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Gout and blood type - might there be a relationship? And the gallstone connection.  RSS feed

 
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Anne Miller wrote:I had my 2nd gout attack on 1/9/18.  I feel my attack was brought on by stress and dehydration.  I am still having some minor pain.

From reading here on permies, I feel the long term cause is the high calcium content of our well water.

We are trying to find a water filter that will remove calcium and is reasonably priced, will last and do the volume of water that we need.

I am doing the ACV and cherries.



Anne, we also have high calcium well water. Maybe you've read about this already but I read some where that vitamin K2 is required to properly utilize calcium (as is vitamin D?). K2 is in meats (especially organ meats, egg yolks, some dairy products) or fermented foods.

We fell short on fermented foods for a bit with Paul (my January busy) and he noticed his fingernails were going soft. I'm back on the ferments now!

 
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Thank you for the info on K2.  I had not found that though I understand its use for dental problems.  I recently purchased it so I will be sure to keep taking it.

Due to the gout I am trying to limit meat to 1 or 2 oz.  At the end of the day my foot still has some pain, I don't know if it is from meat or being on my feet all day.  Since I have fermented veggies I will add some of those daily.
 
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howdy,

had my first gout attack last week, horrible pain.

anyways, have been doing lots of research about it.
a few things I keep running into is that gout is common in vegetarians and vegans as well as meat eaters.

so the theory that meat (purines) cause gout seems strange.





    First of all, there’s the problem of vegetables. Even though most vegetables are low in purines, a few (like spinach, for example) have a significant amount. But in the NEJM study linked above and in this one (completely different authors and population), purine-rich vegetables weren’t associated with gout at all.

    Then there’s the fact that only about 1/3 of uric acid in the body comes from dietary purines; the other 2/3 is produced by the body itself. In other words, no matter how many purines you eat or don’t eat, the majority of uric acid is coming from somewhere else anyway.


from https://paleoleap.com/gout-forget-purines-skip-sugar/


most of the research I am doing is on paleo/keto relations to gout as thats the diet I feel best on.


I believe for me years of alcohol, sugar spikes and dehydration lead to gout?

just throwing it out there,
any imput?
 
Jocelyn Campbell
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Tlr:dr:  I would agree that it's not simply how many purines one eats. There's more to it than that.

jordo acorn wrote:howdy,
had my first gout attack last week, horrible pain.


Uff. So sorry to hear that! I haven't had it myself, but watching Paul suffer, it seems excruciating.

jordo acorn wrote:anyways, have been doing lots of research about it.
a few things I keep running into is that gout is common in vegetarians and vegans as well as meat eaters.

so the theory that meat (purines) cause gout seems strange.





    First of all, there’s the problem of vegetables. Even though most vegetables are low in purines, a few (like spinach, for example) have a significant amount. But in the NEJM study linked above and in this one (completely different authors and population), purine-rich vegetables weren’t associated with gout at all.

    Then there’s the fact that only about 1/3 of uric acid in the body comes from dietary purines; the other 2/3 is produced by the body itself. In other words, no matter how many purines you eat or don’t eat, the majority of uric acid is coming from somewhere else anyway.


from https://paleoleap.com/gout-forget-purines-skip-sugar/


most of the research I am doing is on paleo/keto relations to gout as thats the diet I feel best on.


I believe for me years of alcohol, sugar spikes and dehydration lead to gout?

just throwing it out there,
any imput?


Well, you've likely researched more than me, though I think I confirmed somewhere (?) that it's the kidneys that process the uric acid (whether produced by the body or from the diet). It seems likely to me that sugar, alcohol, and dehydration would all be huge stresses to the kidneys (as well as the liver).

Our theory, that seems to be working to keep Paul gout symptom free, is that when he was dumping a LOT of pounds and water weight from the gallstone recovery (which was a pretty "clean" diet otherwise - no grains, low sugar/no refined sugars, no alcohol, high veggies, limited or at times almost no meat or dairy proteins), we didn't realize that his body was being overloaded with uric acid. Then, we had switched his diet to some high purine content foods both meat* and veg (to help with gallstone/gallbladder and liver issues), on top of what we didn't know was the freaky-high purine content chlorella (blue-green algae). So the dumping weight, high purines in food, and the chlorella created a "perfect storm" so to speak, creating a build up of uric acid crystals in his foot.

