How Do I Get Rid Of Gout ASAP?

[Gavin Robinson]

Hi there

My name is Gavin, I turned 40 in Jan this year and been suffering with flare ups since then 🙁

No family history but my diet has always been varied and fairly healthy although I am no doubt overweight and as a CAMRA member in the UK I do like to put a few ales down! Well, those have been on the back burner now for nearly 3 weeks since my worst attack to date which has now been going on and off for 3 weeks with a major flare up each week.

I recently invested in a Benecheck uric acid tester and I’m testing myself daily. When I started I was up at .44 mmol/l I’m now down to .37 and hopefully continuing in that direction. It’s been tough though I have to say but I am determined to hang in there and get into the safe zone before I then start to look at how normal I’m going to be able to get my diet back to although I don’t see it ever being the same as before.

I’ve been prescribed naproxen for the pain with limited results. No allopurinol but j can see that it may be the only way forward, at least to help to at least get my weight down. ( I was playing football weekly before Xmas but after playing for the first time this year last week I have now had 2 separate flare ups ).

Anyway hello to all, any tips/advice that anyone has for a newcomer would be greatly appreciated!

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Which is best? BeneCheck Uric Acid Tester? UASure? Or a different uric acid test kit?

[Keith Taylor]

Hi Gavin,

I’m encouraged by your progress so far. Also, I hope you are addressing all the key gout issues with your diet. It might be that you can get control just with lifestyle changes. On the other hand, a year on allopurinol might be the best thing until you get your diet fully under control. So, it’s up to you. Because there’s no right or wrong way to get uric acid safe. Only the best way that suits you.

As for gout pain control, you might need more than just naproxen. What dosage have you been prescribed?

Are you ready for Gout Treatment Reconnaissance? Seek out the best plan for your gout.

[Gavin Robinson]

Thanks for replying Keith

Yep the battle with Uric Acid seems to be a daily struggle, i.e. today I’m back up to 0.39 so on the brink of the danger zone 🙁 I’m going to get in with the docs this week to talk about the options going forward and likely I’ll need to take the allopurinol as you say. At least that way I can aim to get somewhere near back to normal and it gives me some bandwidth to be able to get on a low cal diet and exercise properly (seems to set it off for me!). At the moment I just seem to be tracking between 0.37 and 0.4 and as soon as I go over 0.4 I get another attack so not sure what else I can do at the moment tbh. I’m nailing the ACV and tried the cherry juice (didnt seem to work for me) and obviously I’m completely off all meats, gravy, booze etc. as I just cant risk tipping over that 0.4 mark.

Naproxen wise, doc has told me to take 2X250mg as soon as it hits, then repeat every 4 hours until pain has gone. With this latest attack it does actually seem to have relieved the symptoms but previous attacks its either not had any effect or just taken the edge of it.

[Keith Taylor]

Gavin, it sounds to me that you’re in a place I call Gout Hell.

To explain, uric acid crystals often bite twice. Firstly, when new crystals form, our immune system triggers the painful inflammation process. Our white blood cells often fight the invading crystals silently. But, when they have to call for reinforcements, we get inflammation in the form of a gout attack. As an aside, colchicine can block that process. Though, it does nothing for inflammation once it has started. So, I often recommend a combination of colchicine and naproxen (or similar anti-inflammatory).

Secondly, when uric acid levels fall below the crystallization point, old crystals start to dissolve. Now, the crystallization point varies from person to person. Also, it varies in different parts of our bodies, and at different times. But, typically, it’s in the 0.35-4.0 range. So, as crystals start to dissolve, they are visible to our immune system again. Not only that, but the dissolved uric acid can push levels up again, causing new crystals to form.

So, Gout Hell is a place where our immune system is constantly challenged by old crystals dissolving, and new ones forming. Which means:

1) You need a gout pain control package that is more effective than naproxen alone. Modern thinking is to combine it with other drugs. So, I’ve mentioned colchicine. But it’s not for everyone. However, naproxen/paracetamol combos are often very effective. Anyway, there’s thousands of combinations that will keep gout pain under control while you enjoy your life. So, you need to discuss this with your doctor.

