[Patrick]

Jaime,

I would have insisted on a blood test if you think you have Gout. In all honesty, staying off red meat and beer for 4 weeks isn’t going to change the fact that your Uric Acid is above the “safe” level. If indeed you DO have Gout, you got this acute flare up because your Uric Acid spiked and your body response was to attack the area.

Delaying a blood test for 4 weeks may show a reduction from the initial attack levels, but chances are your Uric Acid levels will still be high and you will still be susceptible to future attacks. Your doctors logic is silly.

Go insist on getting it checked so that you have some sort of initial baseline so that you can get on the road to recovery sooner rather than later.

[Patrick]

Hey dq, buddy. Sorry I haven’t been around much. Summer in Los Angeles is a bear, and with wildfires burning all over the state, our Fire Department has been bouncing around all over. At one point, didn’t see the wife and kids for 11 days!!!

Anyway, back to the quetion. I have had major flare ups in both summer and winter. It didn’t matter. 2 of my biggest flare ups were in Summer, and 1 major one was in the dead of winter. I’m not really sure what the scientific correlation is, but I have some theories, at least as it pertains to me personally.

In summer, hydration is key. I find myself drinking tons of water, especially during fire season. BUT…I found when I didn’t stay hydrated, I would get an attack. In LA, it can easily top 100 degrees for weeks. It is imperitive to stay hydrated. That is one aspect. Another….summer is a time for more outdoor activities, which leads to bad eating and drinking habits. Again, me personally, not you per se.

But I also have a winter home in the mountains. I love to snowboard and have been in temps well below freezing and I never found a link between cold extremities and Gout, even though Keith has mentioned this before. I do know that your bodies metabolism slows when the weather is colder, but I haven’t really read up on the link between cold and Gout. I used to sleep with socks on in the winter to prevent my feet from being cold and hopefully preventing attacks. Not sure if it actually helped though.

All I know is before I controlled my Uric Acid with Allopurinol, I was so hyperconcerned about preventing attacks that it didn’t matter where I was, or when it was. I just was really prepared for it. Hope all is well.

[Patrick]

Hey Colin,

I’m a little late to the thread but I have read it in its entirety. Glad to see you went to seee a doctor instead of self diagnosing. Now you have an answer, and this will start to lead to a plan, like Keith suggests.

You say you have been a Gout sufferer for over 30 years but in reality, it might be even longer. You probably have been a Gout sufferer for 30 years, but may have been a Gout patient for even longer.

I know you are leery about taking medications, but starting to tackle your Gout with 100mgs of Allopurinol WITHOUT the safety net of Colchicine can be tricky, especially for a long suffering Gout patinet like yourself. Your body is trying to rid itself of over 30 years of Uric Acid crystal build up in your joints. Allopurinol, in conjuction with Colchicine is a normal “tag team” combination for new Allopurinol users.

You might want to ask your doctor about it, before you experience your first major, post Allopurinol, flare up. You won’t regret it. Good luck, brother

[Patrick]

Eric,

I have taken Allopurinol every day for over 18 months and I’ve never felt tired, groggy, or not alert. With most medications, the drug producers have to disclose every POTENTIAL side effect, and more often than not, drowsiness comes up quite often. Allopurinol also may cause upset stomach, and other GI problems, but I haven’t had any of those either.

I take my dose in the morning simply because it’s easier for me to remember to do so. Like Keith says, it really doesn’t matter when you take it because of the long acting period in the body.

[Patrick]

My “pitch” for Allopurinol use

As a Gout sufferer for over 5 years, my story has been told on this site several times. Long story short, my Rheumatologist was very reluctant to put me on Allopurinol. I literally had to DEMAND it, of which, he finally obliged.

