🦶 Gout Assessment & Prevention

You Have 6 Major Gout Risk Factors:

1️⃣ Furosemide (Lasix) - BIGGEST RISK! Diuretics increase uric acid by 25-50%. You've been taking this since May 2025.
2️⃣ Type 2 Diabetes - Increases uric acid by 30%
3️⃣ Obesity (BMI 45-49.9) - Major risk factor for gout
4️⃣ High Blood Pressure - Closely linked to gout
5️⃣ Post-Menopause - Risk increases after menopause (estrogen normally protects against gout)
6️⃣ Bilateral Knee Swelling + Pain - Classic gout symptoms! Gout commonly affects knees.

❓ WHAT IS GOUT?

Simple Explanation:

Gout happens when uric acid builds up in your blood and forms sharp crystals in your joints.

These crystals cause:
• Severe joint pain (feels like broken glass in joint)
• Swelling and redness
• Can't touch or put weight on joint
• Most common in big toe, but also knees, ankles, hands

Your knee pain and swelling could be gout, NOT just arthritis!

🩺 YOU NEED THIS TEST

Ask Doctor For Uric Acid Blood Test

Normal for women: 3.5-7.2 mg/dL
Gout risk: > 6.0 mg/dL
High risk: > 8.0 mg/dL

What to say to doctor:
"I'm taking Lasix, have diabetes, obesity, and high blood pressure. I also have bilateral knee swelling and pain. Can we test my uric acid level to check for gout?"

🚨 SIGNS OF ACUTE GOUT ATTACK

Call Doctor IMMEDIATELY If:

Sudden severe pain in big toe, ankle, or knee (often starts at night)
Joint becomes red, hot, swollen, extremely tender
Can't touch the joint or put weight on it
Pain goes from 0 to 10/10 in a few hours
Fever with joint pain

Acute gout attack needs immediate treatment! Don't wait!

🍽️ LOW-PURINE DIET (If Gout Confirmed)

SAFE FOODS - Eat Freely:

🥦 Vegetables (All)

Spinach, okra, kontomire
Tomatoes, peppers
Carrots, cabbage
Sweet potatoes

🥛 Low-Fat Dairy

Milk (reduces uric acid!)
Yogurt
Low-fat cheese

🌾 Whole Grains

Brown rice
Oatmeal
Whole wheat bread

🍒 Fruits

Cherries (reduces gout!)
Oranges, apples
Papaya, mango
Berries

🥜 Nuts & Beans

Beans, lentils
Peanuts, almonds
Eggs (safe!)

☕ Beverages

Water (12 glasses daily!)
Coffee (protective!)
Low-fat milk
Cherry juice

❌ AVOID COMPLETELY - High Purine:

Food Category	Specific Foods to NEVER Eat
Organ Meats	Liver, kidney, heart, brain, intestines (highest purines!)
Seafood	Sardines, anchovies, mackerel, herring, shellfish (shrimp, crab)
Red Meat	Beef, goat, lamb (limit to 4-6 oz per week if you must eat)
Alcohol	Beer (worst!), liquor, wine - ALL increase uric acid
Sugary Drinks	Soda, fruit juice, sweetened tea (fructose increases uric acid)
Yeast Extracts	Marmite, Vegemite, some stock cubes

⚠️ LIMIT THESE - Medium Purine:

You can eat small amounts:

• Chicken: 4-6 oz, 3-4x per week (skinless, grilled)
• Fish: 4-6 oz, 3-4x per week (salmon, tilapia, catfish - NOT sardines/anchovies)
• Pork: 4-6 oz, 1-2x per week (lean cuts only)

Total meat/fish: No more than 4-6 oz per day

💊 GOUT MEDICATIONS (If Diagnosed)

Two Types of Gout Medicine:

1. PREVENTION (Daily)

Allopurinol 100-300mg
• Take every day to prevent attacks
• Lowers uric acid over time
• May take 3-6 months for full effect
• Safe with your current medications
• Side effects: Rare rash (stop if rash appears)

2. ACUTE ATTACK (During Flare)

Colchicine 0.6mg
• Take at first sign of attack
• Stops attack from getting worse
• Works best if taken within 24 hours
• Side effect: Diarrhea (common but not dangerous)

💧 HYDRATION IS CRITICAL

Drink 12 Glasses of Water Daily!

Why: Water flushes uric acid out through kidneys
Goal: Urine should be light yellow (like lemonade)
If dark yellow: You need MORE water

Best drinks for gout:
✅ Plain water (most important)
✅ Low-fat milk (reduces uric acid)
⚠️ Coffee (LIMIT to 1-2 cups decaf - can raise blood sugar)
❌ Cherry juice (too much sugar for diabetes - use capsules instead)

Worst drinks:
❌ Beer and alcohol (increases uric acid)
❌ Soda and fruit juice (fructose increases uric acid)
❌ Energy drinks (sugar spikes uric acid)

🍒 NATURAL GOUT HELPERS

Foods & Supplements That Help:

🍒 Cherries: 10-12 fresh or frozen cherries daily, OR cherry extract capsules 1000-2000mg. Studies show 35% fewer gout attacks!
⚠️ Cherry Juice - NOT RECOMMENDED: Contains 16-18g sugar (spikes blood sugar with diabetes). Use capsules instead - same benefits, <1g sugar!
☕ Coffee - CAUTION: Can raise blood sugar 8% in diabetics. Limit to 1-2 cups decaf OR skip entirely. Not essential for gout.
🥛 Low-fat dairy: 2 servings daily. Milk proteins help kidneys remove uric acid. SAFE for diabetes!
🍋 Lemon water: Juice of 1 lemon in water daily. Makes urine less acidic. No sugar!
💊 Vitamin C: 500mg daily (ask doctor first). May lower uric acid slightly. Safe for diabetes!

🏃‍♀️ WEIGHT LOSS HELPS GOUT!

Lose Weight = Lower Uric Acid

Every 10 pounds lost = 15-20% reduction in gout attacks!

If you lose 40 pounds over 12 months:
• Uric acid levels drop significantly
• Gout attacks become rare or stop completely
• Less medication needed
• Joints heal faster
• Lasix dose might be reduced (lowers gout risk more!)

Weight loss is THE BEST gout treatment!

📋 QUESTIONS FOR YOUR DOCTOR

Print This - Bring to Appointment

Uric acid test: "Can we test my uric acid level? I'm on Lasix and have multiple risk factors for gout."
Knee pain cause: "Could my knee swelling and pain be gout instead of just arthritis?"
Lasix alternative: "If I follow strict low-salt diet, can we reduce or stop Lasix to lower gout risk?"
Preventive medication: "If my uric acid is high, should I start allopurinol before I have an attack?"
Emergency plan: "What should I do if I have sudden severe joint pain? Do I need colchicine prescription?"
Diet guidance: "Should I see a dietitian for low-purine meal planning?"

📊 EXPECTED RESULTS

If You Follow Low-Purine Diet + Medication:

2-4 weeks: Uric acid starts dropping
3 months: Uric acid normalized, fewer attacks
6 months: No attacks if well-controlled
12 months: May reduce medication, joints feel better

🦶 GOUT RISK ASSESSMENT

🚨 WHY YOU ARE HIGH RISK FOR GOUT