2) You need a uric acid control package that gets your uric acid safe asap. Then, once you’ve recovered from your current uric acid burden, you can take a longer term view about lifestyle changes that might reduce your reliance on uric acid lowering meds.

I can help you as much as you want me to. Either continue to ask casual questions like this topic. Or make a bigger time commitment in a personal gout diary. Possibly leading to structured gout help plans. It’s completely up to you how you use my gout support services. Just remember, I’m here whenever you need me.

[Gavin Robinson]

Hi Keith

Thanks again for taking the time to respond and with such a detailed post.

The Gout Hell theory makes a lot of sense based on what you are saying and the readings I’m getting.

These are my readings since I started tracking (mmol/l). I do these each morning between 7:30 and 8:00 am :

Sat 08/04/2017 0.44
Sun 09/04/2017 0.42
Mon 10/04/2017 0.39
Tue 11/04/2017 0.38
Wed 12/04/2017 0.41
Thu 13/04/2017 0.38
Fri 14/04/2017 0.37
Sat 15/04/2017 0.37
Sun 16/04/2017 0.39
Mon 17/04/2017 0.39

This is basically what I’ve been eating since 8th April (does any of this look dodgey?):
Cheese
White Bread
Bananas, Apples, Blueberries, Raspberries
Weeatabix
Skimmed or semi-skimmed milk
Cabbage, Carrots, Potato
Cocunut Oil
Olive Oil
Spread
Fresh squeezed lemon/lime/orange juice (watered down)
Lots of filtered water (I mean like 8 pints a day!)
Tea (general 1 or 2 cups a day)
Yellow and red peppers
Cucumber
Eggs (normally omelette)
Garlic
Onion
Tomatoes
ACV (2 glugs per day)
Honey (small quantities)

I’m going to try for an emergency GP appointment tomorrow, will let you know how that goes and will be raising the points you’ve made for sure!

Thanks again for your help
Gavin

[Keith Taylor]

That’s a great post, Gavin! I love lots of data, as it helps me draw real conclusions rather than guessing.

In conclusion, I agree your detailed readings match a Gout Hell scenario. Also, your diet seems healthy enough. Although I don’t have portion sizes to quantify that view. But, the true tests of diet are mainly covered by 2 simple measurements:

– Firstly, your weight. Because if this is slowly falling, you should see a small fall in uric acid numbers. But, I think we should wait for your doc’s input before taking that any further.

– Secondly, your urine pH. Because that tells you if you are getting the right proportion of fruit and veg in your diet. Then, if pH is less than 6.5, swap some foods for healthier options. For example, swap a slice of bread for spinach. Or, a little less cheese for a little more onion. Slow changes in the right direction are easier and more sustainable than sudden big changes.

Finally, I can’t wait to read your doctors opinions and advice. Hopefully, we can all work together to make sure 2017 is the only year you’ll ever suffer gout pain.

[d q]

@Gavin,

I’m sorry about your situation mate and if it’s any consilience I am literally in the same boat as you. I had an attack attack 3 weeks ago yesterday and had my second flare up about 5 days ago (literally back-to-back). The attack started off lightly, got worse then got better then I started walking on it (maybe a little too early) only to be struck by another attack 5 days ago. I too stopped naproxen about 10 days into the primary attack as it didn’t do much. The primary attack came literally 3 days after increasing allopurinol from 200mgs to 300mgs (hoping its me coming out of Gout Hell as Keith explains). I’ve tried to hold out measuring my uric acid levels until the attack subsides to avoid incorrect results but was too worried the increase in allopurinol might be causing liver/kidney problems so decided to get the blood test anyway. I’ll have the results tomorrow so as Keith said we’ll have a rough idea were my levels stand.

