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Surely there are also dietary differences between the UK and your ancestral country.
And mild or chronic gout is often misdiagnosed.There are links between D deficiency and many diseases, but it’s typically unclear if D deficiency contributes at all to these diseases. Indeed, a third factor (such as lack of physical activity) could cause both D or the disease.
And even if D deficiency directly contributed to gout, I’m not aware of any evidence that D can cure it.
That said, it would make sense if D deficiency had a connection with bone-related gout complications and I would be interested in looking at any D/gout studies.If there is no gaps or they are short, you might as well start allo as soon as you get your genetic test (if applicable) and baseline blood tests done (unless you already have the data).
People who do have long gaps between attacks or who only had one attack thus far should indeed wait until symptoms are completely resolved (and then some) before getting that baseline blood test and starting allo but if you’re having attacks all the time anyway, the timing is irrelevant.2 attacks per years is a problem because that’s more than zero. The longer you don’t fix this, the higher the risk of complications.
One of the milder complications is attacks every other week. People often get something like this without taking D. That said, I have no idea what D2 might do (I take lots of D3).Hi!
Gout attacks getting more frequent is the expected outcome without effective treatment so there is no need to look for an explanation.
How bad was your deficiency?
You probably are still having “offending” foods by the way but that probably makes little difference unless your uric acid happens to be just right. You can’t expect a dietary change to have much of an effect so quickly anyway.
Why don’t you simply take allopurinol or something and cure your gout?Thanks but this is Keith’s site, not mine.
Yes, starting allopurinol can potentially be a trigger but this issue is somewhat overblown. I’d say it’s less of a concern if several blood tests have produced results in the 6.5mg/dl range in the past.
What really matters is that allopurinol takes a while to work, even when the dosage is adequate. So people’s expectations must be tailored accordingly. And if the “this can trigger flares” message works better than the “you’ll need to take this every day for a surprisingly long time before flares stop”, I can’t blame people for going with the former.There are other anti-inflamatory options than naproxen-type drugs or prednisone which has its own risks. A rheuma could perhaps help but considering the special concerns with side effects and interactions, a few doctors may need to discuss the issues among themselves.
Any drug your husband was or will be taking for other problems (blood pressure in particular) should also be evaluated for adverse effects on uric acid.
Dietary anti-inflammatories could easily be more dangerous than the drugs. They’re typically fine for healthy people but I would be very careful in this case.
You also need to have a real painkiller on hand if at all possible. Don’t let the doctors look the other way! They don’t feel the pain and don’t see it in their numbers so you sometimes have to be an annoyance.You should evaluate the diet as a whole instead of focusing on one thing like fructose but in this situation I would quit all sweetened drinks, regardless of sweetening agent. It’s hard enough to settle on diet which is both nutritious and uric acid friendly without complicating the matter with products which have no nutritional value.
I have no idea what would or would not be appropriate for this kidney problem but most gout sufferers should drink a lot of water and avoid diuretic foods, drinks and drugs. So unless you know that an additive is safe, beware.Good luck!
Hello,
Obviously I can’t tell if this might be gout over the Internet.There are other diseases which might look like gout. But I can tell you that 6.5mg/dl (is that the unit on the lab report?) is enough uric acid for someone to have gout. If the doctor doesn’t understand that normal is irrelevant, ask to see a doctor who understands gout such as a rheumatologist!
Considering all your husband’s health issues, some gout treatments might not be advisable, and the same goes for pain relief. But Tylenol is in my opinion much too weak for a gout flare! There are many types of drugs which can alleviate a flare or simply help with the pain so you should harass doctors until all remedies have been explored. Trying a drug people take specifically for gout such as colchicine might also help with diagnosis.I could give you some information about diet and uric acid you would most likely not get from doctors but it is probably more important to tailor your husband’s diet to his other health issues and his kidney problem in particular. That said, some changes such quitting alcohol should have no downsides.
I don’t understand what you’re looking for. I hope you aren’t going to advertise snake oil here!
