I’m desperate non stop gout attacks

[KK D]

I’m at a point of desperation. I’ve had gout for the past 3 years. The first year I started getting 1 attack every two months I can live with that but it has progressively gotten worse. I now get an attack every three days. Just as I start to heal I get it again. It goes back and forth between right and left foot from big toe to ankle. It’s relentless. My shoulder AC joint is a continuous attack that has lasted 5 months and counting. I’m 36 years old extremely physically fit I love working out but that has stopped since I get no relief. I’ve tried every drug and every herbal nothing works – in the Pharma world, this is what I have tried – colchicine, allopurinol, Uloric, Prednisone.

In the herbal world, I’ve tried: tart cherry, nettles, celery seed, baking soda, mums apple cider vinegar, kyolic magnesium. My diet has changed to just salads.

My doctor doesn’t know what to do going to refer me to a rheumatoid doctor. These attacks are endless and I’m desperate. This is my first time posting and if anybody knows of anything please let me know thank you for reading

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Arginex or A-C Carbamide for Gout?

[Anonymous]

Gout is in the genes, no diet will change that. You need to be taking Allopurinol for at least 3 months before it starts to work. The attacks can get worse during this period.

My home remedy during an attack is
1000 mg of effervescent vit C
1 teaspoon of baking powder
50 ml cherry juice
All in one big cup with boiling water.

[KK D]

Thanks for the remedy I will try it. I know things take time. I’ve tried alopernol for 4 months it didn’t work I’ve tried uloric also 4 months didn’t work. I gave everything plenty of time just haven’t been successful.

[Keith Taylor]

To control gout permanently, you have to get uric acid below 5mg/dL. Start by posting uric acid test results.

Allopurinol and Uloric are 2 of the drugs available to control uric acid. The dose has to be high enough for you to get uric acid safe. There is no standard dose – you need the dose that is right for you. Wrong dose is the usual reason why gout never gets controlled.

As Michael says, it takes many months for uric acid lowering drugs to work. During that time, you need proper pain control. The best gout control needs a 3-line plan of attack. That is:
1) Stop inflammation getting worse (colchicine).
2) Reduce inflammation, which also reduces pain (NSAIDS).
3) Block residual pain (analgesics).

Your doctor should be able to prescribe a package that is safe and effective for you.

If you need clarification, or more help on choosing the right combination for you, please ask.

[KK D]

Thank you for the response. This can can give me some hope. My doctor thinks it should have kicked in by now and doesn’t want me to go any higher on uloric dose she doesn’t know what to do therefore referring me to a rheumatoid arthritis physician. I started taking Urloic 4 months ago started 40mg it initially worked I had 10 days without an attack and my Uric acid level was 5.5 then After a week I started getting more attacks once a week. My doctor had me on 80 mg urloic but doesn’t want me to go any higher. I should have asked but I didnt. My attacks are relentless and are just days apart with each other. Colchasene used to work with me but it doesn’t any longer, why I don’t know. Prednisone works for only couple days not a good drug to be on. My last level check was 6.2. My doctor is internal medicine doesnt handle gout often. I may need to change physicians or the rheumatoid arthritis doctor may help as well. Either way you bring up a lot of good points I really hope an increase in Uloric will do the trick.

[Keith Taylor]

Uric acid in the 6 to 7 range is hell. You get old crystals dissolving. And, you get new crystals forming. Both those cause gout attacks. So, little wonder you are in constant pain.

Hopefully, your new doctor will prescribe an effective uric acid lowering treatment that gets you safely under 5. It’s not rocket science, so I don’t understand why every doctor can’t do this.

Unless uric acid is controlled properly, gout gets worse every day. That means it is harder to control the pain. That is why you see colchicine failing to stop gout pain completely. That is why, in serious gout attacks, I say it should be supported. An NSAID such as ibuprofen, naproxen, etc is good. Then, pain blocker such as acetaminophen/paracetamol. There are lots of combinations that work. Your doctor should review your medical history to suggest the best combination for you.

