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Question about gout: Hello, I am currently on the Allopurino treatment to bring down my uric acids and hopefully rid myself of these horrible gout attacks. I have been on the treatment for a month and a half and suffered 2 major attacks in the short period I have been on it.
My questions;
Is it normal to suffer these attacks while on the treatment and it is ok to take Colchicine to help bring down the pain and inflmation?
How long will it take while on the Allopurino treatment to bring down these uric acids and after say 6 months of treatment can I start eating regular food again (by regular I mean gout inducing foods like red meat, poultry, alchol).
Thank you very much and I look forward to your response.
Firstly,
I LOVE your name. Like a Shakespearian character with a sore foot!
Yes, it is normal and unfortunate that these attacks tend to accelerate a bit when allopurinol first starts to do its work (I was lucky and had no major attacks from day one of allopurinol.)
Yes, it is fine and WISE to take colchicine at the first tingle of an attack. You can get quite good at learning the exact minimum of colchine to abort the atttack…sometimes ony 2 at the first sign, sometimes 4. Wait too long and its LOTS of colchicine. It seems the more tophi you have the longer it takes for allopurinol to get completely in control.
I assume you're on the “generic” dose of 300 milligrams/day?
I think you could start eating “normal” food now and trust the allopurinol top do its work. It was for times WITHOUT allopurinol that people got these dreary stringent dietary restrictions. Just don't go overboard with booze, small fish, and organ meats…but even they can be eaten in moderation. But lots of veg and fruit never hurt anyone either.
ROFL,
“It is the Procounsel, Oh Caesar, along with his aide, the Probenecid! They crave audience to herald their defeat of the HUN chieftan, Uric the Terrible!”
Alright, what can you do with Paul Bunion?
zip2play said:
Firstly,
I LOVE your name. Like a Shakespearian character with a sore foot!
Yes, it is normal and unfortunate that these attacks tend to accelerate a bit when allopurinol first starts to do its work (I was lucky and had no major attacks from day one of allopurinol.)
Yes, it is fine and WISE to take colchicine at the first tingle of an attack. You can get quite good at learning the exact minimum of colchine to abort the atttack…sometimes ony 2 at the first sign, sometimes 4. Wait too long and its LOTS of colchicine. It seems the more tophi you have the longer it takes for allopurinol to get completely in control.
I assume you're on the “generic” dose of 300 milligrams/day?
I think you could start eating “normal” food now and trust the allopurinol top do its work. It was for times WITHOUT allopurinol that people got these dreary stringent dietary restrictions. Just don't go overboard with booze, small fish, and organ meats…but even they can be eaten in moderation. But lots of veg and fruit never hurt anyone either.
I've stated before that my doctor wants me to take the 24 hour urine test to determine whether i am over-producing or under-excreting before putting me on medication. i have read that 90% of gout sufferers are under-excretors and 10% are over-producers. Allopurinol if for over-production and Probenecid is for for under-excretion, right? If that is true, why are so many people on Allopurinol?
My other question is, just how normal of life do you live when on Allopurinol that gets your uric acid under 5 mg?
The results from my 24 hour urine tests are in and my uric acid production was insanely low, like almost zero according to my dr. he has prescribed probenecid. i think my concern over that is the much smaller volume of information available about probenicid on Goutpal. can anyone give a testimonial about it? should i start a new thread?
