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  1. #1
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    Cycling with gout?

    Hi folks!

    I am a 51 year old guy and have been cycling about 2K a year for the past 4 years.

    A few weeks ago I had an attack of gout in my big toe. It was my first attack and hopefully last!

    I wonder if anyone else here has gout and can share any experience they have had with regards to prevention of further attacks and cycling. I would think exercising and sweating would help eliminate the build up of uric acid which is repsonsible for the painful symptoms, so cycling should be a good thing. But my MD has cautioned me however about letting my feet get cold, and that could seriously hamper my cycling activities, since I have yet to find a way to keep my feet warm from November through March in the Pacific Northwest!

    Ansel

  2. #2
    Get A Life - Get A Bike cheeseflavor's Avatar
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    Quote Originally Posted by Ansel
    Hi folks!

    I am a 51 year old guy and have been cycling about 2K a year for the past 4 years.

    A few weeks ago I had an attack of gout in my big toe. It was my first attack and hopefully last!

    I wonder if anyone else here has gout and can share any experience they have had with regards to prevention of further attacks and cycling. I would think exercising and sweating would help eliminate the build up of uric acid which is repsonsible for the painful symptoms, so cycling should be a good thing. But my MD has cautioned me however about letting my feet get cold, and that could seriously hamper my cycling activities, since I have yet to find a way to keep my feet warm from November through March in the Pacific Northwest!

    Ansel
    Hi Ansel,

    I've had gout for about 10 years now. When I had my first attack, I thought I had sprained my foot and just let it go thinking it would get better. Big mistake. The joint on my big toe, right foot is pretty much destroyed now. That's the bad news. The good news it really doesn't bother me.

    The other good news is that gout attacks are pretty much preventable by diet and medication. Medications to help your body eliminate uric acids are available (allopurinol is one) that you take daily and others are available to help alleviate the symptoms when they strike (colchicine) are very effective. I have at most one or two attacks per year. I can tell this right away, and if I treat them immediately, the symptoms pass in a day.

    So, bottom line is take care of it, take your daily meds (if prescribed), treat the symptoms if and when they pop up and you really shouldn't be aware of it most of the time.

    Take care,

    steve

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    Thanks, Steve, and some further questions...

    Quote Originally Posted by cheeseflavor
    ...gout attacks are pretty much preventable by diet and medication. Medications to help your body eliminate uric acids are available (allopurinol is one) that you take daily and others are available to help alleviate the symptoms when they strike (colchicine) are very effective. I have at most one or two attacks per year. I can tell this right away, and if I treat them immediately, the symptoms pass in a day.

    So, bottom line is take care of it, take your daily meds (if prescribed), treat the symptoms if and when they pop up and you really shouldn't be aware of it most of the time.

    Take care,

    steve
    Thanks Steve. Yikes, what do you mean that your foot is destroyed?

    I have a supply of colchicine on hand in the event of another attack. My MD does not want to prescribe allopurinal unless I have further attacks, and that conservative approach is fine with me. I have a list of foods to avoid eating, though I notice there is not agreement whether some foods actually cause a problem or not (such as asparagus and cauliflower). But sadly it IS clear that lemonade will be replacing beer after those long hot summer rides.

    How strong do you let the symptoms get before you take the colchicine? In the past few weeks since my first acute attack I have felt some achiness on several occasions and was tempted to take the colchcine but then it subsided.

    Have you noticed whether letting your feet get cold while riding aggravates your symptoms?

    THANKS!

    Ansel
    Last edited by Ansel; 03-26-06 at 06:45 PM.

  4. #4
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    Quote Originally Posted by Ansel
    ...I wonder if anyone else here has gout and can share any experience they have had with regards to prevention of further attacks and cycling...
    Hi Ansel.

    I have gout. Diet has made no difference whatsoever in my pattern of acute attacks. My doctor says my gout is genetic. I have taken allopurinol and probenecid at different times. Both have been effective in preventing acute attacks. I find absolutely no issue with having my feet get hot or cold. The "trigger factor" for an attack is the uric acid level in the blood - nothing else. If there isn't enough uric acid to crystalize out in the joints (which is what an acute attack is), then temperature should be a non-issue.

    There is enormous dissent about what effect diet has on gout. My experience is that diet is a non-issue. Others have found that their acute attacks can be prevented by diet alone. The only way to find out is to experiment (unfortunately). There seems to be enough difference in personal metabolisms that different foods affect different people in different ways.

    I take a daily allopurinol pill. It has no side effects that I can detect. I can eat (and drink) anything I want and have had no acute attacks at all since I began taking the pills. Your experience may vary.