(*The irony for Paul is that beef and pork are considered major gallstone triggers, and not part of the blood type A diet. So we switched him to occasional chicken and fish. Though the chicken and fish are probably twice as high in purines as beef and pork!)

Now, Paul's weight has stabilized and he is off the chlorella. We've been able to add back in higher purine foods - spinach, green peppers, chicken - and he has stayed symptom-free (both for gallbladder issues and for gout). Paul said the uric acid build-up is a cumulative thing, so we're still keeping purines a bit on the low side to help his system (and kidneys?) normalize even more.

I realize I'm repeating a bit of what both Paul and I have written here, though I'm trying to relate it to your research and theory, too. It's plausible (probable even?) that without the chlorella, Paul never would have had gout issues. For some reason, for his system (years of pie and slight dehydration, too?), that supplement put him over the edge, and the gallbladder recovery/stress made it worse when he was dumping weight too fast.  

 
Anne Miller
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I don't do Paleo, though I have been doing low/no carb since I was in my twenties. 

"Gout is strongly associated with diabetes and metabolic syndrome. This suggests that there may be some kind of blood sugar connection, and there’s evidence that it goes both ways. Insulin resistance contributes to hyperuricemia, and hyperuricemia induces insulin resistance."

For me this may have some bearing as I was diagnosed with low blood sugar and a sluggish thyroid before I started doing low/no carb.

Before this 2018 attack, I have hard pain in both of my thumbs and have been wondering if I am going to lose use of my hands.  This attack lead me to believe the pain is from uric acid.

Over many years I have had a unknown pain in my big toes, now I know why.

It has been hard for me to adjust my diet to lower meat consumption since many times all I ate was meat.  I read somewhere that if you want to eat meat then over compensate with more vegetables. So what I am doing is eating a two cup salad made with 5 different vegetables (1/2 Cup each more or less) and then slowly decreasing my meat intake.  Let say I was eating a 4 oz serving normally so then I went to 3 oz. for a week or two.  Then to 2 oz., then 1 oz.  I am probably now at the one ounce stage.

" Eat more fresh vegetables (and fruits with low fructose levels): higher intake of Vitamin C may help control uric acid levels."

I also read somewhere that if you want to eat high purine vegetables then limit them to no more than a 1/2 C serving 5 times a week.

jordo acorn wrote:   I believe for me years of alcohol, sugar spikes and dehydration lead to gout? 



I agree about the dehydration as I feel the second attack was caused by stress and dehydration.  My 1st attack in Oct 2016, I believe was caused by aspirin.

I hope you are doing better and getting rid of the pain.  Mine lasted for a month before it finally slowed down.  After more than two months, the bump on the side of my foot is still red and shiny but no more pain.

 
Jocelyn Campbell
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Oh gosh, Anne, that sounds really rough! I hope you, too, are feeling better!

The insulin resistance, the non-alcoholic (or alcoholic?) fatty liver, the kidneys, the thyroid, the low blood sugar...and the resulting gallbladder issues and gout...all these things hinge so much on diet and food.

I, too have struggled with low thyroid and low blood sugar for a while now. So, in trying to heal both myself and Paul, I'm now attempting to focus on the mitochondria. Which is admittedly a broad, somewhat gobbledygook term.

Here's a couple easy reference points in my efforts to dial that in a bit (this first one is a repeat, but I think worthy of repeating even more!):


And then, this podcast helped me make further sense of what the mitochondria need and why anti-oxidants in our diet, among other things, don't do what we think they dohttps://wellnessmama.com/podcast/ari-whitten/.

While The Energy Blueprint guy, Ari Whitten, does have quite the stuff for sale at his website, I think that's okay (even smart!) to do and I also think his theories and content have quite a bit of merit. The mitochondria issues are well summarized in this podcast. Stick with his background on all these systems in our bodies at first, because he does tie it all together, and it's not just about fatigue and adrenals, IMHO. Blood sugar is controlled by cortisol which is linked to the adrenals, and since all these other systems are tied to blood sugar issues, too, I think it's relevant even if you're not interested in the "adrenal fatigue" topic.


 
Anne Miller
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Thanks for the links.  I probably should have explained better. 

A few years after being diagnosed with the thyroid/low blood sugar, I felt really bad, like tired all the time.  I went to the Dr. for blood work and he said everything was fine.  I knew I didn't feel right.  While searching a book store for something that might help I found low carb. Since I started eating low carb my thyroid is Ok. I had blood work last year and my thyroid was in the desired range.  When I eat too many carbs I can tell by the way I feel. 

