This page about flying with gout was last reviewed, or updated, on 9 May 2013.
Can you fly with gout? It may not be something you have given consideration to, but if you get an attack of inflight gout, and you have forgotten your medicine for gout attacks, you'll wish you had. And there's at least two gout triggers inherent in flying, which are not as common on terra firma. There's the possibility of a nasty experience.
And I have met a gout sufferer who had an attack immediately <i> after </i> a very long flight. It seems the flight built up the symptoms.
So what are the inflight gout triggers?
Flying with gout trigger No.1 is your lack of mobility. Economy class aircraft seats are small and so is the leg room. It's a cramped location.
Keeping blood circulating well is one of the ways of delaying/preventing gout attacks. The theory is that sluggish blood circulation, especially with plasma over saturated with uric acid, is more likely to trigger an attack of gout. That is to say, uric acid is more likely to crystallize into the MSU crystals. The immune system’s response causes the pain and inflammation of acute gout attacks.
And circulation is more sluggish in the feet than elsewhere, one reason for the tendency for attacks of gout to occur first in the big toe.
Take extra care if your feet are cold. It's thought that coldness is another reason why uric acid crystallizes. The feet are the coldest part of the body.
So to get, or keep, blood circulating better you need to get walking - up and down the cabin's aisles. At stop-overs, a walk is a much better idea than propping up a bar, lounging on seats, eating in a restaurant. Go searching for medicine for gout attacks for example, and wander around the shops.
Flying with gout trigger No.2 is dehydration. Aircraft are dehydrating places because their cabin's air has much less humidity than the air most of us breathe elsewhere.
Dehydration is NOT good for gout. It can trigger a gout attack. The risk grows with a longer flight. Uric acid is not very soluble but drinking water dilutes it. This dilution makes it less likely to crystallize, the event you must avoid. The usual recommendation is 6-8 x 8 fluid ozs glasses of water a day. If you are on board an aeroplane this amount of water (a lot for most people who haven't become used to it) is crucial.
On a plane, don't count the water in coffee, tea or juices. Just count the plain water or alkaline water. And make sure you are well hydrated before you board.
Flying with gout trigger No.3 is the wine or other alcohol. Unless you've experienced differently, a couple of glasses of wine a day aren't going to trigger an acute gout attack. But an alcoholic binge might, and if the airline you're flying with is generous with the drinks you might just trigger your first attacks for some time. In other words a few over your limit - in this case your uric acid crystallisation limit - could trigger an attack.
What is the uric acid crystallisation limit? At 7.0mg/dL (0.416 mmol/L)or higher, uric acid is more likely to crystallise (crystallize).
INFLIGHT GOUT ATTACKS - WHAT CAN YOU DO IF YOU FORGET YOUR MEDICINES?
So you forgot your gout medicine. You are flying and gout rears its ugly head. What can you do? Is there a worse place to have a gout attack than an aeroplane? It's the lack of freedom and mobility. You can't even make a beeline for a hospital's accident and emergency unit (emergency room, ER), or your doctor's surgery or clinic. You are trapped in a flying tube.
Here's some ideas for what you might do.
* Make sure your attack is known to the flight attendants. Don't suffer in silence. They can find out if there is a doctor on the flight.
* Ask the flight attendants if they have any pain killing medicine on board. For gout, best is probably indomethacin or voltaren.
* Ask around with other passengers. As long as the flight is reasonably full someone should have at least Ibuprofen.
* Remember, remember. Don't use low dose aspirin. It increases your risk of a gout attack and it can worsen it. And paracetamol (acetaminophen) has no anti inflammatory action, but may help if you feel a fever coming on.
* If you are on a long haul, intercontinental, flight at the next stop airport there will be a pharmacy, or a shop selling some pharmacy products. Ask for its gout medicine or strongest pain killer, but it may only be Ibuprofen.
* If you're travelling economy, ask the flight attendant if you can move to one of the rows at the beginning of a cabin. (There's usually an adjacent emergency exit). You won't be parachuting out, although you might feel like it, but these rows have more leg room and you can raise your legs higher than in other economy seats, which only have those tiny foot rests. These aren't much good. You want to raise your legs if possible.
* For a gout attack, first and business class are clearly better to be in. If you’re in economy you could try your luck, tell the attendant the story, and ask if you can move to first or business class. Or ask to move to a seat where there are one or two (better) spare seats next to it.
* If a meal is served, do not drink wine, nor any other alcohol, and only eat low purine foods. If you don't know which they are, visit this page for a list.
* If you are flying beyond the next stop, ask the flight attendants (if you're lucky they will have dealt with an acute gout attack before) to get you a wheelchair if you think you need it.
* If putting your foot (if that's where the attack of gout is) in ice cold water dampens the pain, ask the attendants for it. They have the ice and they have the water.
* If you suffer from cold feet (which might just have something to do with your gout) take an extra pair of socks, or wear two pairs.
* Next time you're on a flight, ask the flight attendant what they do for a gout attack. Partly play the role before it happens, and you find it easier to deal with if it actually happens.
* Consider taking your own special drinks e.g. alkaline water, cherry juice, or celery juice on board. Especially if it's a long intercontinental flight. If you want to do this, these days you had better first check if there are any security issues about doing this.