My current gout, so annoying again.1 big trigger cause.

[Phil]

Hi just a word on my current gout symptoms,currently been suffering constantly up and down for 6 weeks.lowest level was 6.1 now 10.1 and painfull.I get my gout in my right toe and struggle to walk also I get sharp shooting pains from my toe up my leg.i went the doctor and he gave me 3oo mg a day allopurinol, I made a big big mistake of taking this while my uric acid level was around 6.5, doctor didn’t say any different, within 2 weeks the pain started, went up to 8 mg, went back the docs he gave me 300 mg.twice a day of NSAIDs could not wait for theses to kick in. 4 days later relief,anyway had these for two weeks, stopped them pain returned again,no allopurinol since on NSAIDs either, so back the docs, he put me on stronger NSAIDs a different type for a week 500 mg twice a day, I also take lansroprazole daily with these as they can cause stomach problems. Next finished these the pain was gone from a 10 to a 2, made the mistake after a walk around a park of having a ice cream, wow 3 hrs later I was in so much pain,toe swelled up more than ever and gout reading up to 10.1. So back the docs Asaph next day, prescribed me 30 mg oral steroids for 5 days, now on my 3rd day and pain gone to 40 percent now, so I am on a good gout diet and avoiding all things bad, not touched any drink for 3 weeks or so and trying as hard as I can to get my level down to below 5, so I can start the allopurinol on a lower dose. So frustrating and will be avoiding ice cream for me in the future. I have lost a little weight even though I am not overweight and feel mor healthy with my diet.i also have been taking montmorocy cherry capsules daily from the health shops. I believe these help in a way. Any one else had to take all these mess just for relief. Thanks Phil.

[Paul]

Colchicine and Naproxen works for me.

[Keith Taylor]

There’s 2 issues, Phil. One is treating uric acid. The other is treating gout pain.

Uric acid treatment is long term. There are times when a drop in uric acid can trigger an attack, but the answer to that is to treat the attack. Get uric acid below 3mg/dL and you turn the tables, because most crystals dissolve so fast they don’t get time to trigger an attack. You have to help this with sufficient hydration, and avoiding prolonged exposure to cold.

As Paul says, colchicine and naproxen are good combinations for gout. I’d also add paracetamol in extreme attacks, alternated with the naproxen (or other NSAID). Personally, I think steroids should always be a last resort for gout sufferers, because they destroy your body’s natural ability to fight inflammation.

Remember, with allopurinol, there are 2 things guaranteed to make gout worse:

• Starting and stopping it
• Insufficient dose

[Phil]

Cheers,every bit of information helps Keith, I have just finished the 5 days steroid course, the pain has eased but not fully, my toe still bulges out at the side, got some naproxen so will goon these for a week or so and take colchicine when required. My problem starts when I come off the drugs, the pain reoccurs. Fewmonthsback my level was 6.7 and going good last week it was 10.1 and in pain but today it’s 9.1 hopefully drinking all this water will help… How long can you take naproxen for as I take mine with a 15 mg lansroprazole due to past stomach issues. Thanks Phil

[Phil]

Hello Keith. My doctor advised me that I need to get you Uris acid level down to below 6 before I start the allopurinol again. I went on it 8 weeks ago at a level of 7.5 mg but had a massive pain attack in my big toe,so off I trot to the doctors, he told me to come off the tablets after a week on them and have been having readings at the hospital blood tests as high as 10 in the last 6 weeks. It is now 8.8. I was put on NSAIDs and oral steroids as I couldn’t walk much and the pain was severe. I am doing my best with my diet and avoiding all beers. I do have a few ciders at the weekend or one or two vodka and cranberry juice maybe 2.my drinking as gone to nothing as I used to love my bitter and 30 pints in a week was the norm to me.now 2-3 ciders. Miss my beer tho ????… I am still learning with my gout and taking on board all the great advice on here from everyone and also will try to add my bit if I find anything interesting that helps my gout attacks,this one has gone on for 7 weeks now and I think you are correct in saying that yes the tablets just mask the pain and not help in any way to rid the thing. I blame my doctor for ill advice starting me on 300 mg of allopurinol whilst my reading was high. Hopefully this attack will resolve and my levels will lower off soon. When my level drops to 6mg is it best to start say on 100 mg for a month or so and go up another 100 the next month and so on till I reach 300 mg in 3 months then stay at this level for good.. I have it in my head this current attack which won’t go away was started by going straight in by my doctor on 300mg. Maybe I am wrong. The frustrating thing for us gout sufferers is there isn’t a tablet you can take for it like a headache and it will just go.here to listen learn and help others if I can cheers Phil

[Keith Taylor]

Hi Phil,

I hope you don’t mind, but I moved your last post here from the Beers and Cider discussion. I know beer is something we can discuss, but there’s a much bigger issue that I think we need to sort out first.

People sometimes accuse me of pushing allopurinol too much. I don’t like to do that, but for many gout sufferers there is no alternative for lowering uric acid.

You seem to be saying that you need to lower your uric acid so that you can start taking allopurinol. I’m sorry if I’ve misunderstood this.

Now, it’s a great thing if you can lower your uric acid by diet changes. Some can, but most can’t. I tried and failed miserably. Here’s what I don’t understand:

If you can lower uric acid without allopurinol, why would you need to take it?

[Phil]

Hi Keith do I need to be completely clear of gout pain and my Uric acid reading below 6 before I start the allopurinol. Want to go back on it ASAP but struggling getting my reading down. I am back on NSAIDs 500 twice a day and colchicine,also trying the baking soda twice a day to alkalise better. Thx

[Keith Taylor]

If you get uric acid below 6, why do you need allopurinol? That’s what it does. I’m still confused.

[Phil]

Ok seen a different doctor today my blood test was around 7, still in pain. He has started me on 100 mg alpurinol and colchicine twice daily, the pain started when I was on 300 mg and the other doctor gave me bad advice to stop taking them as soon as I got a gout attack,he should not have done this.what seems to have happened is the Uric acid in my big toe have hardened to tophi and are stuck there, hence getting on the allopurinol straight away. Once my level comes down hopefully in another month I am going for a blood test again and then going up to 200 mg a day and move up monthly to 300 mg and stay at that, anyway that’s the new plan,also come off the naproxen straight away to give the kidneys a rest. Hope this makes more sense. Thanks

[Keith Taylor]

Belated thanks for the update, Phil.

I can’t believe that a doctor in this day and age would suggest stopping allopurinol at the onset of a gout attack!

It must be nearly time for your next test?

It sounds like a good plan to me, except that there is no need to stick on 300mg allopurinol per day. There are very strong arguments for increasing the dose to get uric acid as low as possible. The most important thing though is to get lower than 5. If that requires more than 300mg, then so be it.

I didn’t realize naproxen is a kidney risk? I thought it was just heart and stomach related problems. Your comments made me take a look at http://www.niddk.nih.gov/health-information/health-topics/kidney-disease/analgesic-nephropathy-painkillers-and-the-kidneys/Pages/facts.aspx

It looks like that’s yet another reason for controlling uric acid as soon as possible.

[Author]

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