So far, I am mainly eating vegetable and fruit carbs and everything seems OK.

I really want to control the gout with diet.

 
Jocelyn Campbell
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Anne Miller wrote:Thanks for the links.  I probably should have explained better. 

A few years after being diagnosed with the thyroid/low blood sugar, I felt really bad, like tired all the time.  I went to the Dr. for blood work and he said everything was fine.  I knew I didn't feel right.  While searching a book store for something that might help I found low carb. Since I started eating low carb my thyroid is Ok. I had blood work last year and my thyroid was in the desired range.  When I eat too many carbs I can tell by the way I feel. 

So far, I am mainly eating vegetable and fruit carbs and everything seems OK.

I really want to control the gout with diet.


Ah, gotcha! I guess I babbled a bit there.

I'm sure you read Paul's comment here that said:

paul wheaton wrote:

https://www.jstage.jst.go.jp/article/bpb/37/5/37_b13-00967/_html

A few numbers:

rice 26
almonds 31
peanuts 49
dried nori seaweed: 592
eggs 0(zero)
yogurt 5
strawberry 2
Avocado 18
broccoli 70
carrots 2
ginger 2
parsley 289
spinach 172
beef 79-110
chicken 122-154
pork 62-138

So, carrots and eggs are good.  Seaweed is bad.  During a gout attack, probably wise to not eat anything with a score of 20 or higher.  And eat plenty of stuff with a score of 10 or lower.  And, as always, lots and lots of cherries.

And then I spotted this:

chlorella 3183

This is bluegreen algae.  



I was putting spinach and parsley in a LOT of things, and we were eating nori seaweed snacks instead of chips. That was on top of the chlorella AND the chicken and fish to avoid gallbladder issues! All very high purines. Gah! As we might have already written, we cut those out, or significantly lowered them, and we cut out all mushrooms, too, because of potentially high purines.

I recommend making your own "safe" foods list out of the foods that you like to eat.

I like mushrooms, so I'm coming back to this stuff both to reply and to double-check on what might be "safe" for Paul. In the chart Paul linked to, there is a section on mushrooms which says:

Most mushrooms, except for dried shiitake and hiratake, contained 6.9–98.5 mg/100 g purines, so they were classified in the low or very low group. Dried shiitake contained more than 240 mg/100 g purines. It is thought that the amount of purine became larger because purines in mushroom was condensed and the weight became light by drying.


It listed raw shiitakes as having only 20 mg purines, so I thought that sounded low. Last night I made a curried pumpkin soup with shiitakes and Paul was a little nervous. No gout symptoms though - yes!

Then there is this purine chart:  https://www.goutcure.com/purine-food-chart.html

Which lists:
white rice 10
oats 42
tapioca 37
peanuts 42
almonds 13
pecans 13
sunflower seeds 65
yogurt 0
peas 62
apple juice 3
pineapple 8
apple 6
cherry 6
eel 48
pork chop 49
ham 83
chicken 125

I'm still confused on bell peppers - the former (more scientific looking) list showed them on the high end, while the latter (simpler) list showed them the low end. I use them a lot in our cooking, and have probably only reduced that a little since Paul has had his gout, and he's stayed symptom free with them in our diet.

It frustrates me in my cooking that onions and garlic are considered gallstone triggers, but they are VERY low in purines which makes them super safe for gout. I still cook with onions and garlic, though I have reduced what I used to include by about half and Paul seems okay on both fronts.

Is this kind of diet stuff more what might be helpful to discuss, Anne?

 
Anne Miller
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I really like the information at Mayo Clinic:

"High-purine vegetables. Studies have shown that vegetables high in purines do not increase the risk of gout or recurring gout attacks. A healthy diet based on lots of fruits and vegetables can include high-purine vegetables, such as asparagus, spinach, peas, cauliflower or mushrooms. You can also eat beans or lentils, which are moderately high in purines but are also a good source of protein.

Fats. Cut back on saturated fats from red meats, fatty poultry and high-fat dairy products.

Proteins. Limit daily proteins from lean meat, fish and poultry to 4 to 6 ounces (113 to 170 grams). Add protein to your diet with low-fat or fat-free dairy products, such as low-fat yogurt or skim milk, which are associated with reduced uric acid levels.

Organ and glandular meats. Avoid meats such as liver, kidney and sweetbreads, which have high purine levels and contribute to high blood levels of uric acid.

