[Fire Titan]

Hi Nobody

Thanks for the quick reply.
I took 40mg a day of Febuxostat one a day for 3 days (1/2 a 80mg tablet) only

So currently I don’t get any attacks, some days my toe is just a bit stiff and there are fantastic sensations going on (Hard to explain)

I do feel tenderness in my finger joints when I press them , not sure if thats because the previous stop/start of Febuxostat and Allopurinol triggered something or my gout is progressing

So I have not had this tenderness issue ever before.

So I am more worried long term about crystal formation.
But as you say , no substitute for UA lowering meds.

Indocid does not stop the formation of crystals in my understanding, just kills the inflammation , so I would only take that for attacks.

I was proposing the week on/off approach because then it would interrupt the crystal formation process as a stop gap approach until I am brave enough to start yet another UA lowering med.

But what you are saying is when I feel symptoms, tenderness in fingers, wrist joint, heel etc , then I take Colchicine for a while?

I know I am just stalling the process , but the side effects of both Allopurinol and Febuxsotat are a bit horrific for me.

So I want my body to really calm down and get back to normal before attempting any other UA lowering medication

i am not sure how long it may take , maybe never for my body to stop overproducing or underexcreting UA , now that I am on a virtually meat free diet, that is the issue and of course how long it will take before I get some serious issues i.e Kidney stones/tophi etc

Thanks
Firetitan

[Fire Titan]

Hi Nobody
I am back 🙂

I tried Febuxostat for 3 days side effects included.

1) Bad wheezing just after 3 days, Allopurinol wheezing after 30 days
2) Tinnitus got worse
3) Starting coughing blood
4) Reduced my immune system so much, yellow and green phloegm
Went to GP gave me penicillin (Amoxillin) for 7 days then it went away.

5) A few weeks later I think the Febuxostat activated something in my body
a) Lower base of thumb joint aches/sharp pain
b) Left Index finger , tender bump emerging
c) Some of my finger joints are tender when I brush against things
6) Initial toe joint that I had the initial attack for all good though

So now I have tried Allopurinol and Febuxostat to no avail.

I really dont want to try other URIC acid lowering medicine now , I am too scared, each time it screws up my system so bad and it takes so long to recover.

So yes my Uric acid is 0.51 supposed to be 0.36 , but now I am looking for a solution that will stop ua crystal formation and reduce the inflammation a little

So what to do you think about taking 500mcg Colchine (1 tablet) a day for one week and then dont take it for the next week

So 1 week on , 1 week off , 1 week on , 1 week off ?

I read that Colchicine will not reduce UA but may prevent or disrupt the formation of crystals and reduce inflammation.

I did take Colchicine together with Allopurinol for 16 days , but I did feel a bit unwell after that 16 days so I stopped the Colchicine.

But if I only take it for a week then stop for a week it should be ok.

Colchicine does not seem to have the same bad effects of Allopurinol and Febuxostat when you start and stop, it seems you can start/stop at anytime without impacting your gout? (Does not give you attacks)

So its been 6 months now without a disabling gout attack on my toe joint now, sure I had episodes when I was coming off the Allopurinol and the Febuxostat, but then I just hit that inflammation with six Indocid tablets and it killed it !!!

So now my worry is long term, diet only reduced my UA by 0.01 , but then again it was only for 3 months, if my body has been on a high purine diet for 45 years I cant expect my UA to lower in 3 months !!

So I am thinking laterally and will use Indocid to kill any attacks I may have, try to eat very well so I don’t trigger my existing crystals.
And take Colchicine as a preventative only , in 1 week off, 1 week on cycles.

I know my UA will still be high, but I want to stop experimenting with UA lowering meds for a bit as it kills my body.

Do you know anybody that is allergic to both Febuxostat and Allopurinol? and may be trying this?

I just want to confirm that it may be a stopgap approach , until I find a solution to lowering my UA to safe levels.

Any advice would be great 🙂

Thanks
Firetitan

[Fire Titan]

Hi Unabashed

My concern are the side effects of the medication , I am not unclear on the mechanism of how gout propagates.
My concern is that besides lifelong medicine there seems to be no alternate cure which really kills me as I have not ever had to take constant medication.
For some people there have been no side effects which means there is no impact on their quality of life, so they need not worry.
For me , wheezing means I can’t breathe from the Allopurinol and another potential side effect would be tinnitus which I already have and do not want it to progress or worsen.
These side effects could also exist in Febuxostat which I have yet to try and to be honest not to keen on trying it as it will be difficult to get off it as proved by my 1 month stint with Allopurinol.

