# Gout & Filtering Beer



## thumbsucker (12/2/18)

I have reached a crossroads, since I have gout, the gout seems to flair up whenever I drink homebrew. I tried fining my beer using gelatine, with no success (the beer drops crystal clear put still there is enough yeast to cause me pain). 

I am told that I can use a 1 micron filter to filter the yeast out of the beer thereby removing the yeast thereby removing the purine. However I fear that dead and decomposing yeast whose cell walls have burst will be small enough to leak through even a 1 micron filter.

I seem to be able to drink Grappa, and some whiskey with no ill effects. I also seem to tolerate small amounts of craft beer, however even half a glass of homebrew will put me in agony for days.

Has anyone had the same gout problem and did filtering solve the problem?

I am considering giving up brewing and sticking to spirits.


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## wide eyed and legless (12/2/18)

I don't know if it was gout but I got severe joint pain in my thumbs when I drank grapefruit juice, had to give up the juice because it interferes with medication, haven't had any pain since, definitely something to do with the acid.


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## nosco (12/2/18)

Gout is caused by a build up of Uric acid according to my Dr so i wouldnt have thought that filtering would help.
Acidic food and drink will cause it to flair up.


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## DrewCarey82 (13/2/18)

Time to give up the drink I'd say.


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## thumbsucker (13/2/18)

DrewCarey82 said:


> Time to give up the drink I'd say.



Yep that is my feeling at least as far as beer is concerned. Strict moderation maybe the order of the day. At least I can drink Grappa.


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## goatchop41 (13/2/18)

nosco said:


> Gout is caused by a build up of Uric acid according to my Dr so i wouldnt have thought that filtering would help.
> Acidic food and drink will cause it to flair up.



Beer, in general, contains high levels of purine. Even more so if it has a lot of suspended yeast.
Purine is broken down in to uric acid by our body, hence why beer appears to exacerbate gout to a greater extent than other alcoholic beverages.
Filtering it would certainly help remove the yeast (and therefore _some_ of the purine in the yeast), but not the residual purine present in the beer.

This increased exacerbation apparently also applies to other foods that are the byproduct of yeast (dead or alive), such as vegemite.


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## nosco (13/2/18)

Dam. I just Googled purines. Some nice foods are high in Purines. My dad used to get bad gout. One food that set it off was tomatoes so I assumed acidic foods caused it.


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## Feldon (13/2/18)

There's a few things going on inside your body that causes gout.

As nosco said above, its caused the build up of uric acid. This is the result of your blood having a high concentration of nitrogen dissolved in it. We ingest quite a bit of nitrogen locked up in foods we eat, particularly proteins such as meat. Problem is, meat has heaps of nitrogen and our bodies don't need very much of it. Normally its not a problem - our bodies process the excess nirtogen into a compound called urea, which is soluble in the the blood, and as the blood flows through the kidneys it is extracted, passed down to the bladder, and expelled as urine.

What happens if you get dehydrated and/or have high blood pressure is some of the nitrogen in the blood instead of forming urea can crystalise out as uric acid. The nasty thing about uric acid crystals is that they are like long needle-like knives that can stab at nerve endings causing severe pain. Unlike urea, uric acid crystals are non-soluble and are hard to get rid of once formed.

What causes the uric acid to form? Well, as said too much nitrogen in the blood (usually from meat but perhaps yeast cells too). Answer: reduce consumption of meat (and yeasty beer?). But that's only dealing with the symptoms.

Think about this: The concentration of nitrogen in your blood will be in equilibrium with your blood pressure - the higher your blood pressure the more nitrogen dissolved in the blood. Blood pressure is at its highest immediately after the blood leaves the heart. Blood pressure is at its lowest at the body's extremities such as the feet and toes. Here the relatively lower blood pressure causes some of the nitrogen to drop out of solution in the form of uric acid crystals. And that's why gout is commonly found in the feet.

The other factor is dehydration. Just as of a drop in blood pressure will cause nitrogen to drop out of solution as uric acid crystals, so too will the increased concentration of nitrogen in the blood by the removal of water. Alcohol is a diuretic - it increases urination. With standard strength beer, for every litre you consume you will urinate 1.2 litres. That extra 200ml is water coming out of your blood stream, concentrating it and causing it to be unable to hold nitrogen in solution, and out it comes as uric acid crystals. (For more on the diuretic effect of alcohol see: http://www.abc.net.au/science/articles/2012/02/28/3441707.htm )

So what to do? First seek proper medical advice. But if it were me I'd drink half a litre of water for every litre of beer I drank. I'd sit with legs up on a foot rest and wriggle my toes every now and then to keep the blood flowing freely down there.In between times I'd go for walks, and perhaps cut down on the steak dinners a bit too.

(Gout was the gentleman's disease of 18th century England. Wars with France meant wine supplies ceased, so port wine (fortified with 16% brandy) was imported from Portugal. The average well-to-do English gent was pretty inactive, ate a lot of beef and mutton, and when he started hitting the port gout took hold of him.)