I started taking allopurinol about ten weeks ago. Ten days 100mg, ten days 200mg and 300mg/day since then. My previous experience of gout were isolated pain and swelling in the big toes, occasionally a stiff knee – although this only started happening just before this last Christmas. This last festive period was completely written off by a mega attack in my right big toe – being on vacation I was away from my doctor, and was unable to get immediate access to the diclofenac sodium (NSAID) which I used to alleviate the symptoms. It was shear hell. When I did manage to see a doc away from home, it took a good week of 150mg NSAID per day to calm things down. That was the final straw, and in mid January I visited my own doc and basically said gimme the drugs !!. I was prescribed alloprurinol and built up to a dose of 300mg/day. Since starting allopurinol, I've had gout attacks in places I've never had them before – my ankles, both knees, my fingers, my right elbow – if I hadn't read up on the likely hood of things getting worse before they got better I'd have chucked the pills in the bin. It was about six weeks before I was able to stop taking the anti inflamatories. I had one week free and then the pain returned – albeit with a lesser intensity. Back on the NSAID. My uric acid level was least tested two weeks ago, and it is down at 4.8 mg, the attacks are still continuing even at this low level – I put it down to the dissolved crystals coming out for a final fling. I consider that the worsening is a sign that things are moving in the right direction – just like descaling an old kettle – all sorts of cr*p will come out before things clear up !…… at least I hope so.
43 yrs old, first gout attack prob about five years ago,maybe six, and no major tophi – although my main big toe joint on the right foot (where Ive had the majority of my attacks) is larger than the left, so maybe there is something tophi-wise in there.
Quote:from APcoach: Allopurinol if for over-production and Probenecid is for for under-excretion, right? If that is true, why are so many people on Allopurinol?My other question is, just how normal of life do you live when on Allopurinol that gets your uric acid under 5 mg?
From what I undersand, people are put on allopurinol becasue it has far fewer side effects and even if you underexcrete, if you can be made to produce less uric acid you'll improve your numbers. My life under 5 mg. is perfectly normal with no acute attacks.
Stevo,
My right bunion joint where I had my one and only toe attack is ALSO somewhat larger and I attribute it to a tophus…but then it COULD be a bunion. My only other visible tophus is a small one on the end joint of my right little finger. It sometimes aches slightly.
i have read with great intrest of the many quertions and answers regarding gout i was diagnosed with gout about five yers ago and was put on allopurinol strait away and for those years i have been almost gout free but just lately i have had some really acute attacks of gout having talked to some friends and read some of you`r answers on this site i am begining to think that the 100mg of allopurinol i take daily is not enough as with some of my friends they are taking at least 300 mg dailly i also take diclofenac for the pain as colchisine upsets my stomach as soon as i start to take them is it best to put up with the bad stomach and take colchisine instead of diclofenac as colchisine gets rid of the ulric acid diclofenac dose not i am at a loss of what to do but at this moment in time i have gout in my right ankle left knee and toes on my left foot and a twinge in the fingers on my left hand i have both diclofenac and colchisine tablets can they both be taken together or is it one or the other. (regards david bennett.)
Hello again folks. It was the wise advice here in these forums that finally drove me to start Allopurinol, back in March I think. I've been on 300 mg daily from the start, the Doc didn't ramp me up with low doses at first. My uric acid level a month after starting had dropped from 9.6 to 5.3 Haven't had another uric acid test since then. Had several minor attacks in many joints previously affected by gout after starting the meds, but they stopped within two or three months.
Life's been a lot better, until 1 month ago when I got a pretty bad gout attack in the left big toe, which I got over quickly, within 1.5 weeks. Then 11 days ago, BAM, another attack, very bad, in my right knee, just got off crutches a day ago.
What to do now that attacks have started again despite 300 mg Allopurinol per day?
Get another UA test? Ask doc to increase Allopurinol dosage?
The doc said I shouldn't ever have another attack after starting Allopurinol. Do you guys still get attacks occasionally?
Thanks in advance for any input you might offer.
You hit it right on the head. I would get a UA test. What good is 300mg if you have UA above 6 at times? It sounds like you might be right on the threshhold of the correct dosage.
Apologies to David Bennet for not approving until now (hint: registering and logging in prevents delays)
To you, and others here, perhaps it is time to name and shame those practitioners who prescribe uric acid lowering treatments but do not back it up with uric acid checks.
Not only is under-dosed allopurinol pointless, it can put you through hell.
The only purpose of allopurinol is to get your uric acid level below 6mg/dL. Nothing else matters.
It is so simple, my 3-year old granddaughter could understand it. Why can't the supposedly qualified idiot whose earning thousands?
Any medical negligence lawyers listening?
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