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It's been 2 weeks since my last visit to the Dr. I was prescribed 100 Mg of Allopurinol at that time. Through tracking my UA levels with my home test kit I found that I'm still around 6.5-7.5. Even though I was told to not come back for 3 months, I went back to the office today for an appointment. I explained my home readings and he told me to increase my dosage to 200 mg for 1 month. If I still did not see levels below 5.5 mg to increase the dosage to 300 mg. He then told me to come back in 2 months for a re test. He did not draw any blood today (but I did get an EKG…yippeee). He also refilled my Cochicine script and told me to take 2 in the morning and 1 before bed only if I feel pain developing.
Your intervention was wise, cjeezy, and it just might have prevented an acute attack or two this month or next. I think 5.5 is an excellent target.
Are you bothering with any of the natural and “healthful” dietary interventions or letting allopurinal do all the work. (I use the latter method :))
Hi Zip,
I've tried all the natural methods such as:
BS and water, cherry pills, celery seed pills, limited diet, Indocin, Vocidin, cherries/strawberries, no alcohol, no strenuous activities. To be honest, none of that worked. I'm on 2 months of pain (not acute anymore), and am sore in about every joint now. Tired of it and just want to live a normal life. I know Allopurinol helps to acomplish this?so its a pill a day for me for happiness. Question, I know Allopurinol loses its effectiveness with alcohol, but does it lose effectiveness with diet? For example, if I ate a lot of seafood (if my UA levels were controlled). Also, how long should I wait to test my UA levels on this increased dose? Does allop immpediately lower UA the same day or does it happen gradually over a couple days?
Allopurinol doesn't exactly lose its effectiveness when confronted with high purines like a fish diet, it just has more to do and cannot keep up with all the xanthine oxidase produced. Xanthine oxidase is produced to convert purines (purines>>xantnine eventually) to uric acid and this enzyme is fooled into wastinfg it's efforts oxidizing allopurinol to oxypurinol instead. (Allopurinol is almost identical to xanthine.) There is some evidence oif several other routes by which allopurinol lowers uric acid.
Don't hold me exactly to precision here…I need to brush up on the exact chemistry every so often.
So basically, the more fish, beer, sweetbreads, kidneys and liver you eat the more allopurinol you need to block excess uric acid production.
That makes sense. To bad they couldn't somehow modify Allopurinol so that it didnt get oxidized by mistake. Would 1 night every now and then of heavy seafood and alcohol cause an attack even if you are below 6? I don't eat that much seafood, but one of my favorite things to do everyone once in a while WAS to eat sushi, fried rice w/steak along with some saki and drink maybe 4-8 Saporo's (Japanese beer) 🙂 Man I miss those days!
To bad they couldn't somehow modify Allopurinol so that it didnt get oxidized by mistake.
No, that's it's FUNCTION. It is chemically hypoxanthine and is identical to xanthine except for placement of a couple atoms so that xanthine oxidase attaks IT and turns it to oxypurinol whicch ALSO is attacked by xanthine oxidase. Keeping xanthine oxidase busy while allowing the REAL xanthines to be excreted instead of converted to uric acid is the beauty of allopurinol. It acts as a sacrificial lamb to save us from perdition…
and podagra!
Don't worry about what you eat and drink once you get steady-state low uric acid. You will be able to enjoy the weekly sashimi and beer night…but that's WEEKLY, not DAILY!
One of my favorite restaurants in Manhattan has an all-you-can-eat sushi (40 varieties), sashimi, yakitori, gyoza, seafood salads, teriyaki (beef, pork, chicken, salmon,) raw clams and oysters, crab galore and 100 others all lined up on a block long table with about a dozen chefs refilling the table…oh, and SEPERATE dessert and soup tables. Seating for about 250 patrons.
This goes on from 11AM to 3PM every day. By the time I leave I need a forklift or 4 bearers to carry me to the subway…but it's never caused a gout flair.
LOL! That's funny Zip. I don't do the sushi thing but once or twice a month, but when I do, I like to go all out with the saki and sushi if you know what I mean 🙂 BTW, since yesterday was the first day I started my 200 mg Allop dosage, I tested my UA at 5pm last nite and it was 6.5. I then had 2 glasses of wine and tested it a coulpe hours later and it was 8.4!! Not sure if the meter was off (does a 6.5- 8.4 jump seem right from 2 small glasses of wine?). Anyways, not sure if this was the smartest thing, but I took a 3rd dose of Allopurinol (100mg) before I went to bed. When I woke up this morning and tested, I was at 5.6 (lowest reading ever!). Is it ever a good idea to do this?
I suspect the jump from 6.5 to 8.4 was caused by meter fluctuations, but if NOT, then all I can say is WOW!
If caused by the wine that's REALLY food for thought.Perhaps you had some high purine food digesting over those couple intervening hours?
See if you can repeat the experiment sometime down the line…maybe on an empty stomach?
Good for you on the 5.6…that's EXACTLY what allopurinol is supposed to do. Remember, the active ingredient oxypurinol has an EXTREMELY long half life so you are still building up to steady state. It will take a total of nearly 2 weeks to build to your therapeutic dosage level and I think you will see numbers at 5.0 or below soon.
Hi Zip. Yes I’ll repeat the test again maybe next week.How long should I wait to test after drinking a couple glasses of wine? I have been avoiding high purine foods, but I still think it was a meter fluctuation too. I took a 3rd Allop dose b4 bed last night again. I woke up with a 4.7 reading! I’m gonna scale back to 2 doses again and monitor.
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