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## thumbsucker (13/2/18)

Feldon thanks for the post. My blood pressure is excellent its in the lower end of the normal range. Water definitely helps I have bought a 2 litre stainless steel drinking bottle that I now fill with water at least twice a day. This has helped me.

My protein consumption is medium-high in the 150gm range (Mostly from Whey isolate), but this is because I am working out regularly at the gym.

The other thing with gout is obesity & diabetes, I am overweight I used to be 119kg with 40% body fat and I am down to 110kg and 30% body fat (target is 20% body fat @ 100kg body weight) and I have Type 2, which is well controlled in the 4.5 to 6.5 range with diet and exercise.



goatchop41 said:


> Filtering it would certainly help remove the yeast (and therefore _some_ of the purine in the yeast), but not the residual purine present in the beer.



Thanks for that information, my fear is that the residual purine will not be removed by filtering and therefore may not resolve the problem. I honestly think that beer is out. I gave away 40 litres of lager to a mate, but I still have 300 odd litres of sours. I am considering my options.


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## zoigl (13/2/18)

I take progout to overcome the pain (last resort), and when I get gout my Dr, prescribes lengout daily, I have no problems with beer. My purines come form shell fish, AND PRESERVED meats ham, salami. liverwurst, metwurst. I have been pain free for 3 years.


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## Lyrebird_Cycles (13/2/18)

Feldon said:


> There's a few things going on inside your body that causes gout.
> 
> As nosco said above, its caused the build up of uric acid. This is the result of your blood having a high concentration of nitrogen dissolved in it. We ingest quite a bit of nitrogen locked up in foods we eat, particularly proteins such as meat. Problem is, meat has heaps of nitrogen and our bodies don't need very much of it. Normally its not a problem - our bodies process the excess nirtogen into a compound called urea, which is soluble in the the blood, and as the blood flows through the kidneys it is extracted, passed down to the bladder, and expelled as urine.
> 
> ...




That is badly misguided.

As Goatchop said above, gout is caused by the retention of purine breakdown products. In normal function the kidneys excrete the uric acid via the glomeruli but then some of it is reabsorbed. Gout is associated with a dysfunction of these reabsorbtion mechanisms. Uric acid does contain nitrogen as it is a purine metabolite (dihydro purine trione, C5H4N4O3)
but that's not the same thing as saying it is caused by nitrogen.

For a fairly simple overview see: Regulation of uric acid metabolism, Maiuolo et al

Note: I am not a Doctor nor do I play one on TV. My mother has gout and since I am the son with the degree in biochemistry I had to try to explain it to her so I did some research.

For the OP: since gout has to do with a delicate balance in kidney function, anything that disturbs this balance can make it worse. Beer will tend to suppress the pituitary secretion of ADH which is part of the reabsorbtion mechanism mentioned above, so beer will probably make your gout worse. It isn't the yeast, it's the alcohol.


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## Maheel (13/2/18)

@ LbC, so its a bad idea for him to make his own whisky then ?

Its what i might have suggested


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## Feldon (13/2/18)

Gout is _all _about how the body deals with excess nitrogen. Explaining the basic biological fundamentals in plain English is much more useful on a forum such as this than trying to blind everyone with science few will understand.

You are a very poor science communicator LC. Your ego stands between knowledge and understanding, and you do more harm to scientific understanding in the community than good.


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## DrewCarey82 (13/2/18)

thumbsucker said:


> Yep that is my feeling at least as far as beer is concerned. Strict moderation maybe the order of the day. At least I can drink Grappa.



Who knows mate 12 months to let your body detox you'll probably be right.

Hit liver tablets too.


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## Lyrebird_Cycles (14/2/18)

Feldon said:


> Gout is _all _about how the body deals with excess nitrogen. Explaining the basic biological fundamentals in plain English



Ignoring the _ad_ _hominem: _please explain in plain English how a change in hydrostatic pressure of the order of 10% can materially affect the solubility of a solid.


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## Whistlingjack (15/2/18)

Blood pressure increases as the artery narrows and compliance of the vessel decreases.

Therefore, the further from the heart, the higher the pressure.

The Venturi effect applies when there is a partial constriction (calcification, embolus, etc) of the artery leading to lower pressure beyond the constriction

WJ


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## thumbsucker (18/2/18)

I did not drink any alcohol for a week then yesterday I bought a Little Creature Pale Ale and drank it last night. Had no major ill effect or pain overnight - however I can feel mild pain in my heal so I dare not drink anymore.

Drinking lots of water today.

I am certain that my abstinence has proven that my gout is driven by beer consumption.

Grappa & Tsipouro seem to not cause me grief.

However whisky is sadly an irritant.


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## temper (1/3/18)

Go to the doc, get a prescription for allopurinol - problem solved.
You, like I, have a genetic disposition to metabolic arthritis, it's not our fault so why should we be denied the fruits of our labours?


