During lunch yesterday, inter alia, I informed my wife about some new ailments I am encountering. They include pain in my right center toe area making it difficult to walk at times, floaters in my left eye, the one that has not had cataract surgery, and my weight balancing which readers know I continue to work on.

My wife responded that she too from time to time experiences pain in her toe area and perhaps it is due to “Purines.” So we pursued Purines with a Perplexity search with the following results: (bear with me, it potentially IS related to PD requirements!)

Purines are chemical compounds found naturally in many foods and also produced by the body. When broken down, purines form uric acid. While purines are a normal part of diet and bodily processes, consuming too many can lead to health issues[1][4].

High levels of uric acid in the blood, known as hyperuricemia, can cause problems like gout and kidney stones. Gout is a painful form of arthritis where uric acid crystals accumulate in joints, causing inflammation[2][4].

Foods high in purines that should be limited include:

  1. Organ meats
  2. Alcohol, especially beer
  3. Certain seafood like sardines and anchovies
  4. Sweetened beverages with high-fructose corn syrup[1][4]

A low-purine diet can help manage conditions like gout by reducing uric acid levels. This diet emphasizes:

  • Fruits and vegetables (except asparagus, cauliflower, spinach)
  • Low-fat dairy
  • Whole grains
  • Eggs and nuts
  • Limited lean poultry and fish[1][2][4]

Staying hydrated is also important, as water helps flush out uric acid[5]. While a low-purine diet can be beneficial, it’s typically used alongside medication for treating gout and related conditions[2][4].

Citations:
[1] https://www.webmd.com/diet/foods-high-in-purines
[2] https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/gout-diet/art-20048524
[3] https://myhealth.alberta.ca/Health/pages/conditions.aspx?hwid=ty2036&lang=en-ca
[4] https://my.clevelandclinic.org/health/treatments/22548-gout-low-purine-diet
[5] https://www.healthline.com/health/tips-for-following-low-purine-diet

The essence of the potential tie between Gout and PD is captured above in the statement “Staying hydrated is also important, as water helps flush out uric acid[5]. ” As anyone on PD has been instructed, we are on a strict restriction about intact of fluids, often limited to no more than on the order of 32 oz per day. I have been steadily working outside in the North Texas heat where it is often in the nineties or even over 100 with high humidity. As a result, I have been known to break a sweat every so often. Perhaps I am not ingesting enough fluids to keep up with the environment I’m working in, dialysis aside.

In the short term, I’m going to attempt to injest slightly more fluid and see if the sore toes go away. We’ll see.