    Don't hesitate to consult an expert if you can find one. The "average physician" gives advice all over the spectrum on gout. So far, the only treatment that has worked for me is the "better living through chemistry" approach. Best of luck!

  5. #5
    Get A Life - Get A Bike cheeseflavor's Avatar
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    Quote Originally Posted by Ansel
    Thanks Steve. Yikes, what do you mean that your foot is destroyed?
    No, no... not the entire foot

    The large joint on the big toe is now twice normal size. Doesn't hurt, but I no longer have much movement in the toe.

    Like Far mentioned too, diet doesn't seem to make much difference. I pretty much eat what I want. The doc has me on two doses of allopurinol (one morning and one night), and I really can't see any negative side effects from it after taking it all these years.

    I've gotten attacks in both feet, the ankles, knees, elbow, and it can pretty much happen in any joint. I recognise them now and just immediately treat with colchicine. I haven't been able to pinpoint what triggers them. Cold and dampness doesn't seem to matter.

    Bottom line is it as an easily managable affliction to have.

    Take care,

    Steve

  6. #6
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    I have gout. It is genetic. My brother and father also have it. You have to keep the uric acid level in your blood below 6%. If the level is higher, the uric acid will settle out in crystals in the joints in your lower extremeties and cause pain. Some foods such as organ meats and shellfish have proteins which will trigger this crystallization, but they are not the source of the uric acid. You should have your Doctor test your uric acid level and prescribe medication to bring it into the proper range. When I was first tested, my level was 13%. I was prescribed Allopurinol and took increasing doses with follow-up blood tests until I was stabilized at <6%. Since then, about 8 years ago, I have not had an attack of gout or a single day of pain. Before being treated, I had an acute attack 2 or 3 times a month. I take Allopurinol every day and have to get a blood test every 6 months.

    Even though I don't think cold feet have any thing to do with gout, as an Oregonian, I do know how to keepthem warm in cold, wet conditions. I wear Under ArmourŽ Cold Gear LiteŽ socks. They are knee length wool/olefin/lycra blend. Keeping your calves warm will warm the blood on the way to and from your feet. I wear them with ordinary cycling shoes in temperatures in the forties and my feet don't get cold on rides up to 25-30 miles.

    Dogbait

  7. #7
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    Quote Originally Posted by Ansel
    Hi folks!

    I wonder if anyone else here has gout and can share any experience they have had with regards to prevention of further attacks and cycling.

    I would think exercising and sweating would help eliminate the build up of uric acid which is repsonsible for the painful symptoms, so cycling should be a good thing.

    But my MD has cautioned me however about letting my feet get cold, and that could seriously hamper my cycling activities, since I have yet to find a way to keep my feet warm from November through March in the Pacific Northwest!

    Ansel
    I was diagnosed with gout about 10 years ago, have had several attacks during that time. Abitren/Vioxx were the prescription drugs which I sparingly took during acute attacks. Diet seems to have an effect on me especially meat, beer and red wine. Stress such as straining the foot also triggered a couple of attacks. I found that Advil seems to prevent attacks. Drinking large amounts of water is also recommended. Some say that cherry juice is helpful in prevention.

    Exercise and sweating concentrates the blood and would logically worsen the condition. During an attack it is very difficult to do any physical activity.

    I suppose cold feet reduces circulation, thus may have an effect on the condition, however I never found my attacks associated with cold weather.


    For me gout has been a manageable "disease" knowing what to avoid, to recognize early onset and act in accordance. Don't want to tempt the devil but I haven't had an attack for over 3 years.

  8. #8
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    Wow - thanks everyone for the info.

    I found out that my mother has had gout all her life but has never received any treatment for it - too vain to tell anyone in the family, or even her doctor! I guess I have the genetic tendency.

    My MD tested my uric acid level when I was having my acute attack and it was 7.7%. He said that was "high normal" and probably on the way down. I'll definitely get it checked again at my next physical, if not sooner.

    Dogbait - thanks for explaining the role shellfish and similar foods play. Also for the tip on keeping the feet warm. That makes sense, I solved my cold hand problem by wearing arm warmers under my jersey. Same principle for the feet. I'll loko into those socks, warmer feet will be welcome no matter what!

    Ansel

  9. #9
    Senior Member Deanster04's Avatar
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    Quote Originally Posted by cheeseflavor
    Hi Ansel,

    I've had gout for about 10 years now. When I had my first attack, I thought I had sprained my foot and just let it go thinking it would get better. Big mistake. The joint on my big toe, right foot is pretty much destroyed now. That's the bad news. The good news it really doesn't bother me.

    The other good news is that gout attacks are pretty much preventable by diet and medication. Medications to help your body eliminate uric acids are available (allopurinol is one) that you take daily and others are available to help alleviate the symptoms when they strike (colchicine) are very effective. I have at most one or two attacks per year. I can tell this right away, and if I treat them immediately, the symptoms pass in a day.

