Just as a side note, which makes this a little more difficult, DH has the "John Pinette mentality" when it comes to salad.

Here is a link that might be useful: John pinette on salad

When my friend has gout she avoids anything acidic, but I've never seen her avoid meat. Get you husband on some black cherry juice, it helps get the uric acid out of your system. Get the good stuff at a health food store not what's in grocery stores.

Sorry about your DH's situation.

I am planning to make another veggie dish soon. I will not post it here to avoid distraction. Look for my suggested dish in the next day or so.

Good luck.

dcarch

No suggestion, but here is what the Mayo Clinic calls their gout diet. Basically just a healthy life style. Looks like lean fish and poultry is OK.

Here is a link that might be useful: Mayo Clinic Gout Diet

Agreed on the Cherry juice, actually anything with "dark" fruits is good. Blueberries, cherries, etc Spinach is also very good - maybe blended and put in a meatloaf or pasta sauce?

Two things to avoid now and going forward... Cheddar cheese and beer. Those were two absolute triggers for my DH, he is fine with wine (especially red).

Good luck, I remember that DH was in a lot of discomfort and I hop your DH feels better soon.

Alexa

We're getting cooler weather here & my mind is switching to fall/winter foods. The first thing that popped into my mind was chili made with ground turkey instead of beef. I didn't see anything on the Mayo diet suggesting avoidance of spices and the beans/tomato products would be good for him.

Sure hope your DH feels better soon. Gout is painful.

/tricia

Ya, gout is painful.
I remember watching my father tussle with his gout attacks.

If he has gout and is still complaining about changing his diet I doubt he has had the real, very real, pain of a gout attack.

Let him have a couple of those and he will be out on the lawn looking for something green to eat!

Digestive problems follow meat and potatoes boys in the end, sadly. How I know is my dad is one, he has a paranoid fear of vegetables.

BF says gout runs in his family, but he has only had one attack in his big toe. He avoids pork and red meat. Fine by me. Luckily he likes all veggies. Hubby might do OK with veggie versions of some pork things, I can get fake italian sausage and bratwurst, or there are chicken and turkey versions of those things. We happen to LOVE turkey burgers. I googled a gout diet when I heard about BF's issues, and I guess the word on fish is mixed. Personally, if DH liked fish I would make a lot of that, the fact that it is lowfat and has other good nutrients in it would seem to make it a good idea.

It's a struggle to get meat and potatoes boys to eat anything healthy. If he's visiting me and eating my healthy cooking, dad either goes to the store and stocks up on junk foods he can eat in between meals, or sneaks down to the local pub for fried foods. And he has "green stuff" radar which he will rummage through a whole slice of meatloaf if he suspects there might be an errant fleck of celery in it. So no you can't hide veggies in his food. My dad seems to do well with the starchy veggies though, and they are OK for gout. Maybe load him up on those or mix those in with small portions of meat.

At some point, you might just have to say, "Hubby's problem and if he won't change then I can't make him." That's what I did with my dad. Still breaks my heart to see him up all night with acid reflux and anxious about his bowel problems and fretting over his arteriosclerosis. But nothing will break him of his junk food habit, not even if it kills him.

Thanks for the advice everyone. It's just tough to watch. It hurts him to wear socks! I think for the next few days, I'm going to feed him lots of pasta & potato dishes or like Lpink said, meals with smaller portions of meat. I do appreciate the help.

I have had gout attacks in the past.
And yes, it HURTS! !

I agree with Metaxa,
but I know there is no way you would "let" him get to that point if you can help it.

Avoid asparagus.
(Probably not a problem in your husnand's case)
It is like eating ground glass when it comes to gout.

Cherries (juice, fresh, frozen) can be VERY helpful.
Pineapple even more so.
But it has to be fresh pineapple.
Cooking (as in canned) destroys the Hyaluronic acid that reduces swelling.
Both are good for any type of Arthritis.

Also, many people are very sensitive to potatoes, tomatoes, peppers, and eggplant.
(All members of the Nightshade family)
Eating them can really make any type of arthritis even more painful.

Two supplements that can be very helpful are Devil's Claw and Yucca.
Both are available in capsule form.

And drink LOTS of water!

All the above is written from my own personal experience.
It works for me.

Good luck,
I Sincerely hope your husband gets this under control soon.

Rusty

I highly recommend the "Eating Well" Web site! They have tons of ideas/recipes on how to "healthen up" traditional comfort foods. http://www.eatingwell.com

Did a search under "gout" and came up with ideas for including more "red" foods into diet, and more healthy fiber into traditional meals, and healthy superbowl snacks. They have suggestions for just about any type of healthy food, including comfort foods and weeknight meals.

If you like chili, you can make a reasonable likenss using TVP (textured vegitable protein) and has texture of ground beef.