So my choice bluntly is

Walking or breathing and maybe not hearing (Allopurinol)
Walking or possibly breathing and maybe not hearing (Febuxostat)

Quite a difficult decision to make

So it may have been an easy decision for you as no effect, but for me it has a bit more impact.

I dont think my gout is really chronic 1 bad attack , 42 days later a less severe attack because I stopped the Colchicine and reduced my dosage of Allopurinol and 2 months later I can walk but toe joint still a bit red.

In your case did you try diet and for how long and did it work? or did you go straight on the allopurinol?

[Fire Titan]

Hi Nobody

Yes I understand where you are coming from , at the moment I am just trying to eat more healthy and if I lose weight because of that then it’s good, but i agree slowly slowly.

How about the strategy of buying a home uric acid tester and testing every week, just to monitor if I am on the right track with my UA?

I just had a long chat with my friend who has had gout for over 30 years, he tried a year diet of just boiled chicken and fish ..aargh and it worked for him he managed to get his UA down to below 3.6 constantly
But then due to the strict diet he relented and now he is on 300mg Allopurinol now he eats anything within reason so I agree with you , it can be done by diet alone, just depends on your resolve and of course whether it is genetic or not.
His father and grandfather and aunt have had gout so it runs in the family.

My foot has calmed down now about 95%
I am trying some ointment named Kunzea Cream , it seems to give some relief

I also have some soup made with nearly ripe papaya and barley , which has really helped reduce the inflammation.

I don’t want to take the Indocid anymore as I believe it may have increased my existing tinnitus as it is ototoxic

I took it once when my inflammation was bad and the results this time were instant as I had stopped it for 8 days.

But now too scared to take it as my research has confirmed that this is true together with my personal experience

Yes let’s hope the crystals go quick

[Fire Titan]

H Nobody , apologies I responded to your answer last night but must of forgot to press the submit button !!

No worries, any information you give me is invaluable.
I understand what you are saying about natural remedies difficult to know what works or not.

Yes, I only plan to lose about 2.9 kg not a lot, and the exercise I will take it easy

My question is if I do take Febuxostat for 6 months to a year or until all the crystals are gone, can I stop ?
Or will my body be so used to it that I can’t.

Surely if all the crystals are dissolved, confirmation with a DECT scan then stopping the Febuxostat wont trigger any more attacks as the crystals are gone?

Once the crystals are gone, and I stop the Febuxostat then maybe I get 3 monthly UA tests to confirm my UA is not going back up again?
And if it’s not then problem resolved ? or is it not that simple.

Just very wary of taking long term meds since the wheezing episode with the Allopurinol and the chance of increased tinnitus which may impact my existing tinnitus(Still very minor, but don’t want to take the risk.

Also how long before the Allopurinol leaves my system , i only took it for a month and now its been 12 days that I am off it, but there is still some very light wheezing.

My toe joint a bit sore today I did a lot of walking so a bit red and sore to the touch aaargh.

It seems to me to get rid of these crystals will take at least a year with constant medication !! is this a correct statement?

Thanks again for all the info

[Fire Titan]

Ah , yes those were my thoughts exactly !!
I will give it my best these next 3 months with a very strict diet and daily exercise and see how I go.
Worst comes to worst I will have to accept and then start on the febuxostat.
I agree with you on the dosage of Arcoxia at the 60mg dose my uncle took the 120mg dose as he has bad gout on his knee.
I thought that Arcoxia was like taking Indocid and Panadeine together ?
A mixture of something for the pain and for the inflammation, I may be wrong.

I suppose it also depends on how severe your attacks are, my first one was can’t walk bad, my second was painful but could still walk,

My foot is a bit red today and when I tap it it is sensitive , but I am resisting taking the Indocid again , today is day 4 with no meds at all.

Not sure if thats a wise choice, but lets see how I feel tomorrow, going from taking indocid every day to once every 4 days is not bad.

I am going to try every trick in the book to beat this gout naturally, might as well put up a good fight before I concede !!

