Health: Gout, Purine & Uric Acid

I am at that age, where having regular blood test is normal, especially on uric acid and cholesterol (Yes, I'm old lol). On this post, I will write about Gout and Uric Acid only, and will talk about Cholesterol on next post.

After 5 months since my first Gout attack, reading lots and lots of medical journals and health books, doing so many trials and errors, I can safely say, I now have figure out how to maintain it below 5.5 while still consuming enough protein to support my strength training. I've taken note of my daily food for months and measure my uric acid level in weekly basis to check the reaction I get from each food that I eat (everyone has different reaction towards food), and maintained my uric acid below 5.5 since then.

Most labs and doctors actually take 6 as the normal uric acid level for female and 7 for male, but according to some health book that I read, below 5.5 is the best either for male and female. (*1)

PLEASE NOTE

Here, I will share what I have found and been doing, but first, please note that I am NOT a health or medical expert, and my purposes of writing and posting this on my personal blog are;

1. To save and update regularly all of the information about gout and uric acid that I have found and might need to read again furthermore in the future.

2. To share the information that I have that might help other people who seek for them, as how I was seeking for them before.

What I write here are all based on what I read, do, and how my body reacts towards certain food and activities. As I have mentioned before; different body has different reaction towards food and activities, so what works for me might not work for you. You should keep journaling and do the test and trial based on your own body reaction.

I will always try to put at least one source of where I found the information by giving numbers such as: *1 and you could find the source on the appendix list at the very end of the post. I usually consider an information valid when I have found it at least three times on some articles, books, or info that I read elsewhere, but please do your own research and know your own risk, always.

Now, let's talk about Gout and Uric Acid.

WHAT IS GOUT AND URIC ACID

"Gout is an articular disease, meaning it affects the joints. When there is an excess of uric acid and it crystallizes in your joints, it causes chronic episodes of joint inflammation. Gout can cause joint damage, kidney failure, and kidney stones. Also linked to other damage such as gallstones, heart attacks, and strokes.

High uric acid levels are caused by increased levels of purines in the blood. Purines are a side effect created after the breakup of animal protein in the body, especially red meat and offal.

What causes gout to manifest itself? There are two key factors; increased production of uric acid (result of improper dier) and poor evacuation of uric acid (evacuation done 70% by urine and sweat, 30% by feces). Gout is a disease that one cannot get rid of: it is a disease that is with us for life, but we can manage it."

That is a summary that I found best to describe Gout and uric acid roughly. (*2)

The keypoints?

A. Improper and imbalanced diet (Too much food on high purine level)

B. Lack of water consume

C. Lack of activity or exercise (although rough exercise can create trauma and inflamation on the damaged joint and caused the gout to flare up, too).

A. PROPER BALANCE DIET & PURINE LEVEL ON FOOD

When I was in hospital, I was only being given a list of food that I should avoid, eat less, and eat more. But the list kinda doesn't make sense to me, since I should avoid lots of healthy food including beans, green vegetable, and many great source of plant-based protein, because they are high on purine level.

I already know that I should eat less food that contains high purine, but how less is less? To answer that, I need to know two things:

1. How much purine should I consume a day?

2. How much purine on each food that I consume?

From what I read, we are best to consume not more than 400mg of purine/day, or around 6oz (170gr) of animal protein/day (*3). Our body actually produce purine (More on Purine *4), and every kind of food has its' own purine level (List of food and their purine level *5), it's just how to balance it out especially for the animal based protein. (Some research shown that plant based protein doesn't lead to gout flare up, although some of them do raise the level of your uric acid. *6).

So, at first, get to note what food that you wanna take, check the purine level and manage how much qty that you could eat so that you don't eat over the limit. However, as I said in the beginning, different body reacts differently towards food, so always have a trial error test and note how your body reacts towards them.

Of course for a balance diet, not only the protein intake that you should maintain. You need to eat more healthy and wholefood, maintain your macro well, no matter what diet regime that you are following (low carb, high carb, plant based, vegan, vegetarian, keto, paleo, whatever really). And limit, if not eliminate, your sugar intake.

B. WATER INTAKE

We already know that uric acid is evacuated from the body 70% by urine and sweat, so drinking plenty of water is necessary. I drank like 3-4L/ day now. And actually, the more you exercise, the easier it is to drink more water, which also brings us to point C.

C ACTIVITY LEVEL

The higher your activity level, the more water you consume and release, the better the metabolism in your body, and the better toxic removal process in your body, which lead to a much better health. That is obvious. Higher activity level also combat obesity, one of the main character or high uric acid and high cholestrol.

D. SUPPLEMENTS

This is just something that I found while reading about Uric Acid and I give a try; Celery Seed and Probiotic. To me, they help to maintain my uric acid level and help to strengthen my gut, especially after my body was being bombarded by antibiotics while in the hospital before. I do need to grow more good bacteria on my gut, which the probiotic helps. You could get natural probiotic from fermented food actually, such as yoghurt, fermented fruit, kimchi, etc, but due to simplicity, I chose the tablet ones. You could find on (*7) for the article about celery seed and probiotics.

WHAT I DO TO MAINTAIN A LOWER URIC ACID LEVEL

So, what I basucally do to maintain a lower uric acid are:

• Eat less than 400mg purine/day or not more than 160gr protein per day (just keeping it safe by lowering 10gr), I don't really differ animal based or plant based protein, since I've tested eating fish + red meat + chicken + plant based food in a day and my uric acid level was fine as long as the total amount doesn't cross 160gr/day. But yes, I am less strict on the plant based protein. Yes, this means I am on a high-carb diet, and yes I did lose 16kgs on a high-carb diet (no, carb is not bad for you), and I am still losing weight consistently until now on high-carb diet.

• Drink 3-4L water daily

• Exercise daily, 30mins walk at 4.5 speed (around 2km or around 3500 steps) at least. I do swim 2-3 times a week, and strength training 2-3 times a week. Please start slowly on exercise tho, especially if you alrd had flare once on your joint. Start with just walking 3000 steps a day, and listen to your body. I once pushed to walk 6km in 2hrs and appearantly it created trauma on my joint and caused a gout flare like swollen joint, although my uric acid level was normal at that time. So, take it slow and listen to your body always. Give rest day in between workout days.

• I eliminate most form of sugar, except from cooking sauce, sourdough bread or when I eat at a restaurant. But yes, no ice cream, cake etc. (After months doing this, my body actually react pretty harsh when I eat sugary food. I will have a heavy headache the day after.)

• I also eliminate most form of fried food. (I will talk about this more on next post at Cholesterol topic.)

• I take vit C, D, B12, Omegas, Celery Seed, Probiotics in daily basis.

• Sleep 7.5 - 9hrs/day, 10pm is the latest. Sometimes I do find it hard to sleep, or didn't really get enough deep sleep, which is normal. I just do 80%-20% on sleep, like 80% good sleep and 20% lack of sleep is fine. So, as long as I hit my weekly sleep goal, I'm good. Actually, my smart watch helps a lot by monitoring my sleeping pattern.

Well, I guess that's all for now. I will update this from time to time to see what works for me. Hope this helps you to find what works for you, too.

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