My MIL has suffered with gout for years. The list of dietary restrictions are ridiculous and a real stab in the dark.

Just get him on some good medication.

"Just get him on some good medication."

Is there good medication out there now?
And I am asking that very seriously!

The last bad attack I had, (20 something years ago),
I had meds prescribed.
The side effects were worse than the gout!

Thankfully I've been able to control it with diet since then.

Rusty

From what I've read, there are several medications you take to treat gout. Here's what the Mayo Clinic has to say

Here is a link that might be useful: Treatment of Gout

I've had both Colchinine and Allopurinol.
They don't do justice in their description of the side effects.

Either/or will make you so sick you think you are going to die,
And scared to death you are not going to.
Trust me, I know.
From experience!

Get your husband to do all within his power to get this under control with diet!

And LOTS of water!

Rusty

Thanks for the heads up Rusty. I've been trying to get him to see a doctor about his gout, but so far it's been a no go. He's usually good about seeing doctors when he's sick to. So I'm a little surprised that he hasn't gone yet.

He's actually doing better today. His last flare up lasted a couple of weeks. This one so far has only been a couple of days.

Allopurinol has made a huge improvement for my friend. No gout attacks AT ALL in the many years he has been taking it.

Booberry, I certainly did not intend that he be discouraged from seeing a doctor.

I just wanted you to be aware of what those particular 2 meds can do.
They are the only two I've had,
so hopefully the others mentioned in that article would be better,
without the drastic side effects.

But they did help with the gout.
Or maybe I just didn't notice it as much due to the meds' effects.
You know, kind of like how putting a tack in your shoe cures a toothache? :>)

Denise, it's good to know that some people can take Allopurinol.
I'm very glad it helps your friend.

Everyone has different reactions to things.
And maybe in the years since I took it, it has been improved, too.

Rusty

Thanks Rusty,

I still think do think its a good idea for him to see a doctor. I just know now to look up the side effects if / when he is prescribed those meds.

Ellen,
Thank you too! For some reason right now I can receive emails but can't send emails! I swear it seems like every day I have a new problem with the computer! No - no viruses found.

DH is having another round of gout. So tonight he's getting chicken, pineapples & green beans. Some of the info out there regarding what you can eat and what you should avoid is contradictory out there. Very confusing. Tuna ok or not? - for example. Anyway thought I'd bring this up again in case anyone else is having problems or anyone else has helpful advices.

I've been pumping him full of pomegranate juice and cherry yogurt (cherry does not seem to be in vogue right now. I couldn't find cherry juice or even dried cherries in places where I could in October!)

It is confusing, and for a while I had the idea that poultry was okay, and made that for my son-in-law who has gout. But apparently there is not a whole lot of difference between poultry and meat as far as purine content, which is what matters. His initial huge attack came after eating a lot of shrimp. The worst thing for him was having to cut out beer (the kind with live yeast in it), because he was very into brewing his own. Then he decided he really had to have either a little meat or a little beer, and chose beer!
He takes cherry capsules. His doctor told him the medicines are really bad for you long term, so he only took drugs for a very short time.
Booberry, has your DH seen a doctor about it? I hope he has, or will.

Here is what I know about gout, as a sufferer who has talked to other sufferers and investigated the drugs available.

Gout is a metabolic disease. Your body either generates too much uric acid (''over-expresser'') or fails to eliminate enough uric acid (''under-excreter''). You have a high level of uric acid in your blood (''serum uric acid'') and uric acid builds up in your joints, in the form of uric acid crystals. The crystals cause pain, inflammation, in severe cases deformity, and over time damage the joint. Severe episodes of pain are called ''flares''. Diet can increase uric acid levels and/or can trigger flares. However, diet is not the underlying cause of the disease, and even major diet modification will not always reduce flares or reduce uric acid levels. I know a man who has completely eliminated alcohol, meat, and gluten from his diet, for many years, and continues to suffer severe gout pain. I repeat that, over time, untreated gout can permanently damage the affected joint.

If you go to the doctor with gout pain, a family doctor will usually order a blood test for serum uric acid (''sUA''), with 6 mg/dl being the normal level and above that an indication of gout.

He may prescribe colchicine, an anti-inflammatory that can cut flares off if taken as they start, or taken prophylactically (as prevention). The effectiveness of colchicine varies by the individual, and it causes side effects (nausea, gastric pain) for some individuals. I am fortunate, colchicine works for me with no side effects. The person I mentioned cannot tolerate it.

The doctor may also prescribe allopurinol, a drug that increases the elimination of uric acid. This drug can actually trigger flares, as the uric acid is released from the joints, so you usually start at a low dose and gradually increase to 300 mg/day or more, and usually take colchicine with the allopurinol. The goal will be to reduce your sUA to below 6mg/dl.

