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Gout? Never a dull moment...

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Posted 7/10/2017 8:59 PM (GMT 0)
I'm about 8 weeks past my radiation therapy and have had a painfull big toe for a few weeks now. I assumed it was a small stress fracture caused by my intensified exercises during and after radiation. But since I didn't see an improvement, I went to the dr and he suspects radiation induced gout. Anyone ever heard of that? That was a new one for me. I'm waiting for X-ray results to rule out a fracture. I assume the good news would be that after all the dying cells stopped producing extra purine, the gout attack would be over??? Thoughts?
Posted 7/10/2017 9:23 PM (GMT 0)
I have gout, have had it for decades. Never heard of radiation induced gout. Did you get a test for uric acid? Uric acid, not purine is the cause of gout. Purine rich foods can increase uric acid in your blood. The body can only eliminate so much uric acid per day. Too much turns to crystals and settles in the joints in your feet.

An acute attack can take awhile to resolve on it's own (days, weeks), it's a drop in the blood level of uric acid that has to happen. This will help the body reabsorb the uric acid crystals in the toe. anti-inflammatories can help reduce the swelling and pain. There are a small number of other drugs that can help.

It can be a bit of a diagnostic problem, so you need that X-ray result to know for sure. If it is gout, ice, elevation, and drugs is the plan to get over it - and avoid red meats and highly fatty foods.

Andrew
Posted 7/10/2017 9:36 PM (GMT 0)
My PSA level is still down and that is comforting. However, since I had to have one kidney removed, due to the "Big C" and after getting the last CBC, the Doc has put me on the Rx Allopurinol, 100 mg tablets. Have never experienced ANY symptoms of gout such as big toe problems. Will have another CBC to check out blood and urine in another week. Anxious to seeif I must continue taking these pills.
Posted 7/10/2017 10:03 PM (GMT 0)
I used to have gout attacks.
Don't get them now on a diet low in animal products.

Before my current diet, I got relief from quercetin that limits production uric acid. And celery seed can help elimination of uric acid.
Posted 7/10/2017 10:06 PM (GMT 0)
Thanks for your advise Andrew. However, radiation is a known trigger and you're right it's the uric acid that causes the gout. Dying cells release large quantities of uric acid.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2763408/

I assume that's mechanism behind it, but I'm just guessing.
I was wondering if enyone else has experienced this as a result of RT for prostate cancer and if the acute attack went away by itself, to never return.
Posted 7/10/2017 10:23 PM (GMT 0)
I suffer gout attacks pretty frequently. Have no clue if they have to do with RT (I had them before PCa). I take Uloric 40mg daily, and have been for a dozen years or so. It keeps them under control.
Posted 7/10/2017 11:03 PM (GMT 0)
Had gout in my ankle in 2004. The fever it caused resulted in delay of my double bypass. Had it off and on for years. So whenever I began to feel I had sprained my ankle I would take Indomethacin and it would go away.

Two years ago I had a recurrence. Because I had never had it anywhere but my ankle I did not recognize it as gout. I went to the ER twice and they tested for clots in the legs and then sent me home. I finally had it in both knees at the same time and could not walk on crutches. I had to call an ambulance. When the ER again wanted to release me I said no, not until they found out why my knees were so big and red and why I couldn't walk. They finally admitted me and later that night my knee was aspirated and was diagnosed with gout. Just a few hours after taking the Indomethacin I could walk.

I have never had gout in my big toe, but have had both ankles, both elbows and both knees. Once you recognize it anti inflamatories take quick care of it. Am on daily Allopurinol but still get bouts.
Posted 7/10/2017 11:18 PM (GMT 0)

searchinginla said...
I was wondering if enyone else has experienced this as a result of RT for prostate cancer and if the acute attack went away by itself, to never return.

You're the first I've heard of radiation being the trigger. Rare, but anything is possible. If RT was the trigger, I'd think there is a good possibility that you won't get it again.

But I should warn you that gout does seem to get worse with age, so having it once does put you at risk for having it again. You might want to do some diet modifications to avoid uric acid build up. Personally, I've reduced the amount of meat I eat and eat a lot more veggies. I've also found that strawberries seem really good at keeping things under control. I have a couple everyday with my breakfast.

Well, at least it's a good excuse to buy yummy strawberries all year long.

Andrew
Posted 7/11/2017 12:39 AM (GMT 0)
I had my first gout attack in 2009 after a big red steak and a bottle of red wine. Big toe hurt like heck. Went to my doctor and got the blue and white pills...had gout attcks for several years after and one just before my surgery. Absolutley not related but have not had a gout attack since. Still have several refills available and doctor gave me a prescription for an every day pill which I have a bottle but but have not opened .... for whatever reason...no diet change...touch wood...no gout for over a year. The one thing I did learn was not to take the whole presciption, take for one day after symptoms are gone. Pills are hard on the stomach. Indomethacin....still always have bottle in my travel bag. Greg
Posted 7/11/2017 2:01 AM (GMT 0)
My only knowledge of gout is the grump old man in the wheelchair and sombody always hitting him on the bandaged foot elevated in a leg holster{made up that phrase but it communicates well}...and then him swinging his cane at everyone within strinking distance{another phrase I'll keep from the spellman{not da cardinal...da udder}...the Barrymore from its a wonderfull life comes to mine...they were a kick...the lot of them...
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