Selected seafood. Avoid the following types of seafood, which are higher in purines than others: anchovies, herring, sardines, mussels, scallops, trout, haddock, mackerel and tuna."

https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/gout-diet/art-20048524

 
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Something new to me that I learned a few months ago was that high complex carbohydrate diets can be malicious to the phalanges....because of fungus.  A diet of consistently eating lots of complex carbs often causes the body to grow fungus internally to help break down/digest the complex carbs.  A main byproduct of the fungus that grows within the body is uric acid.  Fungus prefers refined complex carbs, compared to whole.  So if you have gout and you eat tons of pasta or ...... there could be a link in that regard.

The best way to get rid of uric acid is to detox the body with foods, juices, fasting, and herbs.

Without altering your diet or detoxing you could probably get rid of a lot of health issues by making a small change in your daily habits.  Intermittent fasting.  You fast for 18 hours every day and eat within a 6 hour window.  It will give your body a chance to begin removing waste and heal.  There's lots of info about it out there.  A couple things I tend to do.  I prefer to eat in the evenings, and if you can dry fast during the whole fasting period it will be more effective.  You can do your workouts in a fasted state which will kick up the power of the fast and all the hormones being produced a bit more.

And I think herbs could help as well.  BUT....knowing everything I know now, they would work better if used as a wholistic approach instead of trying to target and treat symptoms.  To get the uric acid out of the body it needs to be excreted via the kidneys.  So you need to get the kidneys filtering which means the adrenals also must be working, then once your kidneys are removing waste, you can begin digging deeper into the body by taking herbs for the lymphatic system, and once the lymph system is pumping out the wastes you can take herbs to increase the function of it all.

It all works much better if your willing to cleanse the body so you can begin fasting and more specifically, dry fasting.  You can think of dry fasting like a dirty sponge being wrung out, over and over until it's clean.  That's in it's simplest form what is going on in your body.  You're wringing out all the detritus making you feel terrible.  Dry fasting will get the kidneys filtering waste better than most all of it.  It's the top of the mountain so to speak to get the body to begin dumping waste.  BUT....you must work up to this level, via diet and juice fasting.  Once you can safely juice fast, then you can experiment with dry fasting.

You can melt gallstones with herbs and foods.  The herb called Chanca Piedra aka Stone Breaker dissolves stones within the body.  Malic acid found in the skins of fruit will dissolve stones within the body.  Grapes and apples are high in malic acid.

 
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My doctor asked me to add mozzarella cheese and real dairy yogurt - but all other dairy (including all other cheese) is on the naughty list.

Weird, but okay. 

Further, wheat is on the naughty list, but rice is on the "okay in small quantities list".  When talking about what makes a small quantity - it sounds like it should never be more than a third of any meal.   Or, it can be half, if it is a tiny meal. 

Once every week or two, jocelyn and i pop into town for errands.  I like the idea of giving her a break from so much cooking.   But the food I can eat is so freaky limited.  And my last gallstone (october 20 - about five months ago) was from eating in town.  So we ended up rotating between three restaurants:  sushi, indian and chipotle (vegan bowl).  We tried to think of any other place that we could possibly go, but we would strike out over and over.  Nearly everything has wheat, corn, potatoes or meats and/or dairy on the naughty list. 

So here is something we tried a few weeks ago ...   I ate just a little and was nervous as hell that i would throw a stone.  We went to a pizza place that had gluten free pizza.  The crust is made with rice.  And pizza has mozzarella cheese.   Selected toppings that worked and ... no problem.  

Last night we tried it again, but I went ahead and had plenty.  No stone. 

The thing that makes it especially powerful:   when i first went to the hospital, the surgeon's office called me that day to set up surgery.   She told me that I had to eat a low fat diet until the gallbladder removed.  She specifically said that if i were to eat pizza then i would have another attack. 

To be fair to her:  I think that her advice does work - sorta.  But with a few changes, one can have pizza!

Also:  YMMV.  It could work for me because of my blood type.  This might not work for others.  

But it was nice to eat pizza again.

 
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@Paul,

Have you considered the "Flush" protocols for stones?
 
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jim dee wrote:Have you considered the "Flush" protocols for stones?



Considered?  Oh yes.   I have given thought to the idea that I am probably packing 20 stones that are far too big to go down that little tube, and what would happen if I did something that would make them all try to go down that tube all at once.  Would I die or would I merely wish that I were dead?

 
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