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I checked out your gout basics but I still need help. My husband has IgA Nephropathy and started having gout attacks 4 years ago. He takes levothyroxin, diovan, pravastatin and coreg to help the kidney with its functions. He was also taking allopurinol for gout but decided 2-1/2 years ago to stop eating meat/fish proteins and drinking alcohol. He stopped taking allopurinol 2 years ago and hasn't had a gout attack since he stopped eating protein and drinking alcohol. He eats dairy for protein (eggs, cheese) and tofu (about once a month) and will occasionally put whey protein in a smoothie (also about once a month). He doesn't eat beans, legumes, mushrooms or spinach. He eats a lot of veggie omelets, salads, sandwiches, Thai veggie curries, and Chinese stir fries. He's 56 years old, 5'9" and weighs 165. He's lost a lot of muscle mass. I've lost interest in cooking because most of the ingredients I'd like to eat, he can't. Can you help me out?
While many of the ingredients that you mention can lead to gout flares, it does sound if you and your husband have made positive steps to control his attacks.
For most people, cutting down on animal proteins that are higher in purines is the first step. This means cutting back to smaller portions and choosing leaner meats. Likewise, one of the main culprits in gout attacks is alcohol: not drinking is key.
The best approach to addressing your husband's muscle mass loss is to begin to liberalize your husband's protein intake. There is good research now that shows vegetable protein doesn't lead to gout attacks - even those with higher purine content, such as legumes. Making a vegetarian chili with beans or a lentil soup is a great place to start. Substituting black beans for meat in taco recipes is a good example. Other choices are Chick Pea Salad or Hummus.
If these don't cause flare-ups, you can add back in smaller portions - about 3 to 4 ounces - of fish such as salmon, tuna, halibut, catfish, etc.. If these small portions don't cause flare-ups, then you can branch out to shellfish, and later, lean red meats. Having gout does not mean you have to avoid all protein-containing foods. Having smaller portions of purine-containing foods two or three times a week may be something that he can tolerate now that he has been eating healthier.
Thanks for writing,
Timothy S. Harlan, MD, FACP, CCMS