Muscle involvement in long term allopurinol use

I have been on allopurinol 400 mg/ day for about 2 years. In the last few months I have had SEVERE weakness in my thigh muscles and discomfort there as well.

I don’t know if it is related to allopurinol or not.

I am 71, I do drink a few beers a week (4 or 5). Otherwise reasonably healthy, but I do have daily headaches.

What do you think ?

Hi jokeco68, and thanks for your kind words. I’ve just sent you a welcome email. So, you can see where to edit your Profile, if you want to change your Display Name. Or, maybe jokeco68 is your nickname??!

I’m very interested, and very patient. But, I’m also often longwinded, so I hope you are also patient.

How did I persuade you to start allopurinol without also convincing you of the need to get regular blood tests? Because without that, I cannot give you any worthwhile advice.

So, I might as well write about the placebo effect. But I’ll try to stop myself. Except to say the power of the mind accounts for one-third of all treatment benefits. And, just as it applies to positive benefits, so the power of the mind applies to negative side-effects.

Just to be clear, are you telling me you never had a blood test! I realize Canadians are a special breed. But, that’s because I thought you are especially kind and good. If you’re going to run a health service without blood tests, please explain how that works. Or, have you just forgotten to post whatever results you have?

Anyway, without information, everything is just a guess, so here are my guesses.

1. I guess allopurinol is working fine because your gout flares are getting less frequent and less severe. Also, you went a long time with no obvious side-effects. But, that just means you relax your diet, eat badly, and gain weight. Then, the extra weight puts a strain on your body. So that, coupled with poor diet causes swollen lower legs.

2. I guess the failure to stay healthy, coupled with approaching 50 years old and a complete change in sexual lifestyle give you an occasional drop in sexual performance. But, instead of dealing with the real causes, you look for excuses. Because, if you Google side-effects of any drug long enough, you will find something that fits.

So here’s my plan!

1. Fly me to Canada and give me accommodation.
2. I will supervise your eating, exercise, and waistline.
3. Then, I’ll persuade your doc that blood tests are necessary.
4. You’ll get back into shape, and gout will stop.

Other personal gout support plans are available! 😉 🙂

Let me know how you want to proceed. I hope I don’t need to explain that my little plan is tongue-in-cheek. Because, seriously, we can crack this. But, we have to take it one step at a time. So my first step is to truly understand your blood test situation. Because it’s an essential part of any uric acid lowering therapy.

Your best first step is to tell me the contact details of whoever is prescribing your allopurinol. Because if they haven’t broken the law by refusing blood tests, they have broken every ethical code.

In the meantime, stop reading crap from people you don’t know about allopurinol side effects. It’s not helpful and it will make you worse.

Let’s learn about your gout together.

The attitude of your doctor(s) is insane! Random fluctuations would be a reason to do MORE tests, not less.
Surely there must be some kind of patients association or other consumer organization in your country which defends people against technocratic abuses and profiteers. They might advise you on the best way to proceed in order to obtain rational care.

That said, you aren’t clear about your old test results (how much is above 300?). I can only assume you concluded from your old results that you could get by with 300mg.
In case you weren’t aware, getting flareups 14 months into allopurinol therapy wouldn’t be unheard of in a case such as yours. It doesn’t necessarily mean the 400mg dose was insufficient. You might have avoided that flareup by taking more allopurinol during those 14 months but increasing the dose after a flareup isn’t necessarily helpful. Blood tests would have helped to determine whether more allopurinol was needed.

Any allopurinol side effects could take a few weeks to go away.
And you should get a blood test done about a month after lowering your allopurinol dosage to make sure that hasn’t allowed your uric acid to reach an unsafe level.
If the dose reduction you devised doesn’t solve your problem and considering you have been gout-free for a while, you could also simply stop taking allopurninol for a few weeks and see if you feel better.
You will probably need some drug to keep your uric acid under control in the long run but it seems people who aren’t experiencing flareups can often take relatively short breaks without ill effects.

If you are indeed suffering from unacceptable allopurinol side effects, there are alternatives to that drug.
The most obvious one is febuxostat. It might help or it might not but it’s important to get blood tests done if you try it in order to prevent liver damage.

@jokeco68

A little late to the party and ignorantly haven’t read the entire thread but you mention fatigue and low energy. Do you have any blood test results before starting allopurinol that include your haemoglobin, iron serum, ferritin and folate? If so, compare all those results to the ones you have done a few months after starting allopurinol to check for differences. If you could provide those vital numbers I can try and advise further.

Cheers.

Nausea after 6 years taking Allopurinol 300mg

I’ve been on 300mg allopurinol for the past 6 years to manage my UA. Sadly I have not reduced my weight successfully and still lead a decadent lifestyle e.g. Obese at 235 Lbs at 5″7″ in height. The past 6 years I have not had a major attack, perhaps just a twitch or two when I overindulge in food—thanks to allopurinol. I do notice though that if I miss taking it for more than two days, I’d usually get an attack hence I have not reduced the dosage to the ideal 100mg.

During the new year, I decided to go on a plant-based low carb diet to lose weight.

2 weeks into the program while going about my regular daily routine, I felt some nausea two hours after taking allopurinol. And it has been that way the past 2 weeks.

In fact, every time I ingest something I get nauseous after two hours. It seems to be heightened after I take Allopurinol.

How did I know?

Well after my first episode of nausea I tried to reduce my intake to 100mg. I was able to get by and was still experiencing nausea but not as bad as the first day.

Today I tried upping the dose to 300mh and boom. I was barfing all over.

Has anyone experienced this?

Any advice and insights are highly appreciated.
Thanks