My first Gout attack

by Erik Puura
(Tartu, Estonia)

I am a director of the institute in Estonia and have a background (PhD) in chemical engineering, experiencing the first gout attack at the moment. It is the second day I cannot walk because of the left toe joint, the picture is exactly the same as in your website.

My story is that less than two months ago I changed my eating habits (considerably decreasing eating in the evenings) and started to exercise almost every day. I made a graph of weight loss and during 40 days, lost 10 kg. This was meant also as a practical solution to the hypertension problems. With excellent first results and feeling much better, I started to allow a social event once a week in the evenings with some drinking and eating, of course. A week ago we had a party where I drank approximately 4 litres of beer during the evening and ate smoked chicken with skin and fish. On the next day I realised that I have to lose what I had gained and made two long exercises losing approximately 1500 kcal during two and a half hours. Wanting to see a nice dot on a weight loss graph, I did not drink water enough. And this combination altogether seemed to be a reason for the gout attack. The drinks and the food increased purines and produced uric acid, the exercise removed water and as I was not drinking water, the concentration of uric acid in the blood became too high.

My problem was that I did not know anything about Gout previously. But as a chemical engineer I understand that all this issue can be explained as a combination of genetic background and crystallisation theory. I must have a genetic peculiarity as do many others - either too much uric acid is produced or too little uric acid removed from the organism. This is a very important thing to understand - human organisms are like different car models, some of them run better on petrol than on diesel, some consume more fuel and even the composition of by-products is different. When we do not know which model we are running, we make wrong decisions with fueling it. So, we should know what is the best fuel for our organism - it is not enough if you look what someone else is doing, like diesel and petrol cars look the same from outside.

The second point is the theory of chemical reactions and crystallisation. If we produce and dissolve too much substance and if we have less solvent, the solution becomes oversaturated and crystallisation occurs. Also, crystallisation rate is a function of temperature - in Gout case, the crystals start to form in places where the temperature is lowest - this explains the toes that swell most often during the first attack. Why it attacks other places during the next times? Well, I think that human body has a fantastic capacity not only for self heeling, but to modify the system against the next attack in the place where the first attack occurred. And the first attack is a warning signal. If you ignore it, you will have more severe consequences... Swelling and pain is so bad, that I cried at night, fortunately painkillers helped, but also the impact of painkiller dose decreases during next intakes. You can use it once-twice, but then will have not so good results and have side effects. The swelling and the pain is how the organism itself is dealing with the problem - at higher temperatures, the crystals dissolve faster and the possible bacteria-viruses are damaged, and the pain signals you that you should not move around, because if you do, your problems will be bigger, you are damaging your joint...

So, you are absolutely right that artificial medication is just a try to cheat the normal functioning of the organism and does not provide longer term solutions, having considerable side effects. Human body is so complex - you can have simple cheats in computer games, but not for human body... Soon there will be a possibility to understand through gene banks what are the main threats to your body - if you wish to know. But related to Gout, the most stupid thing to do is to ignore the first signal, because you know what the problem is and you know that your body needs different type of fuel than many others... I hope that I remember the pain and give up drinking beer + skip the highest purine content marine and animal foods... And as a must to drink much water every day. I am sure that the crystallisation theory is valid in this case.

I am 44 and from one side, it is even good that I know now that I do have this problem - it should have occurred sooner or later. From the other hand, the rule for future: if you really had a drinking-eating event, during the next days, drink lots of water, especially if you exercise and lose much water.