My gout daily plan will be

1. 2 celery tablets in the morning
2. 1 tablespoon apple cider vinegar mixed with water
3. 3 litres of water during the course of the day
4. A couple of glasses of cherry juice
5. Some eye medicine(2 tablets) with lutein and 150mg of Vitamin C
6. Gym twice a day ( Lunch & at night)
7. 2 celery tablets at night
8. No meat, chicken or fish
9. 1900 calories max a day
10. Lose 2.9Kg in 1 month
11. Experiment with Traditional Chinese medicine
12. Try folic acid?
13. Try tumeric?
14. 1 packet of Urol dissolved in water , once every 2 or 3 days

Lofty goals I know, but I have done the diet before and it worked, just without being vegetarian so that will be the challenge.

What are your thoughts for my daily plan 🙂

I am getting quite frustrated that there is no natural remedy for gout !!
Surely there must be a formula that people have used to reduce their uric acid that works for them ?
I understand that the medication works much quicker and is historically proven, but depending on the individual reaction to the side effects it may not be worth it.

Regarding the UA magic number of 0.36, that’s apparently the concentration of uric acid in your blood where it will dissolve in your blood , anything above that will start forming crystals, this is supposed to be scientifically proven.So quite cut and dry, therefore I suppose the goal of stabilising your blood to this number or lower, so no crystals will form.

I suppose to change your bodies functioning is quite difficult if you have been eating a meat diet for over 40 years !!
Your body I suppose gets used to producing a lot of uric acid in preparation to cater for all that purine.
So I guess that’s why it’s so difficult to change it by diet only , and medicine is needed to help.

Is it possible to get your UA down to zero? or is that a bad thing, too little UA can also be bad right.

What were the frequency of your gout attacks over the years ? and has it stabilised now and for how long ?

What were your allergic reactions to Allopurinol ?
Are you on Febuxostat now?

Any natural remedies that you are taking or have worked for you ?

Apologies for all the questions, but just interesting to know your experience.

Thanks again

[Fire Titan]

Hi Nobody
Just came back from the specialist, you are right 0.40 is still too high.
The MAGIC number is apparently 0.36 beyond this the crystals will form

So apparently if I diet like a month it will only bring it down by 0.05 !!!
So 0.40(current) – 0.36(Target) = 0.04

So theoretically maybe I can get it down with diet , although the specialist disagrees with me.

She said if I don’t take the medicine(Febuxostat now) then what will happen is the frequency of attacks will increase and the time between attacks will shorten , until I will have daily pain.

She did give me an attack plan for the attacks though

Colchicine 500mcg twice daily
Arcoxia 60mg daily

Until pain stops

My uncle takes Arcoxia when he has attacks and he says the pain relief is great, so this is another med I have not heard of.

So she will see me in 3 months time and then evaluate.

But it seems like I will have no choice but to try Febuxostat and see if I have any wheezing or other side effects !!

[Fire Titan]

Hi Nobody

Thanks for that , seeing the specialist tomorrow, so I have compiled a lot of questions for her, based on our conversation.
Good to be knowledgable in this area, at least I now know the correct questions to ask.
So just wondering what a low uric acid reading is?
I will also ask about the Indocid dosage during an attack an an alternative to the panadeine forte
Day 3 of no indocid and my foot is ok(Day 8 since I stopped Allopurinol) , but feeling tingly and has a bit of pain when i bend my toes up
Not sure if I should take some indocid now or let it ride !!
Decisions…decisions

I will mention febuxostat and Uloric as well to the specialist lets see what she says.

Thanks again !!

[Fire Titan]

Hi Nobody
Thanks again for the advice .

So this is what I have done

Wed(Day 1) :- Stopped Allopurinol
Coughed up phloegm mixed with water when going to sleep
(Maybe the lungs are clearing)
Saw Dr.Got UA Results
Urate has gone down from 0.51 to 0.40 (Normal range between 0.2-0.42)according to the test paper.
Although I am unsure what is high and what is low and as you say , normal may not matter.
Kidney and liver all good !!

I also took the test for the HLA-B 1502 gene just in case as I am Asian as this predisposes me to Stevens Johnson syndrome, but I will only get these results a bit later.