I originally started on 100mgs, but was bumped up to 300mgs 2 months later, as we were not seeing the results we had anticipated. Fast forward to today and my quarterly blood results are in:

Uric Acid: 4.1
Blood Glucose: 70
Cholesterol: 132
Liver enzymes: Normal
Kidney function: Normal
White Cell count: Normal

Body weight: 167 lbs

In 18 months of taking Allopurinol, my Uric Acid has dropped from a high of 9.6 in January 2016, to 4.1 in June 2017. I lead a normal life, I drink occasionally and eat red meat (what!!!????) in moderation. This lifestyle would NEVER have been possible without Allopurinol. I tried the lifestyle thing. It didn’t work. I tried the Vegan thing. It didn’t work, as a matter of fact, my Uric Acid got WORSE…from 9.2 to 9.6.

The bottom line is this (especially if your Uric Acid is really high like mine was)..medication is your only option. ALL MEDICATIONS have side effects, and yes, I read the thread about the sexual problems on the other post, but me, personally have yet to experience ONE side effect. None. Maybe I’m lucky, who knows. But I lead a normal, Gout free life so far and I intend to keep it that way by doing what I’m doing, along with exercise and proper healthy choices. Keep that in mind when you are trying to decide what you want to do to combat this Gout issue.

[Patrick]

d q,

All is going as good as I expected on the home front. My fathers issue is terminal, so we just wait…

To your questions…Methylprednisone is ONLY taken during an acute attack. As soon as the attack starts, you start the 6 pill (day 1) dose. I would normally take 4 as soon as I felt pain, then the remaining 2 about 8 hours later. Then 5 the next day, then 4, then 3 and so on until you are done in 6 days. Usually after the first day, the pain is gone but you MUST finish the 6 day pack.

I took Colchincine in conjunction with the Z-pack and Naproxen. My dose was 0.6 mgs. I would take 2 to start, then 2 more 8 hours later. That was my plan and it worked for me. Consult your Rhuemotologist of course, before you start this plan.

[Patrick]

Hey Brian. Well this is a great place to start to gather information.

Lets start with the obvious question…when you say your “acid levels came back elevated,” what exactly were they? Elevated is a very vague. I think anyone here would ask that question, because there is a pretty big difference between “elevated” and “high.” The good thing is you are 28 years old, and if indeed you do have Gout, the damage from excessive Uric Acid is probably minimal. Also, if your Uric Acid is just a little over the threshhold, maybe some lifestyle changes can help you. That’s why it’s important to know exactly where your Uric Acid levels are.

You also mentioned that your dad had RA…there are some similarities to RA and Gout. The symptoms can mimic each other. Gout, can also be passed down from generation to generation, so it’s important to know if your father did indeed have RA, or if he was ever tested for Gout.

As for your question about what you can do for your condition…it seems you already have some information (and mis-information) about Gout. This all depends on where your Uric Acid levels are. If they are in the low end of “elevated”, some lifestyle changes can help you. Change in diet, limited animal proteins can help. Limit your alcohol intake (and ESPECIALLY all but eliminate drinking COKE with your Whiskey). Fructose and Sucrose are not good for a Gout lifestyle. Vegetables can be your friends. Hydrate your body, and keep it hydrated. And keep exercising. Keep your weight down. Keeping your weight down not only helps with your overall health, it helps keep your supporting internal organs healthy. Your liver and kidneys especially. Elixers, such as Cherry Juice, celery pills, lemon water, etc. may have benefits, but if they do, it would minimal. The are probably doing more for your overall health, as opposed to what they are actually doing for your Gout.

There is a handy “Google Custom Search” box in the upper right hand corner of this page. You could probably find the answer to just about every question you have in there. Or, you could follow some of the threads here and realize that a lot of people out there are just like you, going through exactly what you are.

Most of us here would suggest visiting a doctor to have them explain where your Uric Acid levels are, and where you kidney and liver functions are. If your levels are indeed high, medication may be in your future. But all that can be answered after a consultation with a doctor. Hope this helps.

