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Thank you. But for completeness: I’m not sure how much allopurinol it would take to kill the most vulnerable but 100mg would already be a pretty serious dose for some patients and you can start with less (as some guidelines mention). More importantly, even though allopurinol has more common potentially deadly side effects, people with East Asian ancestry should get a genetic test or simply use febuxostat instead… something I have told people time and again on this forum. Every single easily avoidable death is one too many.
I’d also wager the more serious risk for most gout sufferers is indirect (by the way of lifestyle, obesity and so forth) rather than organ damage.Even more importantly, people such as Chris who do not understand gout aren’t able to tell if a treatment worked (whether it be pharmalogical or not) and too many doctors do not care.
People who publish may be experts at publishing but in medicine, psychology and so forth a distinction is often made between researchers and clinicians. And clinicians are supposed to heed guidelines regardless of whether they are peer-reviewed.
I’ve had this conversations with too many denialists for my comfort (not just in medical matters: climate denialists for instance will also argue for peer review against subject-matter expertise).I vote: someone who has mastered the art of getting research published, mainly because it’s in most cases easy to control gout despite the widespread poor quality of gout care (which does not reflect on all medical services).
I unfortunately happen to be a slightly more difficult case but that still doesn’t make me an expert.
What makes someone an expert I think (and the main job one would want an expert to do in the first place!) is publishing guidelines, not research.Eide, a cherry-picked peer-reviewed paper is nothing like “the medical community”. Are you a physicist or something?
Nevermind the drivel that routinely gets greenlighted by reviewers in many fields: in many cases, outright fraud gets past peer-review as easily as legitimate medical research because it’s unrepeatable. And fraud happens to be cheaper…
What’s irresponsible is not calling out mis/disinformation in no uncertain terms, early and often.I naturally agree there’s nothing wrong with peer-reviewed publications contradicting each other. You may trust the process although I personally do not, but that trust can not logically translate to every claim made in any peer-reviewed publication. That is the issue here, not the process.
Refuting the appearance of substance with substance would be a great way to waste my time, a lesson I have learned too many times already.
You ask “where does that leave us?”. Well, instead of explaining what you figure appears like substance, you could explain the substance of your own thought process about the issue as well as the reason you care about it in the first place… then we could perhaps address that. We obviously have no authority and are of course not trying to review random papers.
If I may repeat myself, the reason most people who come here shouldn’t care is that most people aren’t going to be able to treat their gout through diet anyway.I of course have no credibility. You don’t even know how many persons use this account (or their gender).
The problem is the notion that peer review makes a claim credible. Among other grave consequences, crediting peer review as such opens the door to harmful mis/disinformation through cherry picking peer-reviewed publications. This is an especially serious issue in medicine but is of course by no means limited to “soft sciences”.
Pretentiousness and other pseudo-interpersonal issues are of no consequence relative to the consequences of the spread of medical mis/disinformation. I would have thought this pandemic would have taught everyone this lesson!The forum discarded my reply so I’ll be very brief: your kidney and liver function numbers also need to be checked because you started allopurinol. And gout often impacts blood pressure indirectly, something many doctors neglect.
@Eide It’s logically impossible to trust peer review in this field (as well as many others) because peer reviewed papers naturally contradict each other.
You are confusing gout and attacks, which is why my response made little sense to you.
And you keep cherrypicking (at best) information to mislead people. Allopurinol and febuxostat are dangerous drugs but do not have the issues you claim and, used properly, would most likely make you healthier assuming you actually needed them. Postponing the use of these drugs is of course an option but you would most likely be worse off in the long run for not taking them earlier… again, assuming you actually needed them. Drug interactions aren’t a major concern because you can always stop taking these drugs, whether it be for the duration of an unrealted illness or for good.
I assume you mean NSAIDs by “drugs like colchicine” since that is a unique drug. This drug class kills many thousands every year.Projecting much?
Dietary guidelines can only help if they’re sensible, which is often not the case.
Triggers and dietary factors aren’t the same thing.In any case, no one with a clue ever suggested that dietary recommendations is a good way to treat most cases of gout.
So I urge you to get up to speed and take care of your health with a uric acid lowering drug if you need one. You may be able to tell if you need one with two or three routine blood tests (or simply by looking at the results of past tests). Sometimes the results are borderline, which would leave you with uncertainty. But often enough, the results clearly show people need to be on such a drug.I was nicer in the other thread but if you go out of your way to misguide readers, civility isn’t going to ensue.
Most dietary guidelines are poor to terrible (I don’t know which ones you’re talking about).
Gout is a slow disease which can produce no symptoms for a while regardless of what you drink or don’t drink.Hello to both of you,
Drinking plenty is important as you notices (as long as your kineys can handle it).
But to keep your joints healthy in the long run and avoid nasty complications, it’s important to stop the flares/attacks entierly and to keep the amount of uric acid in your blood consistently low.