This is from taking Allopurinol for 1 month and no red meat , a bit of chicken and fish.
Dr said to see a rheumatologist to analyze alternative Allopurinol options.
Dr said maybe take 100mg of Allopurinol every second day ?
But let me see if I can just stop it.

Thur (Day 2) :- Foot feeling twangs of pain, not serious

Took 2 x 3 Tablets Indocid(Breakfast,Lunch & Dinner) (Just in case)
Wheezing feeling much lighter

Friday(Day 3) : At night twang of pain on foot

Took 2 Indocid after dinner
Wheezing lighter

Sat(Day 4) :- Drove for 3 hours for Holiday so foot a bit sensitive

Took 2 Indocid after dinner

Sun(Day 5) :- Foot a bit achy

2 indocid after lunch , 2 indocid after dinner

Mon (Day 6) :- Stopping all Indocid

Wheezing has stopped , so I am assuming its the Allopurinol
So you are right side effects do not go away immediately , they linger in your body
Foot feels ok today.

Emergency plan for attacks

1. 6 x Indocid (2x Breakfast,2 x Lunch & 2x Dinner)
OR
2. 2 x Colchicine tablets, then 1 every 3 hours until you go to the toilet
OR
3. 3 day course of 1 tablet of predisnone

I understand that this is not a long term solution , but I see the rheumatologist on Thursday , then I can see if there is a medicine that will not give me the wheezing.

I asked the Dr whether there were any case studies where the crystals dissolved by themselves, but she said she had not heard of this before.

If I can control the gout attacks via my attack plan above and diet then I will try do this, as the wheezing from the Allopurinol felt very bad.

It’s just those attacks that can be bad, my first one was the worst , then 42 days later I got the second attack , but not so bad as I immediately took Indocid.

I don’t want to take Colchicine again, as I took it for 16 days when I started Allopurinol and it made me feel really bad, so will leave this medicine as a very last resort !!and then I will only take it for 1 day

Another side effect not sure if its related to the Allopurinol , black floaters started appearing in my right eye , that I did not notice before.

I have been monitoring this and maybe because I am aware of it now , I notice them come more frequently , not all the time though.

I am not too keen to re-introduce Allopurinol into my system, but let’s see what the rheumatologist says on Thursday.

I am taking it a day at a time

It’s very interesting my friend has taken Allopurinol for 30 years with no wheezing side effects, so I suppose everybody is uniquely different.
Just my bad luck I suppose.

I know I am just prolonging the inevitable as the crystals need something to break them down, but if the side effects are so bad then I will need to re-evaluate.

Thanks again Nobody for your wisdom !!

[Fire Titan]

Hi Nobody

I am back.

One of the side effects I have now experienced is extreme wheezing and coughing the last few days, I had to take my Asthma pump (Ventolin) about 6 times yesterday.
Going back to my gout diary I started wheezing 1 week after taking allopurinol , and so now I have been wheezing for 16 days now so not good.

Went to the Dr and she referred me to a rheumatologist,

The thing is the appointment is only next week and I desperately want to stop the allopurinol as it can’t be healthy to wheeze like this.

I dont have a cold or anything.

I read one of the rare side effects is wheezing and you should see your GP straight away if this occurs

So I asked what the alternatives are febuxostat(Uloric) , but my Dr seems to think that I will still get the wheezing, so she said I need to see the specialist to make that decision.

I really want to stop the allopurinol even though I know I have only been taking it for 1 month and the crystals cannot be dissolved yet.

So the choice is walk or breathe !!!what a decision to make

I had another uric acid blood test and kidney and liver function test as you suggested., so lets see what the results are.

My last measurement for UA was 0.51 and she said the normal is 0.42

Any ideas would really help 🙂

Thanks

[Fire Titan]

Aaargh thats terrible.
I hope that you have it all under control now.

[Fire Titan]

Hi Nobody

Ah thanks I understand now.
Yes it is difficult to estimate the timeframe before you are completely cured if that is really possible.
I am understanding now that this is a long term treatment, as I have never been on “lifelong medication” it sort of scares me.
Sad to hear your experience with the doctors.
I will keep your advice in mind, so need to do more UA and kidney/liver tests and see levels first after my first treatment with Allopurinol.
So 3 months may be too short , lets see how long it takes before my toe becomes normal again, its been 42 days since my first attack and my toe is still not back to normal again and now the second attack aaargh.
So 22 days on Allopurinol (16 days on Colchicine)
So only half the time I was on Allopurinol and the other half on Indocid and Predisnone.
Here’s holding thumbs.
By the way what area did you get gout in ?

