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You haven’t said what you’ve tried so far to make this go away. I don’t want to tell you to do things you’ve already done but maybe you haven’t tried to do the obvious…
And what has your doctor told you to do?More generally, have you measured how effective the cherry extract is? Or are you only counting on it to suppress inflammation?
I have no way of telling if this really is gout but it’s plausible since untreated gout has a way of turning from brief metatarsal episodes into a mess unfortunately…Could you clarify your question?
There is a balance of risks to strike and the details matter a great deal.Generally, .4mmol/l is too high for someone who has gout but 4 mg/dl is fine.
There are guidelines recommending 5 mg/dl or less and guidelines recommending 6mg/dl or less.
Since it often takes at least a year to get rid of acid uric crystals, the 5mg/dl guidelines seem safer to follow months into the therapy unless there is a specific reason to reduce the dosage (such as bad liver function markers).
But each case is going to be different. If there are tophi or evidence for other large uric acid deposits, you’d want to keep uric acid as low as possible for instance.Keep in mind you can have gout as well as something else at the same time. If something reduced the blood flow to your toe for instance, that would increase the odds of a gout attack.
While ankle pain isn’t the most common symptom of gout, I think it’s still pretty common. The whole foot being swollen while the toe isn’t constantly swollen on the other hand, that might be less common.
Icing is somewhat problematic but elevation should work provided you are resting your foot when it’s elevated and not relying on your muscles to hold its position.
All in all, I’d say the signs of gout aren’t very clear for the time being.
An ultrasound and joint fluid test (easier said than done!) might provide more information and possibly a definitive diagnosis. But your doctor may prefer to simply wait for more symptoms. Just don’t keep waiting if similar symptoms occur time and time again!One thing you should definitely take control over is your uric acid testing:
a) the “normal range” (whatever your doctor means by that) is irrelevant and you need to know your actual test result (number and unit both!)
b) you need to get your uric acid tested again after the symptoms have gone away completely (or in a few weeks if they persist), and if you haven’t been tested regularly so far you need to schedule yet another test in a few months regardless of the result (after that, a yearly test might be sufficient if you aren’t overwhelmed by gout-like symptoms)
Uric acid testing is cheap and easy so don’t allow yourself to be short-changed by poor medical habits or the inability of your doctor to make use the results! It’s not your last uric acid test result which matters but your uric acid history so start documenting it even if you aren’t seeing a knowledgeable doctor right now.Hi Ben!
Best see a doctor in person. I don’t think anyone here can guess what is causing this itching on your back.Especially after failing to treat gout for many years, flushing out uric acid can take a very long time (possibly several years).
Diet-wise I would recommend avoiding all diuretics (not just beer), drinking a lot of water and eating foods containing a lot of minerals (such as most vegetables).I really can’t venture an opinion with regards to your allopurinol dose based on the limited information you have shared. I can only say that, if your SUA test results (notice the plural) are under 300 umol/l, your current dose is serving you well already.
If you have OA at the typical locations where you get gout attacks, your symptoms must be confusing.
It is unfortunately next to impossible to tell gout symptoms suppressed by colchicine and naproxen from other problems, except perhaps by drawing sinuvial fluid which isn’t the most reliable of procedures. And for the time being, I would not recommend you stop taking drugs to suppress inflammation whenever your symptoms look like they are flaring up…Hi!
I don’t know if you can trust your meter. The meter itself might be fine but the blood you feed it might not be representative of what’s running in your larger veins/arteries.
I assume you’ve been taking allo for a few weeks if not a few months. So get another lab test done and try to test with your meter immediately before or afterwards. The meter might be getting the changes right while reading too high.
In any case you should get a lab test to see how your body lives with the allo (you want to watch the kidney and liver values in particular). If you’re doing fine, you could take a bit more than 300mg/day. Note that if you’re taking ibuprofen every day, that could also explain bad liver values in particular (allo isn’t always the problem).Going from zero to 300 isn’t recommended but what’s done is done. Now it’s just another reason to do get a blood test done!
In your situation, I wouldn’t bother with sinovial fluid and simply stick with allo for a bit.
I’ve used a gel containing a NSAID. It works better on some joints (the smallest ones) than others but the pills are more effective anyway, assuming your body doesn’t react badly to prolonged use of NSAID pills.
If you have inflammation that won’t go away, you could try combining colchicine and a NSAID.
For a serious attack, you could try a larger NSAID dose first (get your doctor to approve the dose you’re planning to take). You don’t want to take a huge amount every day for too long but if a large dose ends your attacks quickly, that might be the best course of action as long as your body is doing OK on NSAIDs.Hi Joe!