Do you want me to tell you that managing gout starts with measuring the amount of uric acid in your blood?
Do you want me to tell me that you that the longer you are having symptoms, the higher the risk of complications is and the harder it will be to stop the symptoms?
Do you want me to tell you that everything you eat matters (beef isn’t special for instance)?I can’t say I’ve had such a bad experience with gout treatment but my dosage was initially very aggressive and I had lowered by uric acid levels for many years through diet before moving on to drugs.
What I can say though is that allopurinol doesn’t work that fast, unless you start it as soon as you start getting attacks perhaps. If you’ve let gout fester for years before taking it, you’ll need patience to get rid of it. 4 months isn’t much when it comes to this disease.Checking your uric acid and increasing your dose if it’s not low enough is the right thing to do, assuming of course your liver can take it and you’re not suffering from other dangerous side effects.
But maybe you could also do better when it comes to treating your symptoms. I don’t know how much colchicine you’ve taken or what other drugs you take so I can’t suggest anything specific but do consider and discuss with your doctor(s) a more aggressive and comprehensive approach to suppressing attacks (again, if your body can tolerate that).You can have good kidney function and still have gout. I understand this is actually typical when it comes to young gout sufferers.
There are different reasons why one’s uric acid might be high, some of them avoidable and some genetic.
But since your uric acid seems to be “extremely high”, maybe there are several causes combining to make the problem especially bad. So perhaps you are more likely to have a kidney problem than the average gout sufferer. Depending on how high exactly is “extremely”, it might be prudent to ask your doctors to perform whatever tests they can to make sure they’re not missing a serious problem which could in time cause more problems than just gout.I said “the one people usually take” instead of allo because I didn’t want to suggest specific drugs since that’s your doctor’s job, I don’t know your case anywhere as well as your doctor and I don’t know which drugs are available or how much they cost where you live. But like I said above, there is an alternative that works just as well and would arguably be safer for you so allo might not be your doctor’s first choice.
Unless your case is unusual, your doctor will most likely suggest allo or that alternative so I do not expect you’ll have to push for anything. If your doctor doesn’t suggest either, they’ll probably have a good reason not to so listen to them anyway.Hello,
Sure, your symptoms aren’t typical of gout. But non-typical symptoms happen.
Developing gout at 33 or younger seems quite common as far as I know, and you don’t need to have kidney disease to get gout (though it would be prudent to rule out such a disease).
For what it’s worth, I’ve gotten the patella misdiagnosis as well as the strangely self-spraining ankle. I haven’t got something that looks like a bunion but if you have enough uric acid, I guess you could get a tophi that looks like a bunion.
Gout treatments work very slowly so you’ll need to be patient but in time, you’ll know if all the problems you’ve experienced were caused by uric acid or not. In the meantime, it might be prudent to investigate other explanations (just in case).Extremely high levels in the blood plus crystals means you would probably benefit from gout treatment even if you do not actually have gout because these crystals are a problem anyway and you’ll probably get more and more without treatment. You also are at risk of developing gout as long if you don’t already have it. Treatment might actually trigger gout but even if it does, you would probably have ended up with worse problems without treatment.
The one thing to be careful about with gout treatment is the side effects. Some people get bad reactions and the doctor may offer a genetic test or a less risky drug than the one people usually take for gout. Whatever drug you get, start with a very small dose, report anything strange to a doctor and get tested for hidden side effects such as liver toxicity. Hopefully the doctor will take care of all this and more but I’m warning you just in case the doctor you’re seeing Monday isn’t very careful.Yeah, 19 years old is unusually young. I was hoping you had less than 6 or 7 years of untreated gout. With such a history, you may need some patience with the treatment and it’s especially important to make sure it makes the amount of uric acid in your blood fall to a sufficiently low level.
One benefit of your age is that you can probably tolerate most drugs better than the average gout patient. Maybe it’s different in your country but some doctors see a young man and assume he doesn’t need drugs because he’s strong even though a young man might actually need more because his body processes drugs quicker. Sometimes it helps to be a bit emotional with the doctor to help them understand that the problem is serious.Hello,
It’s great that you’re treating your gout when you’re still young. Make sure your blood tests are showing that the treatment works. Hopefully it’ll all be behind you before long.