For rapid relief from severe flares, the doctor may give you a steroid injection directly in the affected joint. This is not a long term treatment.

The doctor may also tell you to drink cherry juice, take glucosamine supplements, modify your diet, and lose weight. He may order an x-ray of the joint to assess damage.

Or, he may refer you to a rheumatologist, since gout is often treated by specialists. The rheumatologist's bag of tricks is largely as described above but they are more familiar with the disease.

Gout is a poorly treated disease. About 60-70% of patients under a rheumatologist's care still fail to achieve sUA below 6 mg/dl and/or still have flares. Note you can have flares even with sUA below the ''normal level''.

There are some new drugs in development for gout, Febuxostat (''Uloric'') has been available for about a year; it is essentially a better allopurinol. There is another drug designed to reduce sUA, and another one that is designed to control flares. Both look effective but are likely 1+ years from the market.

Bottom-line, gout is not a disease that should be tolerated for a long time while using home remedies and diet modification. That strategy is often ineffective, and your joint can be permanently damaged. I still have less range of motion in my affected ankle, and am not sure it will fully recover.

Tell your husband to go to the doctor and to get a referral to a rheumatologist if the family doctor does not appear highly familiar with this disease.

Oh, three additions/corrections to the above.

Only about 10% of the purines in the body come from food. Purine breakdown is the source of uric acid. So diet modification can do something, maybe enough for some people, but not that much.

I should have said, allopurinol reduces the generation of uric acid. There is another drug, probenecid, that increases the elimination of uric acid, but it is not used much, I'm guessing it is not that effective or has side effects. I've not used it.

Gout can be severe enough that you become physically inactive, due to the pain of walking. For much of two years, I was on a cane, only able to walk a few blocks. Naturally, you gain a bunch of weight when that happens - and that can lead to all kinds of other health problems.

Not really something to treat at home with cherry juice.

Thanks everyone.

I'm going to forward the thread (again) to the Dh. Hopefully he'll adhere to the advice and get his butt to a doctor.

Becky

BF's gout is mild enough to treat with diet. His worst triggers are beer, pork and coffee. Neither one of us eat beef for a while host of reasons. I seem to recall your husband is a meat and potatoes guy. BF is lucky, he likes all kinds of foods, has few dislikes. We do quite well with subbing turkey or chicken for the heavier meats. I make turkey burgers, use turkey bacon and sausage, etc. But again, we are lucky since many of our meals feature soy products which BF will eat and thankfully I am back to eating again! Also beans, except for kidney beans, which are bad. Lots of whole grains. Honestly I don't think there is any magic food bullet except that one should eat healthy like we all know we should do--lots of fruits and vegetables, whole foods, particularly whole grains, low in saturated fat, etc. And lots of water. That one is a difficult one for me!

Obesity contributes to a lot of illness because a lot of toxins are stored in your body in fat. Hard to say how to help hubby switch to a healthier diet, he has to be self motivated to some extent. I've been trying to get my dad to eat healthy for most of my adult life. He has suffered quite a bit unneccesarily because he refuses to cut out the high fat, salty, refined carb diet he insists on eating. He views vegetables and whole grains as the enemy. He gets up in pain most nights with acid reflux, even with medication, and has heart disease. His siblings all have heart disease too, but have not suffered near as many problems due to their eating right. It is hard to watch someone you love suffer, especially when they could do something about it.

One thing my mom does is put out trays of vegetable sticks, unsalted nuts, whole grain crackers, and dried and washed fresh fruit so when my dad, the chronic snacker, heads for the kitchen, there are healthy foodstuffs waiting. There are other options too, like spreads made with yogurt cheese, string cheeses, humus, etc. I know some people say whole grains bother people, but that may be due to other issues, like mild gluten intolerance. There are some good rice products out there if that is the case. But really, I just think the best thing, (besides going to a doctor) is to encourage hubby to maintain a healthy weight, exercise together, and keep pushing the healthy stuff. The rest he has to do on his own.

But if it is really bad, he needs to see a doctor because there are also kidney implications.

The Johns Hopkins Arthritis Center web page on gout says:
"About 20% of uric acid is derived from purines ingested in food."
That seems a significant amount that can be changed by diet. But definitely a doctor should be consulted.

The Hopkins site is a good source of general information about gout.

Here is a link that might be useful: Gout- Johns Hopkins Arthritis Center

I was looking at some online sources, some claim gout flares can be controlled by NSAIDs (non-steroidal anti-inflammatory drugs). Hmmm. No over the counter NSAID made the slightest difference to my gout flares, or to the gout flares of other sufferers I know. When it feels like someone is twisting a hot icepick in your joint, popping ibuprofen or naproxen doesn't make any difference. Tell your stubborn hubband not to waste his time thinking that two Aleve will work.

