Gout, medication & diving

[FritzCat66]

OK - I was concerned because it's known that dehydration can cause the uric acid to precipitate and trigger an attack, and of course we all know how open-circuit diving tends to dehydrate us in many ways. Then there's all the pressure changes, and I wasn't sure if that might also hasten the precipitation of crystals.

But the news about gout not being triggered hyperbarically makes me more confident that diving itself should not be a factor for gout. You wouldn't happen to have any sources for that info, would you?

As for the other factors you mention: I have not been so unlucky as to experience an attack on a dive vacation, but I can see where the alcohol and purine-rich (and metabolically acidifying) diet would definitely predispose one towards a gout event. I have had less than a half-dozen attacks in my lifetime, but they have almost always (make that ALWAYS) occurred during or after the holidays or some other special celebration where normal diet goes out the window for several days.

As for alcohol, I was already in the habit of refraining if a dive is planned within 24 hours due to the extended dehydrating effects of ethanol. But unfortunately since I am predisposed to gout it's also looking like beer and similar brewed beverages are just too risky... oh well, margaritas all around then!

 

[diverdoug1]

NO specific sources, juast a lack sources mentioning this in a medline search, no mention of it in any of my medical library, or hearing of in my practice of hyperbaric medicine.
As far as the margaritas, any ETOH can trigger an attack but tequila is probably less likely than beer to do so. I leave it to you to do your own risk/benefit analysis, but a tasty margarita sure is hard to pass up after a day of diving! Hope this helps.

 

[Scuba_tacoma]

I am researching this because I woke up the morning after a dive with what the doctor calls gout. The doctor took x-rays but did not perform any other test. I did not think diving could have caused the outbreak and did not ask the doctor if maybe the dive may have caused the outbreak.
I am a little confused because I am unlikely candidate for gout since I am 29 years old in good shape and have a descent diet. I have two dive planned for Monday which is 4 days after the outbreak. Both dives have a 63 foot floor and would be done well within time limits. Other than dealing with the pain anything else I should worry about?
I appreciate your thoughts

Thanks
Anthony

 

[driftwood]

One thing that is overlooked is the gout has a big hereditary component. I had my first gout attack (acute) at age 41 and for me they seem to be linked more to dehydration. For one brother in law, it is eating shell fish. On trips, I never leave without my meds and at the first sign of an attack, I knock it back with indomethicin

 

[vickywatts]

Thanks for the info.its a very useful advice.

 

[rigdiver]

Beer is the worst thing for gout. As mentioned purine rich foods can trigger it. Drink lots of water. Stay away from alcohol and red meat. Eat plenty of veggies. Take allopurinol and something else like Moebic(nsaid.) Indocin is tough on the stomach.
Bill as in RN living with gout.

 

[mirasol]

Gout is a form of arthritis that is still somewhat different. Arthritis is more of a constant nuisance, causing pain and uncomfortable feelings at a regularly normal place. Gout is different in the sense that it comes to someone in the form of attacks. A gout attack is random, and causes severe pain and swelling in the person who is dealing with it. Natural gout cures are a way to attempt to help gout attacks, and also prevent those gout attacks.

 

[FritzCat66]

I am a little confused because I am unlikely candidate for gout since I am 29 years old in good shape and have a descent diet.

Hi Anthony - I wanted to directly address this part of your post. While gout is often associated with unhealthy diet and/or obesity, as Driftwood said, there is also a hereditary link.

My first gout attack was in my late 20's while I was a healthy, active mountain biker & hiker. It struck in the "classic" place, my big toe joint, and was utterly crippling for an entire day. Not knowing what it was, I simply ate ibuprofen and was OK the next day, when I saw a doctor and had the gout diagnosed. I don't think allopurinol was available back then (early 90's), but in any case I didn't do anything about it but had no further attacks for over 10 years.

My understanding is that there are two causes for gout, both leading to the same problem of increased uric acid in the blood. In one case, your kidneys simply aren't as efficient at filtering out uric acid, so you end up with more of it in your blood. In the other case, your kidneys work fine, but your digestive system (and liver?) break down proteins you eat in such a way as to produce excess uric acid, so even with your normally-functioning kidneys, again you end up with too much uric acid in the blood. Either way, the excess uric acid ends up crystallizing in your joints and you end up with painful gout attacks.

Of course, diet affects both kinds in that if you reduce the intake of purines (the protein that breaks down into uric acid), you can reduce the uric acid in your blood. A healthy circulatory system tends to keep the crystals from forming even with elevated uric acid. But there also seems to be a genetic tendency for some individuals towards either of the above problems - i.e. overactive uric acid production, or underactive kidney filtering - that you can't do much about, no matter how healthy you are.

So, don't take your gout diagnosis as some sort of indictment about your health. Just start having your blood uric acid level tested regularly and talk to your doc about getting on allopurinol if your blood levels get high (above around 7mg/dL), since apparently allopurinol helps both those causes (overproduction and underfiltering).