There is no excuse for gout pain in 2017. But, it needs clear analysis of the facts. And a flexible approach that is based on individual needs. I don’t know enough about you yet to suggest anything more specific.

Keep posting, and I’ll get to know you better.

[KK D]

Thank you Keith for your great insight. It’s a relief getting some positive feedback and keeps me hopeful on getting my life back and relief once again. It’s obvious I’m going to have to search for a new doctor who is experienced in dealing with gout. In the mean time I will keep on using 80 ml uloric maintain and sightly tweeting my anti inflamitory diet and using the tips provided. I’ll keep this updated on anything new. Thanks again

[Keith Taylor]

I’m really pleased to read your positive feedback. If you cannot find a better doctor, we will just need to train the one that you have got. I can provide appropriate medical references if that helps.

Let’s see how 80mg Uloric works for now. In particular, you should get blood tests to check everything is OK. Maybe 2 to 3 months time would be good for that, unless your doctor has advised sooner. Blood tests should include uric acid, kidney function, and liver function. It’s important for all gut patients to get those blood tests at least once a year.

I’d be very interested to read your tips for ant-inflammatory diet. And, I’m sure thousands of GoutPal readers would also like to know more about that.

[KK D]

Thanks again hopefully the higher dose of Uloric will work along with a few other remedies. Patience is the key and within a few months I hope I can post positive gout feedback. My anti i flamitory diet is a salad I make every night but not just any salad. I try to utilize as many anti oxidase foods as possible that taste good to me I also love the heat. I start with frying green yellow red baby peppers along with mushrooms celery jalapeños cilantro basil Brockley my protein can consist of either tuna salmon or chicken I’ll coat everything with Sarata and hot Szechuan sauce after few minutes I’ll pile on spinach. In separate bowl I’ll have plain salad. When everything is through cooking I’ll put everyrhing in the salad bowl. The sauces bring enough flavor but you can either add a little ranch or I will squeeze fresh lemon on top. Some people may think this is disgusting but I really like it and it is very flavorful.

[Keith Taylor]

That sounds great to me. And, I must try it when I return from vacation.

I’ll probably substitute mixed beans as a protein source. With occasional tuna/salmon. Maybe pulled pork or brisket once or twice a month. For the other ingredients, I worked out broccoli. But, what’s Sarata? Is it Sriracha Hot Chili Sauce?

[KK D]

Yep it’s sriracha chili sauce, best stuff ever made. I’ll use pulled pork and occasional hamburger meet as a protean substitute as well. I don’t know if I mentioned but I also add fresh ginger, ground Turmeric and ground cayenne as added bennifit while sautéing everything else. Yeah give it a try, its definitely filling and flavorful while being healthy at the same time.

[Keith Taylor]

By unbelievable coincidence, I’m right on track for this. As you can see from my vacation post, I’m travelling the Southern States. I’m using Airbnb, so experiencing real life in American homes. Maybe I’ll write about why American food stores are gout-producing hell sometime. But, my point is (eventually!), my temporary New Orleans home has a large bottle of Sriracha Hot Sauce. Yummy 🙂

[KK D]

Question? Have you or anyone else try Uricel? Urcinol? AC-Carbamide? Arginex? I’ve heard good reviews online but really don’t known what to believe and how fabricated they may be. I’ve never tried but bought all 4 just don’t know what to try first. Yes they were all impulse buys late at night suffering from another big flare. Thanks

[Keith Taylor]

KK D, I think you need to step back, and understand the gout problem.

Fundamentally, gout is excess uric acid. The only way to stop gout permanently is to control uric acid. Every uric acid therapy is different. But, I have a rule of thumb that says:
“Once you get uric acid safe, it takes about a month for gout recovery for every year that uric acid was not safe.”

Again, generalizing, most gout sufferers have unsafe uric acid for many years before they realize they have gout. And, once you start uric acid control therapy, it can take up to six months to get uric acid safe, depending on how aggressively you manage your uric acid lowering treatment.

So, you must be able to control gout pain, during the time it takes to successfully control uric acid. And, you only know if you are controlling uric acid from blood test results.