Thanks for the speedy reply as usual 🙂

[Fire Titan]

Hi Nobody

Good to hear , I have never suffered any symptoms of gout before this attack, the only one thing I can remember is that after a big BBQ with lots of meat , my knees did feel a bit achy.But I though that was just old age !!

Just wanted to clarify your point about desensitizing your immune system, could you please explain that concept a bit more? not sure I understand.

Yes I wanted to take a blood test after 1 month of good diet but the Dr said it was too soon and UA levels take time to normalize.
But after this 3 month stint of Allopurinol, hopefully I can stop and then from that point till one month after of dieting they can test the UA and if it does not go up the it must be diet.

Yes I was trying to pinpoint what triggered the attack, I don’t believe it was food related as I have been good, the only thing I could think it was , was lowering the Allopurinol dose or the day before I went on a very long walk (12000 steps)

You are correct the Indocid tablets are 25mg and I take two three times a day
You are correct , it seems they take a long time to kick in.
Maybe thats why as soon as I took a predisnone tablet I had immediate relief not sure(That was a 5 day course 1 tablet a day)
Not sure I want to do the predisnone though over the past few months I have taken 3 courses of 5 days each (1 for tinnitus, 1 for skin rash , 1 for gout)
So I think too much

Today my foot feels much better although still swollen, it is much better than the first attack , but maybe I took the Indocid immediately as it came on as well as the fact I am on Allopurinol.
At least I can walk ok.
I think one more day of Indocid (On my second day) then I need to give my body a rest.

I took 2 x Panadeine forte on my first attack as I was in so much pain and that worked very well, the second attack I only took one tablet.
So yup , need to discuss with my Dr the overall effect in combination with my other meds.

Are you on any Allopurinol ? , how long have you had gout for.
I would like to know what your experience has been.

Thanks again for your comprehensive answers it is really appreciated, so good to chat to somebody who understands

[Fire Titan]

Hi Nobody

Thanks for the comprehensive advice , greatly appreciated.

So using myself as a guinea pig after taking 100mg Allopurinol and 300mcg of Colchicine for 16 days , my toe stopped hurting about 80% better.
I saw the Dr and she recommended dropping the Colchicine.
The Colchocine was making me feel very unwell , made my skin really oily and acne prone.
I dropped the Colchicine and dropped my Allopurinol dosage to half (50mg)
I did this for 5 days with no impact.
Then for the 6th day I dropped to a quarter (25mg)
That night 2:30am in the morning I got a gout attack , first one in 46 days.
So I took 2 tablets of Indocid and one tablet of Panadeine forte to kill the pain
The next day I took 2 tablets three times a day of Indocid and back on the 100mg of Allopurinol again.

I understand that gout is a chronic form of athritis and the UA crystals may have take a year to form, so I suppose I cant expect them to vanish after taking a low dose of Allopurinol for 21 days.
But I was being very optimistic!!

So my strategy is to keep on taking the 100mg daily for 3 months and then check my UA or even sooner as you state.

I just felt I wanted to wean myself off the Allopurinol , but if the crystals have not dissolved then I will always be prone to attacks.

It seems though I am looking at a 3 to 9 month time frame if not more for the crystals to actually be dissolved.
Does that seem to be your estimate?, I know each person is different , and the amount of crystals they have in their body may be different.
And I suppose it also depends on your dose amount.
I am just trying to calculate when the crystals will dissolve and if they have totally gone, how I will check besides sticking a needle in my toe joint !!
But for now I have to deal with my 2nd attack, the pain is much sharper this time and skin is getting ultrasensitive again.
So the last time the Indocid did not do to much , but the predisnone did the trick immediately, If I don’t see results soon then I might switch to predisnone.

And you are right once I stopped the Colchicine I felt much better, its pretty potent stuff!!, So I don’t want to take it again, even though I have an attack now, but then again I did take it for 16 days in a row before.

Chat soon
Thanks again

[Fire Titan]

Hi Nobody

Thanks for the rapid response.

Yes I don’t have a copy of my uric acid levels, but the Dr said it was
6 and normal was 5 , so only one above ?

