How to take control of my gout after 30 years.

[Gary Cork]

My name is Gary and I had my first gout attack about 30 years ago when I was in my 40’s. I had extreme pain in my big toe after flying across Canada and after having a few beers on the flight.
My doctor arranged for blood tests and my uric acid levels were in the normal range but the big toe was purple coloured and very painful!!
The doctor diagnosed it as gout. I would have attack about 2 times per year and they would last about two weeks. It was suggested by the doctor that I take ibuprofen since that can clear out the uric acid.
No other history of gout in my family. A respected western/Chinese doctor suggested that the reason I had gout was because I was the 2nd. child and had the RH- factor. Two children were born after me and both died at birth. I had jaundice when I was about 9 years old which pointed to a weakness in the liver but all medical reports state that my liver is OK.
My last uric acid report was in 2013 and it read 504 which in Canada is an acceptable level since the normal levels are 234-259.
I have taken alopurinol over a length of time which did not seems to be effective and a doctor stated I should not be taking it if I only have an attack twice a year. I have taken colchicine but found that was not effective on my attacks.
I was overweight and worked on loosing weight and getting into shape by working out and following Weight Watchers and lost about 26 pounds and did not have gout attacks until recently.
I had an attack in my left knee which lasted about 4 days and then cleared up, but then had another attack in the same knee about 4 days ago.
I have put on a few pounds and am still working out and have gone off of following Weight Watchers.
I feel my diet can be adjusted but we do eat lots of veggies and some meat.
I drink the odd glass of wine and have stopped that since I feel my body gets oversaturated with it and it does not taste so good, no beer but I do drink tonic water instead.
I have used Chinese Medicine to help since I am a retired Acupuncturist.
Thanks for any help and for this website, I did not know it existed!!
Cheers,Gary

[Keith Taylor]

My last uric acid report was in 2013 and it read 504 which in Canada is an acceptable level since the normal levels are 234-259.

Hi Gary,

Please can you check your test result history with your doctor. Then post as many results, with dates, as you can get. Because, those numbers don’t make sense to me. If it’s easier to send photographs of your reports, you can do that via the GoutPal Helpdesk.

[Gary Cork]

Hi Keith, I realised I should have proof read what I sent to “GoutPal”. My reading in October 2013 was 504. The acceptable norm on my lab sheet was 234-529.
In September 2009 my Uric Acid reading was 433 with the Ref Interval 180-470.
In February 2009 my Uric Acid reading was 433 with the Ref Interval 180-470.
I have just arranged to have liver and kidney tests done and also the uric acid level.
I had them aspirate my knee with a 2 inch needle to see if there were uric acid crystals and they could not get through to the bursa, and did not have longer needles and since I live on a small island and any serum would have to wait for 2 days in order to go to a lab which would allow the serum to break down and give a faulty test!!
I do live on a small island and lab work is only done 2 days a week but they should have had longer needles!!
The doctor said that if the uric acid levels are within the normal levels they would monitor for one month and then 6 months but economically they could not warrant continued monitoring.
I told the doctor that I am considering purchasing my own uric acid measurement kit in that case.
Thanks for contacting me.

[Keith Taylor]

Hey Gary, as you are new to GoutPal, you won’t know about the rages I get into when doctors talk about normal uric acid. But, you’ll get the idea if you search for something like normal uric acid rant.

Anyway, my point is that normal uric acid is medically meaningless. Because, it’s simply a statistical average. But, average people get gout. So 6% of men in that reference interval will have gout. And, Gary, you are one of them. and you don’t need a uric acid crystal test to prove it. Because, any uric acid level over 400μmol/L is dangerous. So, you have to get below 300 to be safe.

Now, allopurinol will make you safe. But if someone doesn’t understand uric acid test results, they won’t manage allopurinol properly. Trust me, I had to argue this out with 3 of the 4 doctors I consulted about managing my gout.

1. Allopurinol needs monthly monitoring through uric acid tests. Because, allopurinol dose must be increased until uric acid is safe. Once your uric acid levels drop below 300, you can extend period between uric acid tests. But, always test at least once per year. Also, uric acid tests should be accompanied by liver function and kidney function tests.

2. Until you have had uric acid below 300 for 6 months, you may experience gout symptoms. Because, partially dissolved uric acid crystals can trigger gout flares. So, we can adopt strategies to help you manage this. Then, it should not reduce your quality of life, as you finally get free from gout forever.

Obviously, that’s a very quick overview, Gary. But please ask for clarification wherever you need it. I’m confident that we can work together to make sure 2017 is the last year you are ever troubled by gout pain.

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For Canada: Dangerous is over 400μmol/L and Safe is below 300

[Gary Cork]

Hi Keith,
Thanks for your information. I am getting my uric acid levels tested next week plus liver and kidney function. I am thinking of contacting my brother-in-law in England to see about getting my own uric acid monitor kit since our medical system in Canada will not do monthly checks if my levels are in the normal range.
I will keep you all informed.

[Keith Taylor]

Gary, I must apologize for introducing the idea of monthly blood tests. That was in relation to my suggestion that allopurinol is the correct medical treatment for you. So, if you do not want to pursue that with your doctor, then please forget my suggestion. But, if you do want to push for proper medical treatment, I will look for some Canadian guidelines that show allopurinol is the correct medical treatment in your situation. Also, if you are getting allopurinol treatment, uric acid monitoring is definitely your doctor’s responsibility. So, in that case, buying a monitor would be pointless, in my opinion.

Now, let’s think about other alternatives for controlling your dangerous uric acid level: herbal gout medicine or lifestyle changes. In either case, a uric acid monitor can be useful. Personally, I think it’s best to have an outline plan before investing in a uric acid meter. But, I accept they are cheap enough to just buy one to see if it suits you.

Maybe you’ve seen the discussion about Where can I buy an Accurate Uric Acid Monitor?. Because, there’s been a recent post about comparing different uric acid meters. However, I’m still of the opinion that the UASure uric acid meter is the best tool for the job. Arctic Medical are global distributors of that meter. But, although they are based in the UK, they do provide global pre-sales and customer support. Anyway, only you can judge if it’s easier to deal direct or through your brother-in-law.

I’m sorry if I confused you, and I hope this clarifies your choices. Also, I hope I can continue to help you decide your best way to get rid of your gout.

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