If you’d like to keep working in retail, you probably won’t have to give that up. But if you wanted to quit anyway, this would indeed be a good time to try something which wouldn’t require you to stand all day long.If you’ve just started allopurinol, maybe it would be prudent to take something else on top to prevent attacks. Colchicine is the classic drug to take in this situation but people who tolerate anti-inflammatories well can simply take them every day for a while instead.
Taking enough anti-inflammatories at the very beginning of an attack can also make it much less severe so that’s something you ought to discuss with a doctor if you haven’t already (because when the attack comes, you can’t wait for a doctor). This would perhaps allow you to keep working.
Good luck!Hi!
Yes, recurring flare-ups seem pretty common. What definitely helps is patience and lowering the amount of uric acid in your system. What might help in the meantime is a combination of largish amounts of colchicine and anti-inflammatories (or possibly less common drugs which are known to stop attacks). What certainly doesn’t help is neglecting this disease whenever symptoms go away.
You’re reading too much into the timing of your attacks. Gout is a slow disease and you can’t know exactly what caused a particular attack or tell if you’re managing the disease by the symptoms (or lack thereof). For the same reason, allopurinol takes a while to work so you would do best to learn how to manage attacks because you’ll probably still have a use for that skill after you start allopurinol.Hi!
Swelling sometimes lasts much longer.
Be careful because some of the things people (including medical professionals) might advise are inappropriate for gout. You don’t want to disturb gouty joints.
Patience works great but anti-inflammatories work faster. Other than that, anything that promotes blood flow is helpful. That includes more comfy shoes, chairs which do not put much pressure on the wrong places, lying down often, exercise which doesn’t involve gouty joints… and of course the old classics: hot/cold baths/showers/saunas and bathing the affected foot. That stuff doesn’t compare to drugs but the side effects are typically less dangerous. Do take the usual precautions to avoid slipping in the bathroom though ๐ .Hi!
It can take much longer than 8 months for allopurinol to work after gout has festered for so long. But your symptoms should start to improve. Can you take colchicine or regular anti-inflammatories to prevent or at least dial down these attacks?
The most important thing you can do is to make sure your uric acid level is not “normal” but appropriate to your situation. 600mg daily would be more than enough for most people but you aren’t most people and it only matters whether the dose is appropriate for you.Hi!
Gout symptoms tend to be more affected by foot usage than by what you eat and drink, though that varies from case to case (and I’m also assuming people make sensible choices once they figure out what hurts).
If you want, we can go over your symptoms and the basis of the diagnosis. You’d need to quote lab reports and to explain your history in detail because gout is a slow disease. But atypical gout is pretty common and you’ve already started the treatment so I’m not sure there’s much point as long as you aren’t getting serious side effects from allopurinol. The best way to tell if a problem was gout is whether the treatment makes it go away but unfortunately this can take a very long time…
I think I should make the following clear: allopurinol isn’t supposed to stop the pain, only to prevent it after you’ve taken it long enough. Indeed starting allpurinol can make the pain worse for weeks or even months (and that’s assuming you’re taking enough allopurinol! if not, it will never go away). So you should have another drug (or several) for the pain and the (potentially dangerous) impairment.
It is also not necessary for most people (but I don’t know if your case is typical) to make heroic efforts as far as diet is concerned as long as they take enough allopurinol.
The way you know whether you’re taking enough is too look at blood test results.That said, if you have something other than gout then you obviously need to get that taken care of!
What I recommend is therefore to refrain from trying to guess if your problem is gout or not: stick to the treatment now that you’ve started it but also see another doctor about your troubles. Again, the point isn’t to tell if it’s gout or not but to make sure you don’t have another serious problem requiring timely treatment. So don’t ask them to guess whether you have gout or not and stick to the treatment regardless of whether they find another problem or not.