So far in this discussion, there is not one mention of uric acid test results. And, without uric acid test results it is impossible to assess the value of any of the products you mention. It’s also impossible, without accurate uric acid test results, to measure the effectiveness of any gout treatment.

The other side of gout management is pain control. That should be a 3-part combination that:
1) Inhibits the spread of inflammation.
2) Reduces existing inflammation, which relieves most gout pain.
3) Blocks residual gout pain.

In conclusion, that gives us 4 aspects of gout control that need different treatments. You need to judge each treatment on how it tackles one of those aspects of gout.

Just stopping gout symptoms is pointless – our own bodies do that naturally within a few days. But, our bodies need help to stop the next gout attack. 4 different types of help.

So, before I can advise on any of the products that you mention, I need to know:

How can I help you control uric acid?

How can I help you control pain until you get uric acid safe?

You can decide which is most important. As you started by asking about non-stop gout attacks, I suggest pain control is most important for now. But, it only makes sense to control gout pain if you are also starting to control uric acid.

[Gout Patient]

I would just like to add that I have been taking Allopurinol for years and only gave me minimal relief with attacks every month or 2. It only started working when I switched to the brand, (non generic) Zyloprim. When I took the generic, I still had uric acid levels that were borderline high and I was taking 200mg. Currently, I take 200mg of Zyloprim and haven’t had an attack in over a year. The only problem is my insurance doesn’t cover it and its expensive. From my point of view, worth it. I hope you can afford it.

[Keith Taylor]

I don’t understand? 😕

“minimal relief” ❓ Allopurinol is for uric acid control, not pain relief.

Medically, there is absolutely no difference between any brand of allopurinol, unless it is one of the combination drugs. Zyloprim is allopurinol. Zyloprim is a Sabela brand, and the one that Walgreens promotes on it’s website. Unfortunately, I’m leaving the USA today, so I won’t have time to check pricing.

Norkin, it sounds like you’re being misled by some poor advice. Why not start a new topic with more details of your experience to date?

[Gout Patient]

I have had gout for over 30 years and consider myself to be an expert on the subject. I was doing research on the long term effects of taking allopurinol when I came upon your discussion. I am simply offering up advice to someone that is suffering.
When I speak of relief, I thought I was clear that relief came in the form of lowering my uric acid level to that recommended to people with gout. (5mg/dl) Sorry if I implied it was analgesic, which it clearly is not. Allopurinol is in a class of medications called xanthine oxidase inhibitors. It works by reducing the production of uric acid in the body. High levels of uric acid may cause gout attacks or kidney stones. Allopurinol is used to prevent gout attacks, not to treat them once they occur.
Keith, I dont mean to say you’re naive, but to say that generic drugs are the same as brand is just not right. Please see this article: http://www.theatlantic.com/health/archive/2015/03/generic-drugs-the-same-but-not/388592/ as well as many others that can be found, that explain exactly why generic drugs are NOT the same.
All I know is that when I started taking the brand (and I am not endorsing or being paid by Walgreens or Sabela), my serum level dropped to 5mg/dl, as recommended by doctors, and gout attacks stopped. Whereas with the generics, it was always borderline high, and I continued to have attacks.

[KK D]

Thank you for all the useful information. What both of you say make a lot sense. I usually get constant flares with little relief but this last one started December 27th and hasn’t let up. At this point I’m concerned about joint destruction. Last level was 5.5 mid December. I’m on 80 mg urloric My doctor obviously doesn’t know a whole lot and told me she doesn’t know what else to do. She refered me to a rheumatoid arthritis Doc a month out. I’m gonna get a test prior to my appointment.

[nobody]

Hi KK,
For what little that’s worth, at one point when I was prescribed an inadequate dose of colchicine by a GP I got flareups which moved from one foot to the other and back every few days.
There are also other drugs besides the ones you mentionned which people use for gout symptoms. But maybe you can’t take them (your doctor ought to know your situation best).
Unless you couldn’t afford it or something, I think you should have had an appointment with a specialist earlier.
I hope you get better soon!

[Author]

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