Unfortunately fixing gout often takes a long time. But the sooner you start, the better.
You can try to mask the symptoms with heavy anti-inflammatory doses and colchicine so as to get back on your feet quickly but in the long run, controlling uric acid is what matters.
Because that can take a long time, it could be worth your while to find ways to exercise a bit which are very gentle on whichever foot is currently affected. There are a few things you can do at home even if you don’t have room for a gym-type contraption but perhaps you could get to a gym with the help of crutches.“Within expected parameters” isn’t good enough when it comes to gout.
You really should get flareless values for the amount of uric acid in your blood, even if you have to pay for that yourself (basic blood tests ought to be fairly cheap). For all you know, your allo dosage is wrong!Colchicine isn’t that bad if you’re careful with the dose and don’t take it for too long. It certainly kills far fewer people than anti-inflammatories.
This sounds like a nerve might have a problem. Inflammation in the right (or rather, wrong) place can affect a nerve.
That said, the combination of about 8 months on 300mg allo together with recurrent symptoms for about a month… well, this isn’t what I’d expect. Nevermind that these symptoms aren’t typical gout symptoms (weird pains after starting allopurinol is a thing after all), they shouldn’t last this long.
If inflammation caused some kind of damage manifesting as a sort of tendinitis, I guess that might explain why the symptoms are lasting so long… or am I grasping at straws?
Obviously a solution to this conundrum might be: something else is going on than your immune system reacting to uric acid. Just to be sure there’s no misunderstanding though… the therapy is successful, right? Meaning that your uric acid has been tested a few times since you started allo and the dose you’re taking has been shown to be sufficient.These symptoms need not be related to allo in any way but I also hope you had standard bloodwork done to make sure your liver, muscles and so forth aren’t doing something obviously weird.
It might also be worth making sure allo isn’t affecting your gut in a way that prevents you from absorbing certain nutrients (I assume you didn’t make radical changes to your diet which could also end up causing nervous or muscular problems after a while).You need protein to be healthy. Excess protein is generally bad, and is probably a bit worse if you have gout than it would be for the general population. But 17g isn’t a huge amount, especially if your diet otherwise wouldn’t contain enough of the specific proteins found in peas.
Bottom line: either you trust your nutritionist or you don’t.If you know this is gout, you must have already discussed treatment options and so forth with a doctor. In that case, you’ll need to post a good bit more about your history with this disease and its treatments if you want help that’s actually helpful.
If you’re only guessing this is gout, go see a doctor.Sometimes gout comes from a kidney problem. The cause is always high uric acid but there are several ways it can get too high. Kidney function is only one of them.
Lots of natural products aren’t any good.
Lots of natural products help with symptoms. Colchicine is one of them (see above), and I recommend you get it in a pill because it’s much easier to get the dose right that way (people have killed themselves by drinking infusions made from the plant). Many natural products are similar to arcoxia (but inferior). My only problem with arcoxia is that it can be a bit slow when compared to some other drugs of the same type. If it’s fast enough for you, there’s no point at looking at anything else (other than colchicine which is even slower but has a different effect).
Some natural products do basically the same thing as puricos, except they’re less effective and harder to use. There’s little point in bothering with them as long as you take puricos.
That leaves you with the natural products which help your body get rid of uric acid. These could be useful in addition to puricos as long as you are getting attacks (puricos alone will be enough to keep them from coming back once they are gone for good). I already mentioned the ones with the best evidence to back up their effectiveness above: water, milk/yoghurt and vegetables. The problem is, I don’t know if they would make much difference in your situation because I don’t know why your uric acid was high in the first place. But unlike many natural products, milk and vegetables are pretty safe as long as regular food safety regulations are followed and you don’t consume utterly ridiculous amounts so I think it’s OK to recommend them to everyone.If I may quote myself in order to answer your question:
“If you’ve had gout for 10 years (simply having had 0.6 is not sufficient for a diagnosis), you’ll probably need several years on puricos or similar before the symptoms go away completely. You’ll need to check your dose is right by measuring your uric acid a few more times (and while you’re at it, make sure your liver and kidney function are evaluated”I would also recommend eating very little animal flesh for a few months as well as drinking plenty of water. Also avoid very large meals as well as starvation or unusually strenuous exercise. Some milk or yogurt every day might help. And you should of course make sure you eat enough vegetables and low-sugar fruits such as lemons to get all the minerals and vitamins you need. But the most important thing is to avoid alcohol and other diuretics.