Yes the Dr said 100mg for the first month, then increase to 200mg for the next month , then to 300mg , so I understand the amount is quite important.

Yes will get this tested after the first month of allopurinol and colchicine
Yes I want to stop the Colchicine, so just waiting for the 1 month mark.
New symptoms after taking both for 11 days
a) It seems my inside leg bone by my ankle is sore when I press it, not sure I dont think I knocked it
b) My index finger seems to have a bony raised portion that I did not notice before and yesterday my left index finger was sore when I was typing on the keyboard.I compared it to my right index finger and it was not so prominently raised.Not sure if this is the allopurinol somehow activating crystals in my index finger joint ?I hope not
c) My inner elbow joints are sore, these were sore for 3 months before but I put that down to to many bicep, tricep curls at the gym ,maybe not maybe its the crystals, they seem to ache more now after the medicine
d) I took 3 x 5 day courses of predisnone , one course when I had Tinnitus, the second course when I had a skin rash and the third course for this gout.
So I dont think I want to take anymore.This was over a few month period.

e) My inflammation is coming down a lot in my toe joint , peeling skin still a bit purplish red, and still sensitive when it touches my shoe and expands when I walk for a long time. But at least I can walk now.
I still get sharp shooting pain sometimes, but its bearable.
I’m not expecting this to go away fast maybe after a month of meds maybe?

f) Not sure about the side effects if they are serious , you say they warrant further investigation ?

g) Yes variability of UA level reduction must depend greatly on the individual, but from ,my short research it seems that it does not reduce by much or trying to maintain such a strict diet is very difficult.
I don’t drink alcohol at all and do gym at least 3 times a week , but I think how the crystals formed was because my uncle has gout so genetic and I have been eating mainly meat and chicken for lunch and dinner with no vegetable days for a long time(years) so must have UA crystal formation because of this.
Also I drink soft drink maybe one a day , lemon lime and bitters or sprite , no pepsi or coke.And one coffee.

So my initial trigger for my first gout attack was

Day 1 :- Drank two glasses of champagne (I never drink)
Also ate a lot of “unknown” finger food at a school function

Day 2 :- Ate a pizza

Day 3:- Ate a 7 course chinese meal for my Moms Birthday !!
Meat,Chicken,etc

Day 4:- Gout Attack, could not walk excruciating pain !!

Yes diet is key , but I dont think I could live without some chicken at least 🙂

So I think my trigger was the alcohol, but it could of been the unknown finger food I ate, some kind of sea food.

So a question I have is how long do you have to take Allopurinol and Colchicine together for ?
I understand Colchicine is to prevent gout attacks and Allopurinol reduces the uric acid in your body.

The other thing is what are serious side effects ? of the meds and as you say which med is causing it.

I think the treatment length will depend on how many crystals you have and how your body responds to the meds.Not really keen to have a needle stuck in my toe joint to extract the synovial food , so they can estimate crystal number !!!

What about having an MRI? will this show the number of crystals or are they too small

I did have an X-ray but nothing comes up.

One thing for sure, without medication I don’t think the crystals will go away by itself.
If I eat like a monk for a long time maybe, but then what happens if your body has a natural tendency (genetic) to make high UA

I read that some vegetarians still get gout !!!, so must be genetic then if they dont drink any alcohol and stay away from high fructose.

So many questions, and your body is the guinea pig.

Anyway thanks for the comments, just counting the days when my foot is normal again !!

I did ask the Dr for another Uric Acid test after I dieted for 2 weeks after the attack , but my doctor said this too soon, so I could not find out whether the dieting had any effect on my UA levels.
But I will ask after taking the meds for a month and see what they have dropped to, the thing is even if they have dropped which they are sure to , the crystals still exist and this is the source of the pain.

[Fire Titan]

Hi.

