I suppose it was inevitable. Years ago, sitting at a Brazilian Steakhouse with friends, I joked that I was busy getting “The Gout” as I shoveled bite after bite of steak into my mouth and washed it down with a mojito and mashed potatoes.

That was before I had a full-blown case of gout. After having had the gout, I can tell you, it’s no joking matter. Although, it is still fun to call it “the gout” instead of just gout. And it seems appropriate, too–gout deserves its own definite article.

The first thing the gout suffer thinks about is probably, “How can I get rid of gout?” The second thing is probably, “How can I make sure I never get gout again?”

In this article, I’m going to detail what I learned about getting gout, what I did to get rid of gout, what I think contributed to my gout, and how I’ve modified my diet to avoid experiencing it again.

The article is the result of research, experience, and PAIN. My attempt here is to provide a framework for making the modifications necessary to eliminate the gout-causing agents in your life.

How You Get Gout

Gout is hereditary. You have a predisposition for it. But you play the vital role to manifest gout in your life—and that means indulgence. So, let’s forget the hereditary part and discuss things that you can actually control.

There are two forms of indulgence which lead to gout. John Tilden describes them well: Rich Man’s Gout (meat and alcohol) or Poor Man’s Gout (pastries and cakes and sugar).

A little honesty and self-awareness will reveal your particular form of gout, unless you’re truly deluded and still in the denial phase. (Some people think they can do no wrong–it is these types which must suffer increasingly painful lessons until they admit, and address, their flaws.)

Most information that I saw about gout left out the role that sugar played. For me, sugar seemed to be everything. After my full-blown gout attack, a sugar over-indulgence sent warning signals to my big toe and persuaded me, gently (thankfully), to quickly reform. In those early cases, I took to fasting for a day after my toe acted up.

Of course, meat and alcohol play their roles, too. For many, the finger can be pointed squarely at those culprits–but don’t discount Poor Man’s Gout. It’s real, and it sucks just as much.

In summary, heredity helps load the gun, but your actions—be they poor man gout or rich man gout actions—pull the trigger.

How Long I Endured the Pain

It took about a month before there was no pain. I would still feel twinges up to about 6 weeks afterwards, and the twinges would be due to transgressions of sugar. The first week was the worst. I had to limp and couldn’t wear my regular shoes. My foot would throb and swell up at night. The weight of sheets on it was sheer agony (I slept with my foot out of the covers). I didn’t take any medication whatsoever, but I did fast for three days eating only cooked apples in the morning, broth during the day, and a very light dinner. John Tilden believes that you need to allow the body to rest from the taxing process of digestion, and in allowing this rest, your body can build back health.

From what I read, the duration of symptoms varied. Some things are out of your control. What you can control is what you’re putting into your mouth and anything that is acid-producing has got to go. The quicker you can do this the faster your body can get rid of the uric acid.

What I Think Contributed to my Gout

In my twenties, I transgressed the laws of health of wellness. I ate poorly, drank too much, and in general had too much meat and not enough vegetables.

For the two years prior to gout, I was exercising too hard. In Ayurvedic medicine, I’m Vata/Pitta, and my Vata nature demands less intense exercise. Some people try to make their body do things it’s really not supposed to. That is why professional athletes typically have shorter life spans—they use their bodies up. I was using too much of my nerve energy and wore myself down. My body type doesn’t like intense exercise.

Then there was the month before the attack. I ate poorly: there was travel with a family reunion (you know how groups of people overeat and indulge in sugar), a big cookie cake at work (which lured me in like I imagine cocaine luring in a coke head), and a marriage celebration. Finally, in that last month, one of the writers at work retired, leaving the full responsibilities of the position on my shoulders. It all added up.

Similarly, if you have gout, you’ll have to look at your life, your past and your recent past, and see what stressors have added up to manifest the gout.

How to Get Rid of Gout and Keep it Away

To get rid of anything, you must first remove the causes. This is obvious, but because so many are looking for shortcuts, it must be stated. There are no shortcuts.

Drinking cherry juice or taking cherry extract will not magically make your gout go away. Taking medication is the coward’s way out. Take the pain like a man. You did it to yourself, feel the pain in its full glory to motivate you to never do what you did to get what you’ve gotten (a nefarious case of the gout). Besides, if you’re taking a medication that treats the symptoms, you’re not addressing the cause. So what are you really accomplishing? You’re neglecting to learn the lesson nature has in store for you.

Here is the approach I followed, based on recommendations primarily from John Tilden.

Acute changes: A three day fast consisting primarily of 2-3 cooked apples in the morning, lots of water, vegetable broth, and a small dinner—no meat.

Long-term changes:

  • Only a max of 1 meat meal per day (ideally meat only every other day – tough in America)
  • Reduction of sugar
  • I wasn’t drinking much at all so no change there
  • Modified percentages of meat vs fruit & veggies as outlined below:
    • Winter – meat 1/2 of diet / vegetables & fruit 1/2 of diet
    • Summer – meat 1/4 of diet / vegetables & fruit 3/4 of diet
  • cherry juice after the attack for a month or so–pretty religious, but then diet, diet, diet
  • I started drinking coffee again*

* An article on the Mayo website discussed how coffee lowered the risk of gout. The article said four cups a day to lower risk by 40%! I do around 2 cups per day and have been symptom free.

A modification of exercise
I realized that I had been exercising quite intensely so I dialed it down a notch. Especially with the endurance stuff that really made my liver work to create energy.

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So, if you’re suffering from gout, I think you’ll find quite a few good recommendations in here. The big thing is diet—you either have Poor Man’s Gout or Rich Man’s Gout. Take away the causative factors (pastries and sugar or meat and alcohol). Pay attention to other factors. I view things like this as warning signs—instruction. It’s spiritual. You’re living your life incorrectly and a warning sign has been given to you. Be grateful for the warning—it’s a chance to improve and be a better version of yourself. It’s also a chance to be more conscious about the choices you are making—all good things.

Finally, don’t judge me or others with gout. That’s another spiritual lesson, not judging. I’ve heard people talk about people who’ve gotten gout with a tone of disdain in their voice—“Rich man’s disease.” Well, as you’ve read, it’s not just rich man’s disease. And yes, the person with gout has transgressed. We all have our lessons to learn in our time that we’re here. Moderation is one of the lessons I need to learn. I tend to go to extremes. What lesson is your gout teaching you?