Colchicine may prevent flares but you shouldn’t be taking it for very long. The side effects are different than indo-type drugs but the less drugs of any type you take to manage flares/attacks, the better.You definitely don’t need it all the time. Only using it all the time would prevent attacks (or make them milder), which may in turn prevent the need for ther higher dosage necessary to stop a serious attack after it’s started.
Curcumin would probably create the same issue since very different anti-inflammatories create it. The side effects of curcumin are poorly known, in part because people very rarely take an effective dose (if there even is such a dose). A small amount will be useful as a mostly harmless placebo if nothing else but if you ever try taking a lot, be sure to monitor your BP (and get your kidney and liver function tested as well in the event of prolonged use).
I understood your BP situation. I’m telling you some BP drugs make gout worse (or even cause it) while others allieviate gout and work well in combination with allopurinol-type drugs.
Such a combination might be especially useful in a case where the patient can’t take anti-inflammatories. But the effectiveness of this combination depends on the reason why uric acid is elevated, something which can not be determined with a simple blood test.Hi!
Gutting it out would be tough, but it can be done (best have proper pain drugs on hand though!). Any NSAID could be used after an attack start rather than as a prophylactic if that’s better for your blood pressure.
Also see if you can get a blood pressure drug that helps without gout rather than making it worse! That along with allopurinol might make it easier to get rid of gout without taking loads of NSAIDs.
If everything that drives down inflammation messes with your blood pressure, chances are tumeric will do the same thing (that or you won’t take enough to make a difference) so I wouldn’t mess with stuff that comes in uncontrollable doses.I was editing my post to add a few points when I saw your reply so let me add this in a separate post: some blood pressure drugs can trigger gout so make sure a knowledgable doctor has looked at your prescriptions and ascertained you’re not taking the wrong blood pressure drug for someone prone to gout.
I’m getting a clearer picture, and I can make a few guesses as to what went wrong. The information you gave is still patchy so I may be on the wrong track. Let me know if I guessed wrong!
It seems like you (and at least some of your health care providers) haven’t understood a few key facts:
-allopurinol often takes more than a few months to work so, even if the gout diagnosis was correct, it’s no great surprise your troubles haven’t gone away
-for the same reason, if someone’s uric acid numbers are low on allopurinol, it doesn’t mean they don’t have gout but that allpurinol is working
-if you tested 4.5 on 300mg allopurinol per day, chances are your uric acid was easily high enough for you to develop gout before you took allopurinol (but it would be best if you could get your hands on pre-allopurinol test results to make sure)
-as long as you keep taking 300mg allopurinol per day, what you eat probably won’t matter much as long as you avoid alcohol, diuretic additives and the very worst foodstuffs like single-celled organisms (yeast, spirulina and so forth) and some very small animals
-the drugs that provide relatively quick relief are called anti-inflammatories (non-steroidal or steroids, both kinds work as long as you take a strong enough dose) and you surprisingly didn’t mention any… if you really didn’t try common anti-inflammatories yet, discuss the matter of the maximum dose you could possibly take over a short amount of time to kill a gout flare with a doctor as soon as possible!
-colchicine doesn’t provide immediate relief but is taken every day to prevent flares or help them cool down (either way you need to take more than 1.8mg pills over time… but of course you musn’t take more than 1.2mg in one go! this is an unusually dangerous drug so be careful and do not take more than is written on the box unless a doctor tells you to)
-opiods work to relieve the pain obviously and allow people to sleep during a gout flare if they can’t take anti-inflammatories for instance but do not get at the cause or prevent damage due to inflammation so aren’t a solutionIt could be that red meat is a problem because of its heme iron content (that depends in part on how much iron there was in your system to begin with) but, although I would avoid all animal flesh as well as mushrooms in your situation out of an abundance of caution, I wouldn’t blame the red meat for this flare when it could easily be a coincidence.
I would also be uncomfortable about the fungus thing unless there is test actually showing the presence of fungus in your body (which is a thing that can happen).
I obviously can’t tell if you have gout or something else and can only recommend you agree to more tests if a doctor recommends any but since you are already taking allopurinol, you might as well behave as if you had gout as long as a different cause isn’t proven. If you have gout, your troubles should go away if you stick to allopurinol. If you were to doubt you have gout then, you’d always be able to quit allopurinol to see if your symptoms came back (it usually takes a while).Hi! I’m sorry but you need to explain yourself better.
When was your uric acid tested and what were the exact results (numbers come with a unit)? I can’t even tell if the values you’re talking about were obtained while you were on allopurinol (assuming that’s what you mean by “AP”) or not (which makes a world of difference!).
Likewise colcihcine does not perform miracles. You need to taken enough of it for long enough (and even then, it’s certainly no cure-all). For all I know, you’ve been taking it incorrectly.
You also don’t say what other drugs you’ve taken.
Finally I don’t know what you call eating “appropriately” but since you mention red meat, you may not know how gout sufferers should eat.
