Chinese Gout
I am a foreigner who’s lived in southern China for over two years. During this time, I developed gout. I don’t know if the Chinese diet, environment, or lifestyle has anything to do with it. I am keeping a record here of all of my gout-related experiences and thoughts. Please comment if you have had similar experience or can offer advice.
June 2006 - At the end of a strenuous Hash House Harrier’s run, I severely sprained my ankle. The night of the injury I had my first gout attack. It was a night of intense pain that had me on the kitchen floor with my foot in the air above my head with packs of frozen meat and vegetables on my ankle. At the time, I didn’t know it was gout
June 2006 - I visited the local CanAm clinic and the US doctor there said he could not confirm the gout due to my injury. He prescribed Diclofenac NSAIDs and said they would treat both the swelling in my ankle and the gout (if that’s what it was).
Apr 2007 - I notice soreness in my thumb and try to remember how I may have sprained it. Soreness persists for two weeks.
May 2007 - Following a late night of moderate drinking (2 beers and 2 martinis) and a small plate of chorizo sausages, I had my second gout attack. I self-medicated with the Chinese version of diclofenac. I visited the doctor again - this time same clinic but doctor is from Jordan. He has me do a blood test. Discovered I had high LDH, Bilirubin (30), and uric acid (600). He prescribed 1 Allopurinol tablet per day to reduce the uric acid.
May 2007 - I remember something that I’ve always wondered about. I experience a strange sensation after drinking the first glass of alcohol - my lymph nodes under my neck are painful for 10-20 minutes. I look this up on the internet and discover a connection with Hodgkin’s Lymphoma - my grandmother currently has this disease. I start to look for connections between gout and Hodkin’s - there are.
June 2007 - I am lifting weights on a regular basis. I assume my high LDH (and maybe Bilirubin) levels are due to this. I completed two more blood tests over the span of three weeks to evaluate the effectiveness of the allopurinol. My uric acid decreased to 430 (still not within acceptable range) but bulirubin levels remained high.
4 July 2007 - Doctor calls to tell me to increase allopurinol to 1.5 tablets per day. Bilirubin still high. LDH now in acceptable range. Also following dinner last night at a Hunan restaurant (after which my wife and I complain of being “very thirsty”), I have significant soreness in my right shoulder the next morning (no weightlifting in the past two days and no previous problems with shoulders). I start to think there may be a connection between my gout and Chinese food. Could it be MSG? Could it be all the spicy food I eat in China? Admittedly, the usual food suspects that increase purine levels in the blood (shellfish, mushrooms, asparagus, etc.) are not common in my Chinese diet.
5 July 2007 - The doctor at CanAm tells me I should “go to another clinic” for another blood test. He says he doesn’t want to waste my time with other liver tests to investigate the high bilirubin. I tell him, the money or time isn’t a worry. He still suggests that the blood test should be confirmed a FOURTH time by a separate clinic. I’m giving up on this guy. Must be some ulterior motive going on. Resolve to review this all with a stateside doctor soon.
7 July 2007 - Shoulder still sore but better. Notice that my thumbs are “stiff”. No other way to describe it - they don’t hurt, just stiff and I feel like I keep wanting to stretch them. Weird. Connection? Bloody stool - this must be from the NSAIDs?