I am also a fellow gout sufferer …aargh
1. 48 years old
2. First attack in toe joint
3. Could not walk for 5 days intitially(Atttack lasted 1 month)
4. Took Indocid (Anti inflammatories 3 times a day for 2 weeks)
5. This did not work so well so took predisnone for 1 week – immediate relief
6. Then Dr put me on 100mg Allopurinol and 1 Colchicine tablet daily
7. Been taking this medication for 10 days now and swelling seems to be going down and pain ok now.
8. Skins is peeling on joint area and reddish/purplish
9. Pad of index finger sore ? , leg bone above ankle sore , elbows sore ?
Is this because the Allopurinol is getting rid of crystals elsewhere in my body that were not active soon , not sure
10. Only drink water (3litres), coffee (1 a day) , tea sometimes & sparkling
water
11. Eating no meat, but some fish and chicken
12. I have high iron, not haemachromotosis, but Dr said two years ago to give blood but ignored her, could high iron contribute to gout , I have heard yes
13. Waiting for Blood place to call me to give blood
14. My friend got gout attack but only took Allopurinol for a month and then stopped and he has not has an attack for years.
12. Good web resources

https://www.hss.edu/conditions_gout-risk-factors-diagnosis-treatment.asp
https://www.medicines.org.uk/emc/files/pil.6006.pdf
https://www.racgp.org.au/afp/2016/may/the-management-of-gout-much-has-changed/
https://ard.bmj.com/content/annrheumdis/33/4/304.full.pdf
http://www.healthtalk.org/peoples-experiences/bones-joints/gout/diet-and-self-management-gout

https://journals.sagepub.com/doi/full/10.1177/2040622312462056
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1954685/

13. So it’s been nearly 1 month now, swelling has gone down but not cokmpletely
14. Aim to only take Allopurinol and Colchicine for 1 month, but according to the above resources , it takes 3 months for the number of crystals to halve
and then from 3 months to 3 years to get rid of them completely
So may need to take the meds for at least 3 months.

14. So many factors to consider
a) Diet
b) High iron
c) Fitness
d) Body weight(fat)
e) Genetics
f) Specific gout triggers

15. Effects of Allopurinal and Colchicine I have had
a) Hot flushes
b) Skin went oily for a few days after taking , acne
c) More joints became achy (Finger,elbow,leg)
d) Funny taste in mouth
e) Upset stomach first few days not to bad
f) Not feeling 100%
g) Cough I had has not recovered (Wheezing like athma)

So in conclusion it seems diet only reduces Uric Acid levels by 1mg
Medication is the answer
Just like others dont want to rely on medication all my life
My friend has been taking Allopurinol for 30 years now , and he says he stopped it once, major attacks

I cant afford to stop walking for a month !!!
So just like you I would like to know long term side effects on kidney etc.

Apparently studies show that after long term Allopurinol use , UA levels go back to what they were 1 to 2 weeks after stopping.

The reason why people may not be getting attacks is that the uric acid “store” has been depleted and needs to build up again before the crystals start forming again (Curse you damn crystals !!)
But those who do get attacks after stopping , maybe crystals still exist and get re-activated ?

One of the articles analogies was quite good , UA crystals are like unlit matches in your joint , unlit no worries , then once it is triggered , wildfire and then the body sends white blood cells to fix it which causes inflammation and extreme pain
So colchicine to dampen the matches and Allopurinol prevents new matches from getting created.
But at the same time as the overall UA level is being reduced in the body , the body will try increase and then suck those crystals or dissolve them out of the joints, that’s how I understand it.
So we need the meds to do that.

The thing is what happens if you have naturally high UA like I have naturally high Iron levels !!
How can you reduce without the meds besides diet and exercise.
Maybe diet and exercise are not enough.

Anyway hope this helps everybody and happy to chat.
I really empathise with all on the forum.
This was the most painful thing I have ever experienced in my life and completely debilitating , I had to work from home for nearly a monnth, but some people can’t do this and could lose their livelihood !!

From the 4 friends I have spoke to which are on Allopurinol for a long time now , none of them have had an attack while on the meds , so very good , the issue is that not happy with taking daily meds forever !!

Good tips
a) Buy a water bootle and put it on your desk to regularly sip water
I bought a insulated Kleen Kanteen one excellent on with a push in nozzle
Dr said dehydration can cause gout
b) Always take meds with food to prevent upset stomach
c) Swimming is a good exercise for aerobic exercise if you cant walk
But my foot was still a bit sore kicking the water !! so sensitive.
d) Buy/wear sandals that dont touch your toe joint , I found that closed shoes make your gout area expand like a balloon

Thanks for all your posts guys & gals the info is really valuable !!
Cheers
Firetitan

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