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## krz (1/3/18)

I get gout too. (Feldons post is real good)
Im almost a vegetarian as well )well I like to eat fish when I catch them).
That said, I suffered real badly. I found out that Wheat beers are a particular curse. 150 lashes also.
I haven't had a severe attack since:-
1. Drinking lots of water
2. Celery tablets 1 per day
3. Sour Cheery juice (1 small glass every mooring)

I doit need any medicines.

Good luck


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## phildo (2/3/18)

I have heard that some foods such as rice can aggravate the condition, are there any facts behind that? Fortunately for me I don't suffer from gout. I have friends and family that do and looks to me to be rather uncomfortable. I could take alcohol or leave it but I don't think that I could say the same for beer


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## Leyther (2/3/18)

temper said:


> Go to the doc, get a prescription for allopurinol - problem solved.
> You, like I, have a genetic disposition to metabolic arthritis, it's not our fault so why should we be denied the fruits of our labours?



I agree, I am fit and healthy, I cycle to work daily, I go to the gym 3 times a week, I only drink on weekends and I am not overweight and I eat healthily (no sweetbreads, lots of white meat, fish, etc) however I am prone to Gout attacks. After numerous visits to the Dr he concludes I just have high natural Uric acid (I am usually recording high 40's in the 0-49 normal range). I never wanted to have to take a medication ongoing but last year I finally gave in and I've been taking allopurinol daily since, I have not noticed any side effects and I have not had Gout since.

Go see your Dr and discuss with him.


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## Leyther (2/3/18)

phildo said:


> I have heard that some foods such as rice can aggravate the condition, are there any facts behind that? Fortunately for me I don't suffer from gout. I have friends and family that do and looks to me to be rather uncomfortable. I could take alcohol or leave it but I don't think that I could say the same for beer




There is lots of incorrect information out there on the web about foods and gout, I've never actually heard rice before, meats high in purines (liver, sweetbreads, etc) and shellfish are often cited as the main culprits but you'll also find lots of others some with contradictions, tomatoes being one I've seen quoted as bad and good.

For me I don't think its food related, unfortunately alcohol does seem to bring it on but only if I binge drink which will sometimes happen on something like a weekend away with the lads.


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## RobW (2/3/18)

Good info here


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## thumbsucker (2/3/18)

Okay a few days ago I suffered another gout attack and so I went to the GP. He has put me on indometacin to treat the acute attack and colchicine and allopurinol. The latter two being gout medications one being a fast acting (colchicine) and the other (allopurinol) being a long term maintenance drug. He says that I will to be on allopurinol for the rest of my life.

I do not like taking drugs as I already am on three medication that I will take for the rest of my life.

The reason I finally asked the GP for medication was because, having cut out all purine food sources from my diet, yet I still suffered from weekly gout, so my dietary restriction where to no avail.

I will see now if the medication works. I planing to brew a beer again. But I still plan to filter.


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## Leyther (2/3/18)

thumbsucker said:


> Okay a few days ago I suffered another gout attack and so I went to the GP. He has put me on indometacin to treat the acute attack and colchicine and allopurinol. The latter two being gout medications one being a fast acting (colchicine) and the other (allopurinol) being a long term maintenance drug. He says that I will to be on allopurinol for the rest of my life.
> 
> I do not like taking drugs as I already am on three medication that I will take for the rest of my life.
> 
> ...



Of those you mentioned I've used all 3, Indomethicin is a pain killer/anti inflam, I had to stop taking it as I have Asthma and it made me chesty so they put me on Prednisolone instead (this is a steroid which is also used to treat Asthma so works for both). Colchicine is a horrible drug but it can work if you catch the gout early enough, just dont take it for too long as it can really upset your insides. Unfortunately I think the allopurinol is probably the only way forward for you.

On one of my most serious bouts (lasted 4 weeks) I actually ended up having a cortisone injection directly into the toe joint, painful but I would have chopped my toe off to relieve the pain at that point.

All the best


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## cooperplace (10/3/18)

allopurinol + lots and lots of water. Allopurinol as a blocker of uric acid production should have a strong positive effect, but nothing is certain in medicine and biology. Good luck, let us know how it goes.
And remember that serum uric acid levels often drop during acute gout attacks. so get your uric acid levels measured when you're not having a gout attack.

I'd speak to a general physician or a chemical pathologist.


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## thumbsucker (10/3/18)

Its coming up to two weeks. I have not had a major attack, however I have had low level pain in my right heel that is persistent, hopefully this will resolve.

I am fermenting a Dunkleweizen and another week I will filter and keg. Then we will see.


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## thumbsucker (24/3/18)

Yesterday I filtered a dunkleweizen and force carbonated the beer it has come out lovely with a clear reddish tone With great clarity you can clearly see my finger through the beer

I had two beers yeasterday and I will have the same today with no ill affect 

I have increased the dosage of the Alloprinol to 200mg a day and this has resolved the last of my symptoms


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## Holden4th (25/3/18)

Prednisone works very quickly on gout.


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