. Maintaining a healthy body weight is always great for gout. Socially, you’ll be regarded as thin. But medically, you’ll be healthy.
Especially Plants, doesn’t mean becoming a vegetarian, unless you want to be. It means that most of your calorie intake should be from plants. Meat is good as an occasional treat, and as a flavoring. Fish is better if it’s oily, such as tuna, mackerel etc. The only plants you’ve mentioned are tomato (possibly highly processed in a commercial soup?) and a few grains. That is not a healthy diet! Where’s the fruit? Where’s the veg?

To summarize, Steve, we need:
1. Clarification that your allopurinol treatment plan is safe and effective.
2. Pain relief until sufficient uric acid crystals have dissolved.
3. Optional healthy eating plan.

With all that in place, there is one potential diet tweak that might reduce gout flares. Eventually, it won’t matter, but it might be useful until the bulk of old uric acid crystals have dissolved. Remind me to tell you what that diet tweak is.

Steve, I hope all this makes sense to you. If not, please tell me, and I’ll try to clarify. If it helps, on the face of it, you seem to be making excellent progress. Your only downside seems to be that you are linking inevitable gout flares with current diet. There is almost no such link, so best not to beat yourself up if you know you are eating healthy. Just enjoy your gout recovery.

I look forward to hearing more from you soon.