[Patrick]

d q,

Hey buddy. I’ve used that 3 step plan before, but I include a 4th step and it works for me. I have always preached the benefits of Methylprednisone (Z pack). I keep one with me at all times, just in case. It’s a 6 day, progressive antibiotic, that I find if taken at the first onset of gout pain, flood the body with Methylprednisone and it’s gone. Early.

Some won’t (or can’t) take it. I understand that. It works for me, so when I used to get acute flares, I’d hit the pain with a mass dose of Methylprednisone (4 tablets immediately, then (2) 4 hours later), 2 Colchicine tabs, and 2 Naproxen (Pharmacy grade) along with my Allopurinol dose. That was my formula, but knock on wood, I haven’t had to do it in over 18 months……and counting.

Hope all is well my friend.

[Patrick]

Holy crap, Pete. You and I must have the same doctor. The only difference is my Rheumotologist said he would put me on Allopurinol after 3 Gout attacks in a year. Like nobody says in the above post, this isn’t sound advice from a doctor, unless this doctor is basing his/her advice to you from blood work that comes back questionable. And by questionable, that would be taking into account liver function and kidney function numbers. The decision to put a patient on a medication for potentially the rest of their life should be discussed between the two, with the caveat being that the patient will continue to adhere to monthly, then quarterly, blood work follow up. Period. If the patient agrees to this, then write the damn prescription and see the person back in a month, to start.

I still scratch my head wondering why I had to endure 4 unnecessary (in my opinion), excrutiating Gout attacks just to fall into this “mentality” of my Rheumotologist. It wasn’t until I went in and DEMANDED to be put on medication, that he finally listened, and I haven’t looked back.

I don’t know anything about home Uric Acid meters, so I will defer the knowledge of those to people who use them. I will say your doctor did give you SOME sound advice. Exercise, losing weight, quitting smoking, and eating healthier will help to lower your Uric Acid somewhat, but it will definitely help your overall health. Stick with that advice, along with proper hydration.

[Patrick]

anyway, sometimes I m thinking how perfect is the human body, what makes this kind of “errors” to appear.?!

Not Sure Rich. I do know that with blood and lab tests, that the technicians only have a certain amount of time to test the blood samples. If blood sits for a little while, false reads can occur. If blood sits for a LONG time, the results can be really out of whack, especially the potassium level results.

I’m not sure what can cause “errors” other than the only ones I’m familiar with….the human kind.

[Patrick]

Cookie,

I would listen to what these posters are telling you, especially d q. His advice is spot on. While your Uric Acid is really high, you are a ticking time bomb. You didn’t state your age, and age plays a role as it pertains to Gout attacks. My Uric Acid was always high, Every physical I had for work, my Uric Acid was always above 7, and the doctor would ask me if I had ever been diagnosed with Gout. I said, “No, never. What is Gout? Is that the condition drunk people get?” I didn’t know jack squat about Gout, and thank God I found this place.

Fast forward to age 44 and BOOM…I suffered my first Gout attack (my Uric Acid was around 9.6 at this time). My Rheumotologist did EXACTLY what d q said. “Let’s wait and see if you suffer more than 3 per calender year.” That is really horrible advice in hindsight and let me tell you why…just because you are not suffering Gout attacks, doesn’t mean your Uric Acid is getting better. It’s getting worse. It’s getting higher and with high Uric Acid comes attacks, and potentailly bigger health problems such as liver disease, heart disease, and kidney problems.

Again, I don’t know how old you are but if that profile picture is you, you look young. If it’s not you, I apologize but don’t confuse high Uric Acid and the lack of Gout attacks as not having Gout. Take care of that high Uric Acid BEFORE you get an attack and you will thank us later. I promise

[Patrick]

Rich,

I’m not a doctor but I’ve been reading and learning a lot about Bilirubin levels because my father is battling liver cancer and because of it, his Bilirubin levels are through the roof. Yours are nowhere near where his is, but then again, I don’t know what the number would be to raise a red flag. That would be a question to ask your doctor or your Rhuemotologist.

