Run Run Away

Question:

I,m training  for my 1st marathon in Sydney April 30. My problem is I get gout after my long runs on Sundays. It started after my 1st 30 k one a few weeks ago. it goes with antiinflammatories in a few days and-doesn’t stop me training. But it comes again after the next long run -last one 32 k’s. I corrected diet and stay awAy from alcohol red meat etc. My theory is it is caused from the muscle breakdown from the run. Anyone got any advice, treatment , cause etc Is this recognised as a complication of endurance running secondary to muscle breakdown ?. ( rabdomyolosis) . I’m 54 male ,ran 3 1/2 marathons last year- no gout. No great speed –around 2 hours and am aiming for 41/2 hours in this piece of mental abboration that has afflicted me . Namely to marathonise myself. Never trained this hard before and only been running/jogging for 4 years I would welcome advice from the wisdom of the list many Thanks  murray

Response:

(snip) My problem is I get gout after my long runs on Sundays.

Did a doctor tell you it was gout or did you self-diagnose?  This sounds more like inflamation that is typical when the body experiences a new stress, like a "1st 30K." It started after my 1st 30 k one a few weeks ago. it goes (away) with antiinflammatories in a few days and-doesn’t stop me training. (snip) I corrected diet and stay awAy from alcohol red meat etc.

The folklore that claims excessive red meat and alcohol as the cause for gout is mostly incorrect. My theory is it is caused from the muscle breakdown from the run.

Gout is caused by very high serum levels of urate, the ionized form of uric acid that predominates at physiologic pH.  Urate is the "waste" product of the breakdown of purines (adenine and guanine), which along with pyrimidines (cytosine and thymine) form the backbone of DNA. This is probably where the folklore above originated.  Sweat meats, like pancreas and other glands, are very high in DNA, and, were at one time considered extravagant.  Only very rich people who over-indulged seemed to be getting gout.  However, scientists have begun elucidating the mechanisms of gout. Humans have evolved to have a serum level of urate very close to saturation, or the point at which a solid will precipitate from suspension.  Much like sugar crystalizes into a lolipop when a super-saturated solution of water and sugar cools, urate crystals will form in cooler areas of the body, usually one’s big toe or other extreme joint, when the body fails to either salvage urate precursors or excrete urate from the body.  I’m wincing just from thinking about those little crystals impaling soft tissues in joints or deposting in one’s kidneys.  The inflamation associated with gout is the body’s response to the damage done by the urate crystals. When muscle breaks down, small peptides (chains of amino acids) and free amino acids are the by product, not urate.  Therefore, I don’t think your theory is valid. Anyone got any advice, treatment , cause etc

Get a doctor’s opinion.  If you do indeed suffer from gout, he will probably prescribe allopurinol. (snip) I’m 54 male ,ran 3 1/2 marathons last year- no gout. No great speed –around 2 hours and am aiming for 41/2 hours in this piece of mental abboration that has afflicted me . Namely to marathonise myself.

(snip) Best of luck with all your goals. — Patrick

Response:

Actually, I’ve heard/read that exercise is actually GOOD for gout, helps relieve the symptoms & frequency of attacks… Eric – Hide quoted text — Show quoted text – I,m training  for my 1st marathon in Sydney April 30. My problem is I get gout after my long runs on Sundays. It started after my 1st 30 k one a few weeks ago. it goes with antiinflammatories in a few days and-doesn’t stop me training. But it comes again after the next long run -last one 32 k’s. I corrected diet and stay awAy from alcohol red meat etc. My theory is it is caused from the muscle breakdown from the run. Anyone got any advice, treatment , cause etc Is this recognised as a complication of endurance running secondary to muscle breakdown ?. ( rabdomyolosis) . I’m 54 male ,ran 3 1/2 marathons last year- no gout. No great speed –around 2 hours and am aiming for 41/2 hours in this piece of mental abboration that has afflicted me . Namely to marathonise myself. Never trained this hard before and only been running/jogging for 4 years I would welcome advice from the wisdom of the list many Thanks murray

Response:

My theory is it is caused from the muscle breakdown from the run.

I actually find that your theory is possible.  Muscle breakdown releases much proteins, but also DNA and the substrates which lead to uric acid.  Furthermoe, long endurance runs dehydrate, which raises the effective concentration of things in bodily fluids. HOWEVER, THAT’S JUST A THEORY!  First, you’ve got to have known gout.  Second, I’d want someone really really familiar with gout, like a specialist (and I don’t recommend too many specialists), to review your story. Fortunately, whether your concepts are theory or fact, true gout is well treatable.  See your doctor to review the options (Allopurinol, anti-inflammatories, dietary changes, etc). Good luck. — Josh Steinberg MD

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