The problem is that by the time you have gout symptoms, you've had years or decades of excess uric acid accumulating in your joints. That's why gout is typically a disease of older people (more men than women). So, for many people, even a radical diet modification is going to be limited, in how much difference it can make in a reasonable amount of time.

Also, most foods contain purine - some are higher in purine, some lower, but it is almost impossible to avoid ingesting purines in food. Purines are an inherent part of our cell structure and metabolism.

http://www.dietaryfiberfood.com/purine-food.php

http://www.whfoods.com/genpage.php?tname=george&dbid=51

I do think someone with gout should make a long-term modification of their diet. I think that what we eat, and how much we eat, has major effects on our health - gout being just one aspect. I just wouldn't, myself, count on a ''gout diet'' for short-term relief.

Quite ironically 2 out of the last 3 flare ups Dh has had, he actually had been eating better (since January - few sweets (maybe once a week), more diet sodas (opposed to full calorie), more fish (since lent), less second helpings). Maybe he should go back to beer and pizza?! LOL! I'm hoping this round convinces him to get to a doctor. I did forward him a link to this thread as well as the Mayo clinic's information regarding gout.

Have his doctor take a blood sample at any time during one of those attacks. It is important to take a sample at that time of attack. The doctor will have the uric acid content and I believe the sedimentation rate performed......those test results will then determine with 100% surety whether or not he has gout. In severe gout attacks.....patients may not be able to walk. I've been there before.....had to use crutches.

There is a medication (don't recall the name) that will will dissolve those uric acid crystals from bone joints real fast. In a matter of "hours" all pain will be gone. Should those gout attacks continue, one can usually take allopurinol to PREVENT it from occurring again. This has worked well for me for many years.

It is important to keep in mind.....if you have frequent gout attacks (uric acid crystals forming in joints), you may well be building up kidney stones too. Yours truly passed three kidney stones which were tested to be composed of uric acid. Gout is bad enough...passing a kidney stone is even worst. My gout suffering dad had a large stone (the size of a white bean) that formed at the entrance to his bladder. It had to be removed by going up his penis with a special retrieving tool. Not too many men are up for that kind of surgery......allopurinol can keep that from happening.

Also, allopurinol ONLY PREVENTS gout. It does no good to take allopurinol DURING a gout attack. In fact, if you take allopurinol during an attack, you will make the attack worst. The other medication I mentioned earlier MUST be taken to remove the uric acid crystals. After the crystals (and pain) is gone, then one can go back taking allopurinol to prevent gout. Usually this is enough to teach one not to forget to take a daily allopurinol pill.

Dan
.......gout free and kidney stone free for 25+ years.

I think the medication Dan's referring to may be probenecid. One concern is, indeed, the possibility of encouraging uric acid kidney stones.

For some reason probenecid is not a very popular drug. In fact, the branded drug has been discontinued, leaving only the generic.

Kidney stones are very painful. Think intense pain that you can't get away from, vomiting multiple times/hr, bloody urine. With the potential for very serious complications. I've had one and don't want another.

One other note - serum uric acid doesn't always conclusively prove/disprove gout. I've had gout flares when my sUA was During one flare, I asked my friend, a family doctor, about what sophisticated tests and complex diagnostic procedures he would use for a suspected gout case. He laughed in my face (rather unkind I thought, as he was eating my food and drinking my wine at the time) and said ''if I think you might have gout, I give you a gout drug and see if you respond''. Of course, this also is the guy who told me to dissolve my gallstones in plenty of red wine. Quite the bon vivant. But he did come over and check on me when I had my kidney stone, so I forgive him. (He is an extremely good doctor, I'm sort of making fun of him here.)

I actually travel with a stash of colchicine (in case of gout flares) and oxycodone (in case of kidney/gallstones, or if I'm bored and simply want some nice opiod dreams . . . )

Dh read through this thread early this morning and then got his butt to the doctor's! So thank you everyone. They have him on Colchinine and pain meds for right now. He's to go back in a week or two to get blood work done and figure out a plan of action from there.

Don't be surprised if the blood test does not show anything. It is real IMPORTANT to draw blood while the patient is suffering from an actual gout attack. Been there and done that.......and suffered needlessly when blood was drawn at the wrong time and did not pick up the correct diagnosis in a timely manner.

Dan
Semper Fi-cus

Weird, this thread showed up on page 1 today w/ date 10/19/11 but I don't see any post after April '11. Hmm. Oh well, any update on the DH?

Dh is doing well. He did start on some medication (I don't know which one off hand.) No more flare ups since he started on the meds. He has been more mindful of the things he eats which I also think has helped.

Thanks for asking & thanks for all the advice you gave me.