Gout and doubt about Puricos

[Mohammad Motala]

Hi, I was diagnosed with gout in 2010. High uric acid level was cause. I’m currently on a diet for 6 months and I reduced weight as well. I did a blood test for uric acid and from 0.60mmol I’m currently at 0.48mmol
I now have severe pains again on the side of my foot. My orthopedic surgeon says its gout attack again. So I started Puricos 100 mg. I can’t understand how could it be when my uric acid levels dropped significantly, and I was experiencing any foot pain for like a few years now. Could somebody please explain?

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Puricos = Allopurinol Brand Name

[nobody]

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.

[Mohammad Motala]

I’m currently on puricos 100mg. Gp says i should use 100mg dosage. However I see my orthopedic surgeon has prescribed puricos 300mg (which he says it’s fine to take lifelong) with Arcoxia 120mg (only at time of gout attack).
So I decided to to have puricos 200mg daily considering a moderate dosage between the 2 views. Haha I know its sounds funny, but I would honestly like to know if I’m on the right track currently. Also my bloods for kidney etc are all fine.

Would puricos 200mg help me bring down uric acid faster?
Do I need to consume probiotic after puricos?
Does it also mean for life I have to have puricos?
Any natural things to consume that really brings down uric acid?

[nobody]

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.

[Mohammad Motala]

Hi.thanks for all the advice. I did bloods again and my uric acid now is 0.30….
Doc says it has reached a good safe zone.
I decided to now indulge a little. I had some steak, red meat etc. I drank some fizzy drinks. I ate like crazy in that one meal.
Next entire day I was perfect. The following morning I woke up with another gout attack but not sooo severe. To stop that attack from worsening, I had arcoxia 120mg again and I felt the pain calming down.

My question now is, since my uric acid dramatically reduced, why am I still getting these attacks. Doesn’t gout have strong links with uric acid?
Also does that mean I cant have red meat lifelong?
If I can eat red meat, will citro soda before bed assist?
Thanks

[nobody]

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).

[Mohammad Motala]

Thanks so much for all that advice.
Is it true that gout is a sickness that’s a result of kidney problems?
I did kidney test also and doc says kidney is fine.
And what natural herbal foods are there to combat gout?
Also I hear chanca piedra capsules are good?
Some advice on natural products and their effectiveness?

[nobody]

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.

[Author]

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