I've had it since 2000, and I had to totally give up alcohol. Liver sausage (or Braunschweiger) causes flare ups in my entire family, my dad had what I now figure is gout for years, and I had it for some time until I had some peas at a local restaurant one night, and an attack started nearly immediately. My wife took me to the HMO immediately, and they saw a dark line across my toe joint on my big toe, that, and the swelling, was considered enough of an indicator for a blood test for uric acid, and I was diagnosed and put on allopurinol soon thereafter. Also on BP meds, but genetics had a big hand in all of my situation. Bicycling is good for what ails ya.