I’ll just give you a number. Normal Bilirubin for a “normal” person should be less than 1. My fathers is 23. That’s for perspective. BUT, as I said, I don’t know what would raise a red flag for a doctor. Just keep up on it because aside from the brain and heart, the liver is #3 in order of importance to the body.

[Patrick]

Rich,

I’ve been reading this thread and haven’t chimed in yet but when I see the word “Bilirubin” in it, I perk up. High Bilirubin in the body could be the sign of a bigger issue, some of them Liver (or possibly Pancreas) related. Anemia may be a cause, but please make sure to get your Liver checked if you have excess Bilirubin, before you start presenting with Jaundice, even though thats a later sign.

I’m going to pay attention to this thread. I’m very interested in it.

PS-dq, check your topic on General Discussion, buddy.

[Patrick]

My doctor says this is coincidence and a gout attack always comes on without warnng

I’d say your doctor is nuts. Early on, my Gout attacks would occur without warning. But as I have dealt with this for several years now, I know what to look for and, more importantly, what to feel for.

Fabian, as soon as you start to get “mildish aches” hit that quickly with Colchicine and Naproxen, preferably pharmacutical grade, but over the counter will work. Take max doses. That should help squash it.

For further information, look up in the right hand box of this web page to “The Gout Search” and type in “2 hour Gout Relief” or however you want to phrase it, and Keith has some great tips on how to kill that Gout Attack quickly. It sounds very similiar to what I just advised you.

[Patrick]

Welcome Don. I also have never heard of Gout flares taking place in an area that isn’t typically a joint. Like Nobody says, you might want to do follow up on that. Depending on where that pain is (under the ribs, near the sternum is kind of generic) it could be one of many other things. Gallstones, Pancreatitus, or something else.

Follow up with a doctor. You don’t want to mess with the thoracic cavity area. Lots of vital organs and vessels in there.

[Patrick]

My only concern is my dosage (100mgs twice a day) because of my really high levels of SUA I have a feeling this might not be enough. I know my target should be 5 & under, but how long does it take to get there if this is the correct dose? I will be getting blood work done in 2 to 3 weeks to see where I’m at.

Ruben, I know I’m a litle late to the party here, but as Nobody says, the answer to your question is “nobody knows the answer to that.” Everybody’s body is different and unique, and based on a myraid of factors, a person’s Uric Acid is affected by a number of things. Body Mass Index, overall health, how long a person has had crystals in their body, etc.

You basically answered your own question when you say you will be getting your blood work checked in 2 to 3 weeks. This is the only way to know where you are at in regards to getting results. This is the ONLY way. No doctor, rheumotologist, GP, or internet friend, is going to give you a definitve hard line answer to your question based on the number of intangibles I stated in the paragraph above.

Keep doing what your doing, and follow up with periodic blood tests and you will see where you stand. Good luck and keep the forum posted.

[Patrick]

Hello Gavin. Welcome to the best Gout site on the web. It sounds like you got the right man on the job with Keith, and listen to what he says, as well as the others who are experiencing many of the same issues as you. Of course, like anything, some will do what they want to do….i.e. Herbs, juices, holistic medication, etc.

I won’t reiterate what the Keith has already said, but I will tell the one thing that I preach… GET HEALTHY, buddy. First off, there is absolutely nothing wrong with putting down a “few ales.” Honestly, I do the same myself. But one thing you mentioned was that you were “no doubt overweight” and this can be an issue, buddy. It looks like you are already addressing it by posting your new diet plan, but couple that with a light exercise plan to go along with that. Walking and swimming to start. Basically any aerobic exercise to get your heart to a target level, and sustain it for a period of time. As you get more acclimated to that, stretch your distance, or challenge yourself. Try a hike, or light jog. Maybe biking, which is easier on your joints. Either way, proper diet, proper hydration and exercise will not only help your Gout, it will help you with any other potential issues you may face in the future.

Keep the posters updated on your progress and as always, good luck buddy

[Author]

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