So the good part first. My wife and I went to Toronto last week and had a very good time. I really enjoyed the city and could definitely see her and I moving there one day.
The bad part started a couple weeks before we left When I started having pain in my big toe at the middle joint. Now, I couldn't remember injuring myself but I assumed I must have done something to it. However, the pain just stayed. Walking around Toronto was somewhat painful, especially if something bumped my toe. My wife wondered if it was gout but I didn't think so, mostly because I was embarrassed that it might be.
Anyway, on Wednesday I went to the doctor and he thought it probably was gout so I got the pills to help it out and the sheet with the diet recommending I avoid meat and eat white bread (seriously, it recommends white bread with whole wheat as a 'be careful' food). The pills have sort of started to work but my toe still hurts and I'm trying to avoid the worst offenders in the meat department (beef and seafood). I'm also going to try to avoid meats for breakfast and lunch for a while until things calm down and stop drinking anything alcoholic.
My take on what probably happened is:
- The fasting was probably the trigger. I have been following a low carb diet and eating lots of meat for almost a year now without a problem but within a week of when I started intermittent fasting the gout set in.
- I also don't really watch my alcohol intake. Not that I drink alot but there are evenings I'll have 2-3 glasses of wine or a glass of wine with a couple ounces of scotch. I don't think this was a major factor but it could be.
- Some of the sprinting I've done hasn't helped. Uric acid excretion by the kidney can be slowed down by lactic acid which could be aggravating things.
- I've been trying to go pretty low carb (well less than 50 g a day most of the time less than 40) which means that ketones are most likely present in my body and ketones inhibit uric acid excretion.
- I may have been overindulging somewhat in more processed meats like bacon and sausages. I do eat beef a fair bit but that is a moderate purine food compared to bacon.
- Seeing as it's winter, I suspect my Vitamin D levels are low because I'm not getting much sun exposure.
Now in looking at some research, the affect of seafood in the diet is the greatest but really looks like it only adds about 1.5 mg/dl to the number (meat adds about 1.3 mg/dl). This is somewhat significant. The normal levels are between 2.4 and 6 mg/dl so a 1.5 mg/dl could push one over the edge. However, if one supplements with 500 g of vitamin C (see here in the last paragraph), that affect can be erased.
So what's my low carb strategy to deal with this (you didn't think I was going to run out and eat bread did you?). Well it's this:
- Wait for the pain and swelling to clear up before getting back to an exercise routine.
- Eat far less of the worst meats (bacon and processed meats) in the long term and lessen the quantity of moderately purine rich meats in the near term until things clear up.
- No more intermittent fasting.
- Supplement with 500 mg of Vitamin C per day.
- Supplement with Vitamin D (currently trying 4000 iu dosages but I need to research this further).
- Add berries into my diet to get my carb count in the 50-100 g a day range to cut down on the ketones in my system. I may try to take it to the higher end of that range and see how things go.
- No alcohol until things clear up and then limit to 1-2 glasses of wine a week and 1 scotch a week after that.
So that's the plan. Now for the results of last week...
Because of the trip to Toronto, I decided to do a bit of a reset this week. I didn't keep track of my food intake and had a couple small cheats in Toronto. I did however take my weight with interesting results. My weight went up a pound but my body fat percentage dropped quite a bit. My 2 day average weight was 212.9 and my body fat was 23.9. When I run the numbers, that means a reduction in my fat mass from last week of about 1.2 pounds and an increase in my lean mass of 3 pounds. I suspect the lean mass increase was water. Anyway, interesting results.
Until next week...