    So, bottom line is take care of it, take your daily meds (if prescribed), treat the symptoms if and when they pop up and you really shouldn't be aware of it most of the time.

    Take care,

    steve
    Right Arm! I am 63 and have had life long problems with gout (genetic). Alloupurinol is cheap and the best daily med I can think of. I haven't had a gout attack in 15 years ever since medication. Also, avoid foods high in purines and pyramidines (sp?) like Anchovies, liver, radishes, and celery. There are a lot of other foods to avoid but those are the main ones. Celery is the most difficult because it is used almost universally as a soup stock. Anchovies are the hardest because I love them on pizza.
    Riding dehydrates your body causing an accelerated precipitation of the uric acid into the crystalline form in the cooler parts of your body. Basic chemistry cooler temperature things come out of solution. The ears are a prime example.
    Last edited by Deanster04; 03-28-06 at 11:34 PM.

  10. #10
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    Hi,

    I also have gout. After my second attack my physician prescribed allopurinol. I haven't had an attack since. According to her. If you have more than one attack within a few weeks of each other, you will continue to have attacks. That's why the meds.

    Check this out and talk to your doc if you have any more attacks.

    good luck,

    billho

  11. #11
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    bout with gout

    I'm had gout since I was in my mid-20s and have had it for over a decade now. I'm on allopurinol and seems to have worked for me. I've had minor flares only since I started taking it and most of them usually just feel like some kind of discomfort and not really painful. I just got into long distance cycling and now getting into running. I'm worried about flares after some century or some long distance run but so far the benefits outweigh that risk so I keep on. One recent thing I did to complement all these activities is overhauled my diet. I discovered that veggies/fruits smoothies work wonders for me. Celery is one anti-gout remedy so I always include that in the blender. So far, the blood results confirm that it works. Got most of my levels back to normal. I think the smoothies help the kidney and it now doesn't have to do too much work and so thus better results. No gout flares nor discomfort since I started this exercise/smoothies combo. And plus it gives me an overall excellent feeling with more bounce to my steps and more stamina for climbing those tough hills. More on this on my blog: www.boutwithgout.com

  12. #12
    A might bewildered... Dudelsack's Avatar
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    Quote Originally Posted by cheeseflavor View Post
    The other good news is that gout attacks are pretty much preventable by diet and medication. Medications to help your body eliminate uric acids are available (allopurinol is one) that you take daily and others are available to help alleviate the symptoms when they strike (colchicine) are very effective. I have at most one or two attacks per year. I can tell this right away, and if I treat them immediately, the symptoms pass in a day.
    The doctor prescribed the same meds for me. Instead, I make sure to drink a full glass of cranberry juice everyday and if not available, then three 4200mg cranberry extract gel tabs, or better yet both. Has kept the gout like symptoms (big toe and foot pain) at bay for the last 6 years.

  14. #14
    Senior Member az_cyclist's Avatar
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    I have been taking meds for gout since 1981 when I was 29, allopurinol since about 1990. I have been lucky and it has controlled the gout. Having said that a minor attack has not kept me from cycling, although it would keep me from running or hiking.

  15. #15
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    In addition to the medication and the cranberry juice I drink Cherry juice. I am the only one in my family that has gout. Natural, unsweetened Cherry juice keeps your system washed of the purines that cause those painful crystals.

    I also "feel" that riding helps with circulation. if you get your CV system moving I think it gets the blockage broken up and keeps the joints from swelling as bad. But when you are having a bad outbreak, getting a shoe on is horrible.
    I think its disgusting and terrible how people treat Lance Armstrong, especially after winning 7 Tour de France Titles while on drugs!

    I can't even find my bike when I'm on drugs. -Willie N.

  16. #16
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    I've had a couple of attacks. They seem to happen when the weather turns cool. Never done colchicine, but Indocin (an anti-inflamitory used for other types of non-gouty arthritis) has worked well, but upsets my stomach. Blood uric acid levels have been "high normal" also. If I feel it coming on, I take Ibuprofin (ASK YOUR DOC, of course!) and that helps a lot. Probably best not to trust medical advice you get on a web forum.
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  17. #17
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    +1 on the Allopurinol. I take one tablet every night, 300 mg. Have been taking it for the past 4 years non-stop! my doctor insists that I do and advises me that the benefits far outweigh the risks. So, taking the allopurinol (along with the hypertension medication and that for cholesterol) is a daily ritual.

  18. #18
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    I have been taking allopurinol for 30 years. It seems to work great. I was told that a side affect is that I will never have any kidney stones or gall stones. If this is true, I like those side affects.

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