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Remedy for obesity and chronic gout - Online Doctor Chats

Date : 13-Jan-2012
User rating for this question
Very Good Posted in: Weight & Lifestyle
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2233 Questions
Doctor :   Hi
Doctor :   How can I help you
User :   hi there
Doctor :   yes
User :   i have a "disorder"...i have chronic gout for almost 15 years already...i am 35 years of age a bit overweight at 220lbs
User :   problem is my gout attacks are not triggered anymore by avoidance of hi-purine foods
User :   in fact i have been vegetarian for almost 3 years already but i still get weekly attacks when i do the ff: User :   engage in 1 hour normal walking or 1 hour worth of swimming
User :   i am trying to lose weight but cannot as the attacks are normally brought by exercise
Doctor :   Ok
Doctor :   Occupation: Location: Marital Status: Dependents: Yes/ No.??
User :   i have been dependent with colchicine but as the years go by i need more stronger dosages to keep it off
User :   occupation is xxxxx xxxxx / married/ with my wife as dependent
Doctor :   Is it gout or pseudogout
User :   in fact i want to get off colchicine or alloporinol as it makes me sick
User :   in the gut
User :   whats the diff between psuedogout and gout?
Doctor :   Did the doctor measure the uric acid levels
User :   yes uric acid levels are at 700
Doctor :   Gout has different type of shapes of crystals of uric acid
Doctor :   the pseudogout has diff shpes of calcium pyrophosphate
Doctor :   Seems you have gout
Doctor :   Let me check if you are following these
Doctor :   avoid foods high in purines
User :   yes gout i believe would be what i have
Doctor :   Organ meats,
Doctor :   fish
Doctor :   sweetbreads
Doctor :   no poultry
Doctor :   Avoid alcohol
Doctor :   Drink plenty of fluids
Doctor :   avoid fasting or rapid-weight-loss diets because they can increase uric acid levels in the blood.
Doctor :   avoid low-carbohydrate diets that are high in protein and fat,
Doctor :   are you following them
Doctor :   till now??
User :   yes definitely
Doctor :   and still you dont see any decrease in attacks of pain
Doctor :   is it?
User :   yes...especially if i exert moderate effort like walking or swimming for an hour
Doctor :   Look allopurinol is to be continued for long term, Colchicine is usually given for acute attacks.
User :   i get the attacks every week
Doctor :   limit consumption of sugar-sweetened soft drinks, which have been linked to an increased risk of gout.
User :   ok just to i need to stop taking fruit juices as well or bread and food that have been enriched in flour?
Doctor :   You can eat flour
Doctor :   and the foods from it
User : gluten is ok? or tofu?
Doctor :   You should not take foods with high protein
Doctor :   The correct combinations are always better clarified by a dietician
Doctor :   The know the quantities of proetine carb and fat in each food item
User :   ok...but would there be a disorder that particularly describes my condiiton
Doctor :   Look you have high uric acid levels
Doctor :   It means that
User :   because mine is pretty rare as the attacks are frequent
Doctor :   Uric acid is a waste product formed from the breakdown (metabolism) of substances in food called purines.
Doctor :   high uric acid levels in your blood
Doctor :   causes are
Doctor :   Obesity
Doctor :   Excessive alcohol us
Doctor :   Diets high in purines
Doctor :   medications, including low-dose aspirin, diuretics and some high blood pressure drugs
Doctor :   so Treatment is directed at reducing uric acid levels and may include lifestyle changes
Doctor :   It is purely a Gout attack I believe
User :   hopefully it is
Doctor :   and what is your kidney profile
Doctor :   Do you have any skin changes
Doctor :   crystals depositing under the skin
User :   kidney profile...pretty normal...i did have stones 4 years ago but was expelled by taking skin changes
User :   i urinate frequently and take 2 liters of water per day
Doctor :   are you in constant follow up atleast 6 montlhy'
Doctor :   Did the doctor ask yu to take only 2 litres
Doctor :   of water per day
Doctor :   in fact that is the quantity for normal persons
Doctor :   and you should take half or a litre more
User :   ok then maybe i need to take more
Doctor :   Uric acid is flushed
Doctor :   with urine
Doctor :   During teh attacks what do you do
User :   funny thing about my gout is it occurs in diffrent places...sometimes the knee, toes, legs, calves
Doctor :   unless the uric acid levels are controlld you gt the attcfks
User :   i stay at home and just take colchicine every 6 hours until the gout goes away
Doctor :   so drink more water, less purines i mean protein
Doctor :   more carbohydrates
Doctor :   allopurinol regularly
User :   put doesn't allopurinol precipitate an attack?
Doctor :   Allopurinol is a drug given to decrease the formation of uric acid
User :   ok then
Doctor :   I think you can take VITAMIC C tablets also
User :   would there be sometimes i get sick in the gut
Doctor :   discussing with your doc
User :   with allopurinol
Doctor :   Look Colchincien causes such
Doctor :   you can take the normal Brufen
Doctor :   tablet to control the pain
Doctor :   400 mg
User :   ok
Doctor :   Naproxen can also be used
Doctor :   instead of Colchincien
Doctor :   when you are sick of taking colchcine
Doctor :   but remember these are not to be relied for long term
User :   ok great
Doctor :   Sometimes steroids are also given by doctors to improve teh outcome of acute episodes so plese discuss with your doctoir
Doctor :   However they are reserved for people who cannto take Brufen or Colochincine
Doctor :   Ok
Doctor :   Please confirm yeour details
Doctor :   YYYY@YYYY
Mobile : 0000
Doctor :   I can send you good infor aafter research
Doctor :   about your conditin
Doctor :   Please fill the feedback form
Doctor :   Thanks for consulting Health care magic. Bye for now. Please refer your friends to our service
User :   thanks very much...definitely i will. appreciate it
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