If you keep taking 200mg and your uric acid keeps reading 0.3 or similar, you’ll be able to relax these rules after a while or even forget about them entirely if you aren’t prone to excesses.Red meat isn’t necessarily worse than other kinds of meat unless perhaps you have too much iron in your body (maybe get that checked next time you have a blood test). With meat, the amount you eat matters as well as the exact type. Lean steak isn’t very bad for instance.
If you do eat meat, there is no magic fix other than following the rules outlined above. You could of course take even more puricos before and after eating meat but I would certainly not recommend it because this drug does have side effects and eating lots of meat isn’t healthy to begin with.Even if you do everything right, you might still get many mild attacks (and even a few serious ones) in the following weeks or months. In that case, ask your doctor for colchicine (you’d take a small amount every day for a month or two in addition to your other medications).
The most practical way to know if your dose is right is to get your uric acid tested after a few weeks on that dose.
Also, you won’t know if your liver and so forth are fine until you get bloodwork for them AFTER you’ve been a while on puricos.Whether you will need to be on puricos for life also depends on your uric acid test results. If obesity was the reason you had so much uric acid for instance, you might be able to lose the puricos once you lose enough weight. But that’s certainly not a given. Time will tell.
I doubt probiotic has anything to do with puricos. But if you heard differently, I’d be interested to know what you were told.
Lots of “natural” things bring down uric acid. But unless you get side effect from puricos, I would recommend sticking to it because it’s cheap, works better and you can also get side effects from the “natural” things.
Hi!
Gout is a slow disease. You don’t feel it progressing until something triggers it. Experiencing pain after lowering one’s uric acid to 0.48 is not an unexpected development.
If you’ve had gout for 10 years (simply having had 0.6 is not sufficient for a diagnosis), you’ll probably need several years on puricos or similar before the symptoms go away completely. You’ll need to check your dose is right my measuring your uric acid a few more times (and while you’re at it, make sure your liver and kidney function are evaluated when your blood is tested just in case the drug was affecting that). Most likely, you’ll need to take more than 100mg per day.
I must stress that I can’t possibly tell if you have gout or not. But if you do, puricos is the right thing to do. Just be aware that it’s a slow drug addressing the cause of the disease and that a much faster drug is also needed for the symptoms.These aren’t typical gout symptoms. It usually develops slowly, affecting the feet for years before moving on to causing inflammation all over the place (and normally it would only affect one location at a time).
Some people get unusual gout symptoms of course. Alcoholism (as well as reducing dramatically one’s consumption) could contribute to an unusual evolution of the disease I guess.
But I think you should try to rule out other diseases before assuming these symptoms are caused by gout. Ideally, a skilled hand would take fluid from an inflamed joint to confirm that you have gout. A DECT scan might be a more reliable alternative to detect uric acid crystals if you are lucky enough to have access to that.
Normally the first thing to do would be to get a uric acid blood test which is quicky and easy but in your situation it could yield a false negative and would in any case not confirm gout. Still, the test is so cheap that I would recommend you get such a test done ASAP. Just don’t assume the result will be definitive so try to schedule a rheumatologist appointment and get ready for more tests.Best double-check that value and the units in particular. Ideally, you’d have that printed on a paper or something. Because there’s more than one unit in common use, even professionals sometimes misread test results and you don’t want to confuse 2.9 mg/dL with 0.29 mmol/l for instance.
You’ll also need to repeat that test in a few weeks or months to make sure this result wasn’t a fluke. It would be best if you could do it it different circumstances. I don’t know how menopause works but that could have a significant effect on uric acid so if you can guess what your hormonal situation is, best take the second test when it doesn’t feel the same as when you had your uric acid tested the first time.
But taking that 2.9 mg/dL at face value, that’s not just “normal” (which is irrelevant to gout) but quite low… low enough that it would rule out gout if that result was confirmed in different circumstances. Someone who has gout would normally get a much higher test result, even if they were watching their diet and taking cherry extract. But it’s too early to jump to conclusions, especially considering your menopause. First double-check the result and schedule another test later this year.If you don’t have gout, there are a number of diseases which could cause similar symptoms. There’s even one which has been confused with gout often enough that it’s called pseudogout.
The type of doctor which specializes in diagnosing and treating this type of disease is called a rheumatologist. There’s a bunch of blood tests you can do on top of uric acid to rule out less common diseases but of course it helps to visit an expert in person. They may recommend a more expensive test than a blood test which you may have to get on a day when you are in pain.
