A couple of questions regarding gout. But first let me clarify that I’m referring to someone with the diagnosis confirmed with joint fluid analysis and finding negatively birefringent crystals. I have seen many patients who carry the diagnosis, but have never had a joint aspirated.
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Are there any worries regarding the 1g protein per pound bodyweight recommendation for the patient with gout? Do gout patients get into trouble with a MPS diet?
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If you have a client/patient with gout and who has demonstrated sensitivity to protein intake, would you rather have that patient take a uricosuric medicine and eat the recommended protein, or do what you could to keep him/her off meds? I can envision such a patient balking at the idea of strength training and increasing protein intake.
Hey DBB,
Thanks for the post.
I think that general caution is warranted here, however my experience with clients and consulting with an expert rheumatologist (see below) suggests maybe it’s not as big of an issue…with some nuance, of course.
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Not really- especially if we’re doing 1-2 whey protein shakes per day (a low purine protein source rich in essential amino acids). I think the bigger issue is weight loss in overweight/obese patients with gout and alcohol.
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Yea I think that if this patient can control their gout with diet alone, I’d probably see how they did with whey protein and if well tolerated, just use that to fill in the gaps. If that wasn’t well tolerated, I’d use BCAAs instead. If that wasn’t tolerated, I’d consider using leucine standalone with each meal.
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Yea I think it’s still somewhat “fringe” to recommend strength training and lifestyle changes in order to help gout, o/a, etc.
That said, we are in a really powerful position as trusted professionals to advocate this to our patients and community.
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