As many of you know, I have been having some major problems with my health lately. Since mid September I have dealt with varying degrees of pain, swelling and inflammation that have left me temporarily crippled. It’s a bad situation, but not as rare as I suspected.
About six or seven years ago, I began having problems with my feet. After several years of dealing with pain I discovered I was suffering from Gout (and Gouty Arthritis). Initially diagnosed as a stress fracture, it took many years and many doctor visits to discover this problem because I am not the typical Gout sufferer. I did not have any of the typical habits, behavior or associated health problems typical of most Gout sufferers and blood tests did not show high Uric acid levels. After much research and experimentation, I was able to control my problem through diet. Until recently, I had not had an attack in almost two years.
In September of this year I met with a personal trainer/nutritionist. My goal was to work up a training plan to cut some body fat and build some lean muscle. The trainer provided me with a nutrition plan high in natural, lean animal proteins and filled with raw vegetables while, also, eliminating sugars and dairy. All in all, a very clean, healthy diet.
Within a week I noticed a problem, but didn’t catch the hint right away. After 5 weeks on the diet I was on crutches and in such ridiculous amounts of pain I could not focus, work or sleep. So here’s how it developed…
Towards the beginning of the second week I was experiencing pain in my right foot, making it uncomfortable to walk. The pain was intermittent and would come and go with varying degrees of intensity. The pain was not as acute as I had typically felt during a true Gout attack, but the result was the same: immobility. Sometimes there was swelling and redness associated with the pain, and other times there was no swelling at all. The pain seemed to move throughout the foot as well, often feeling like the source of pain changed from one day to the next.
This lasted for about 3 weeks before it seemed to leave my right foot, tricking me in to thinking it was gone. Within a day or two, it manifested in my left foot with exaggerated intensity and quickly attacked my ankle making it nearly impossible to walk. I struggled to get around for about a week before the Gouty Arthritis attacked my left knee leaving me no choice but to rely on crutches. Every move resulted in huge amounts of pain, even sitting still the pain was, at times, unbearable. My foot, ankle and knee experienced massive swelling and inflammation. By this time, I had realized what the diet had done and was taking strides to change it.
Now, after dealing with getting the pain under control, I can break down what happened. People with a disposition for, or history of, Arthritis (Gout, RA, Gouty Arthritis, Pseudo-Gout, etc.) should limit their consumption of animal proteins. According to a Mayo Clinic web-article outlining a healthy “Gout Diet”,
“Animal proteins are high in purine. Avoid or severely limit high-purine foods, such as organ meats, herring, anchovies and mackerel. Red meat (beef, pork and lamb), fatty fish and seafood (tuna, shrimp, lobster and scallops) are associated with increased risk of gout. Because all meat, poultry and fish contain purines, limit your intake to 4 to 6 ounces (113 to 170 grams) daily.”
My training diet prescribed 12 to 15 ounces of animal protein per day. In addition to this I was consuming two protein shakes per day and a breakfast consisting of a 7 egg-white omelette. The animal based proteins are the biggest problem. Though some people have reported problems with Gout attacks when taking supplemental Protein Shakes, it is usually admitted that the protein shakes are a part of an already high-protein diet. In fact, most Protein Shake supplements these days are dairy based Whey Protein and in a study published by the New England Journal of Medicine,
“We found a strong inverse relation between consumption of dairy products, especially low-fat dairy products, and the incidence of gout. The ingestion of milk proteins (casein and lactalbumin) has been shown to reduce serum uric acid levels in healthy subjects because of the uricosuric effect of these proteins. Conversely, a significant increase in the uric acid level was induced by a dairy-free diet in a four-week randomized clinical trial. Since dairy products are low in purine content, dairy protein may exert its urate-lowering effect without providing the concomitant purine load contained in other protein sources such as meat and seafood. Although other nutrients in dairy products may be responsible for the inverse association, there is currently no relevant biologic or metabolic evidence available.”
The above referenced study points to the second major flaw in my training diet: the elimination of dairy. Dairy products like low-fat milk, cheese, cottage cheese typically have sugar and salt levels we were trying to avoid in the diet plan supplied by the nutritionist. As it turns out, eliminating dairy from my diet may have been the catalyst that enabled the severe problem I developed on this diet. This from a study published by the New England Journal of Medicine, “…consumption of dairy products, especially low-fat dairy products, is associated with a substantially reduced risk of gout.”
It also seems that the overall goal of attempting to reduce my body fat may have played a factor. Over the last 18 months, I have lost nearly 60 pounds. I have been very careful to lose the weight safely and gradually using a combination of exercise and healthy eating. In an article discussing obesity and Gout from the Mayo Clinic, “…avoid fasting and rapid weight loss because these can promote a gout attack.” Though I never had fasted and certainly do not consider my weight loss “rapid”, the fact that I was working to lose weight may have played a role in my issue as well.
Aside from Gout, there are many studies that point to high-protein diets as the culprit for chronic pain issues. There is a condition commonly referred to as Protein Arthritis, which can cause chronic pain and inflammation in the major joints, back and legs. Pain usually comes on during times of rest and can be mitigated through activity. From The Journal of Bone and Joint Surgery,
“There is a definite relation between high protein intake and chronic joint pain; this is not always indicated by high uric acid content in the blood, although it may be. There is a definite form of arthritis due to or associated with incomplete metabolism, poor elimination, or both. This condition is found in the young as well as in the old; in the lean as well as in the fat; in those of active as well as those of sedentary habits.”
The associated paper, written by Paul B. Magnuson, M.D., describes many case studies where a patient’s chronic pain issues where a direct result of a high-protein diet and could be managed and/or eliminated through diet.
So, what do I do now? Well, I am going back to what was working before, following a healthy, clean raw-foods diet with a limited amount of animal protein. I will also reintroduce dairy to my diet and continue to limit over-processed foods with high sodium and sugar content. This from the New England Journal of Medicine,
“A diet designed to prevent gout should derive its protein content from egg whites (instead of whole eggs) and milk products, and should eliminate or substantially reduce consumption of meats and seafood.”
“A higher total intake of animal or vegetable protein was not associated with an increased risk of gout. Actually, our results regarding vegetable-protein intake suggest that protein from vegetable sources may have a protective effect, although its magnitude appeared to be smaller than that provided by dairy protein.”
And from the same article,
“Overall, however, our findings provide prospective evidence that meat consumption and seafood consumption are associated with an increased risk of gout, whereas consumption of dairy products, especially low-fat dairy products, is associated with a substantially reduced risk of gout. In contrast, moderate intake of purine-rich vegetables or protein is not associated with an increased risk of gout.”
If you have experienced seemingly random joint pain, chronic pain, or any other related issues I would love to hear your story.
If I can help any single person rid themselves of pain, or find an answer to a chronic problem that is continually misdiagnosed, I will be very happy about having told my story. Understanding how your body metabolizes proteins and what problems can come from consuming too much protein is important to feeling better and being more active. Mine was a problem that, multiple times, completely wrecked my health. Doctors have a difficult time diagnosing these nutrition related issues because the symptoms are so general and misleading. If you suspect you may have an issue, simply try reducing (or eliminating) your protein consumption for a month and see what happens. What could it hurt?