Water intake.
I find this somewhat akin to the advice concerning
losing weight: 'don't eat so much and exercise more'.
I have always had a poor sense of thirst and most
views now are that by the time the sense of thirst
kicks in, a male is often already dehydrated.
I do find that if I make an effort to buy containers
of water, its easier to track my intake. I also find
that carrying a collapsible cup with me helps since I
am more likely to use a water fountain. Also many
restaurants or lunch counters attempt to always use
very small glasses for water, insisting on a large
glass will help your intake.
QUESTION:
Just how much water do the subscribers
to this list drink on the 'average day'
when they are NOT subject to an attack
of gout?
And how much per day during a gout attack?
--I find this somewhat akin to the advice concerning
losing weight: 'don't eat so much and exercise more'.
I have always had a poor sense of thirst and most
views now are that by the time the sense of thirst
kicks in, a male is often already dehydrated.--
I agree that the two are related, weight loss and drinking water, but
your third severe gout attack can help you remember to drink more
water. I am, like you suggest, not likely to be thirsty till I am
dehydrated and by living that way, I end up holding on to and
probably accumulating uric acid. I can take water three times a day
like medicine and, the way I have started doing it is, when I have a
drink, I take a full glass and then drink another. I cannot say it
has fixed the problem because it is too early but it will reduce my
uric acid level. I am equally certain that it will eliminate the
problem in a large number of gout sufferers.
At least two gallons more than normal and at times that I would not
ordinarily drink.
Well, well, well-at least anecdotal evidence.
There will be other changes to your system too, such as a potential
electrolyte imbalances that could result from drinking a lot of water
all the time. Does anyone, or has anyone, experienced any problems
from drinkng a lot of water over a long period of time?
Walter Sidney Mathews wrote
doctors advice I have not yet gone on to allupuronol. However after my
last attack about a year ago I decided to have a much more discpined
approach to diet and water intake and resigned to go on to alupuronol if
situation didn't improve.
I started drinking about two litres water along with other diet & life
style changes. I found that my my bladder soon adopted to holding larger
quantities of urine between visits to the bathroom. During this period
whilst I have had warning 'tingles', I have been fortunate enough not to
have had a full blown attack. I always carry a litre bottle in my case and
refill it as necessary.
I am not aware of any long term effects but did find a book written by a
medic 'Your bodied many cries for water', very useful and informative on all
aspects of beneficial effects of increasing water intake. Those of you
interested may go to Amazon site ( see link below) and check. I believe
this medical doctor has done considerable research on the subject.
(I have no connection other than having read the book)
Best wishes & good luck
http://www.watercure.com/books1.htm
Sorry to keep pushing on something like a broken record but it is so
simple and so fundamental that I am both embaressed that I didn't
think of it sooner and elated that it finally penetrated through my
thick head.
We are, after all, a bag of water.
We pour water in the top of the bag and through osmosis, water is
removed from the bag.
Inside the bag, (no I am not talking about my wife, she is a nice
looking lady) there are chemicals and we continuously pour more
chemicals into the bag.
The rate of removal of the offending chemical, that is uric acid, is
going to be proportional to two things:
1)The efficiency of the removal process per liter of water passed
2) The total water passed
(Removal Rate UA) x (liters processed)= (Total Uric acid removed)
As the efficiency per liter of the removal process goes down, we can
compensate for it by increasing the amount of water that is
processed. Clearly, this may not work in all cases, particularly in
cases where the rate of removal has fallen to very low levels, but it
will help in all cases and, as has been posted, it is safe, it is low
cost and although it is an inconvenience to have to urinate so often,
I think it's a good trade off.
Proposed plan of action for me...
1. Stay on allopurinol for 1 year
2. Monitor my Urate level in blood three times, I am now at 7.
3. Adopt the afore mentioned hydration practice for the entire year.
4. Add an electrolyte into the increased water intake.
5. If my urate level drops below 3, I will reduce the allopurinol
dose.
Post script-consistently increasing the amount of water your body
processes will have other effects on your system. It will lower your
overall salt level. That should positively affect your blood
pressure. It should relieve stress on your liver, spleen and kidney
because those organs are stressed by the toxicity level of the
chemicals they have to process and, on average, the chemical level
per unit of time should be reduced from simple dilution. Your overall
level of bodily hydration should drop, that is your actual weight
should go down, because your tendancy to retain water is proportional
to your overall salt level which, as I have said, should be reduced.
Possible down side effects are that the overall level of water
soluble vitamins will be reduced and that might throw you into
deficiencies in some areas. Therefore, I think it would be prudent
to take a vitamin suppliment. By the way, I think that is a good
thing to do regardless of whether or not you are going to "pump
water".
Finally we need to look at our overall electrolyte situation. If the
salt level is reduced too much and you are involved in heat sensitive
activity such as working outside on a hot day, or strenuous exercise,
you will probably need to replentish your electrolyte levels with one
of the electrolyte containing drinks. I plan to add Gatoraid, a drink
that has the approximate concentration of salt that sweat has, to
some of my water. If you exercize and sweat often, it would be
dangerous to deprive your body of normal electrolyte levels and
although it will be good for gout, constantly forcing fluids will
deprive you of normal electrolyte levels.
I've had a tendancy to avoid fluid intake.
Once the gout attack was diagnosed and I
started studying abit about the disease,
I tried to increase my water intake markedly.
I've been using gallon containers that have
been chilled overnight in the refrigerator.
I then leave them out in plain sight as a
reminder to me and also as an aid in knowing
at the end of the day about how much I have
consumed.
During the actual attack when mobility was
severely impaired and the pain was disrupting
sleep, I would consume more than the one
gallon per day. After the attack subsided, I
find my intake is highly variable, but I do
believe that I am averaging atleast three
quarts of distilled water per day.
You are correct that the equation is simplistic but it makes the
point I think.
When I was in training I would consume a gallon routinely each
evening while I recovered from the water loss from earlier in the
day. The right balance is clearly what we need to establish and I
think this is something that can be studied exactly and carefully. We
can know with certainty how much uric acid is removed with x amount
of water in 24 hours and then we can measure that same person when
that person consumes 2x that amount of water.
I am equally certain that the electrolyte balance, and water soluble
vitamin issues are going to be critical though if we are to
systematically go on a dramatically increased liquid intake. I'm not
being enterpranureal here but it would be possible to make a simple
salt/vitamin pill, or solution, that we can drink every day to
replentish the extra we lose from the water pumpingand we will be
drastically depleting the uric acid while we do it.