I am a 39-year-old male, 6 feet tall, weighing 260 pounds. I am a non-smoker and consume alcohol infrequently (about once a month). I am in relatively good cardiovascular shape for my age and engage in regular weightlifting, though I acknowledge I am carrying excess weight.
I experience mild gout flare-ups in my big toe approximately every couple of months, typically lasting about a week. These episodes seem to correlate with periods of weight loss, and the pain can be more intense than past injuries I’ve experienced, such as broken bones and their required surgeries
My understanding of gout remains unclear, as I’ve come across conflicting information on its triggers, including:
• Dietary factors (purines)
• Hydration levels
• Genetic predisposition
I am aiming to reach a target weight of around 220 pounds (at about 12% BF) without relying on medication. However, these gout attacks often hinder my progress. I prefer to lose weight by maintaining my caloric intake while focusing on cardiovascular exercise.
Could anyone provide guidance on effective strategies to prevent or minimize these flare-ups, especially during weight loss?
Have you ever had your serum uric acid levels checked?
Have you ever been treated with urate-lowering therapy such as allopurinol or febuxostat?
Have you ever been treated with anti-inflammatories for these flares, such as colchicine?
I’ve had blood work, taken Allopurional and Colchicine.
I see. The details of medical management here are outside the scope of what we can provide individualized recommendations for via the forum, but if you are having recurrent flares in this context, I would suggest a consultation with your physician for medication dosage adjustments. For example, if your serum uric acid levels remain well above 6 mg/dL despite allopurinol treatment, that would be a situation where I would increase the dosage. You may be a candidate for daily colchicine treatment along the way here, as well.
All of this is in addition to the lifestyle measures you mentioned above, most importantly reducing intake of alcohol and ensuring good hydration. The dietary component (for example, intake of shellfish & meats) is debated, but in general increasing intake of vegetables, fruits, plant protein sources is beneficial regardless.