To be honest I haven’t changed my diet too much after starting allopurinol. The whole point of allopurinol is to give you a sigh of relief with food habits not changing too much providing you generally eat reasonably healthy. An extremely strict diet will only help so much before medication becomes the most ‘convenient’ way to enjoy life. Holidays breaks, burger with friends, etc.

Finally I too would like to hear what your doctor has to say.
Good luck buddy.

@Keith, which PH stripes do you use mate? Any generic ones from eBay/Amazon? Thanks pal.

[Keith Taylor]

Yes, d_q, I got whichever pH strips were best value at the time from Amazon. However, I find color matching the little squares a little awkward in this digital age. So, I’m aiming to get a meter. Because, not only will that make testing easier. But, also, I like to include words like “aiming” when I’m discussing this topic. 😀

[Patrick]

Hello Gavin. Welcome to the best Gout site on the web. It sounds like you got the right man on the job with Keith, and listen to what he says, as well as the others who are experiencing many of the same issues as you. Of course, like anything, some will do what they want to do….i.e. Herbs, juices, holistic medication, etc.

I won’t reiterate what the Keith has already said, but I will tell the one thing that I preach… GET HEALTHY, buddy. First off, there is absolutely nothing wrong with putting down a “few ales.” Honestly, I do the same myself. But one thing you mentioned was that you were “no doubt overweight” and this can be an issue, buddy. It looks like you are already addressing it by posting your new diet plan, but couple that with a light exercise plan to go along with that. Walking and swimming to start. Basically any aerobic exercise to get your heart to a target level, and sustain it for a period of time. As you get more acclimated to that, stretch your distance, or challenge yourself. Try a hike, or light jog. Maybe biking, which is easier on your joints. Either way, proper diet, proper hydration and exercise will not only help your Gout, it will help you with any other potential issues you may face in the future.

Keep the posters updated on your progress and as always, good luck buddy

[Gavin Robinson]

Hello all

Bit of an update.

Finally managed to get a doctor’s appointment last Thursday morning. Explained to him what was going on and showed him my readings. He said they are interesting but they won’t use prick test meters to make a diagnosis.

Because the pain isn’t in my great toe (I get it around my smaller toes, but behind) he’s not entirely set on gout and he’s unsure if it’s gout or a mortons neuromo. Could be both I guess? (Nice ….). Anyway he said to tell my wife I am ‘an odd case’. I have a further appointment booked for Monday morning and a follow up week today including lab blood test.

We talked about diet, he was surprised I had even cut out the moderate purines like chicken, he was fairly adamant I’d be ok on those.

We talked about pain relief, I said the naproxen works to some degree but not for a severe attack so he has prescribed me some colchicine.

Last night I had my first curry (chicken madras) in a month and 1 beer. I got into bed at around 10pm then I was up in agony until 2.30am. I took 2 naproxen at 11pm – did nothing. So I decided to break out the colchicine. Took one of those at midnight, by 1am I seemed to have some relief but still too painful to sleep so took another around 1.30am. Last time I checked the clock was 2.15 am then kids woke up at 6.30am lol. I’m now low on naproxen so took 2x400mg ibuprofen with my breakfast and I have to say the pain today is now much lower (probably more the colchicine?). This is the first time I’ve experienced that on a really bad attack, I’m normally in agony for at least 2 whole days.

Another thing I wanted to mention, was last night when I had the pain my leg muscles were also spasming (this was before any medication) anyone else ever had that? Not sure if it could be just a reaction to the pain?

UA prick test reading was 0.41 this morning so definitely on my high end based on previous results above. My mate (who has gout) says he was told they don’t normally prescribe allopurinol unless you’re over 0.5? Don’t know how true that is? Was just what his doc said.

Anyone know anything about mortons neuromo or what else this could be of it’s not gout or that? Nerve related maybe? I’ve looked at mortons neuromo and although the pain area seems to fit the level of pain profile doesn’t.

Anyway thanks again too everyone that’s responded. I’m sure we’ll all get there in the end.

[nobody]

Hi!
Allopurinol is prescribed in cases when lab test come back at around 0.4. It’s just that if your UA is kind of borderline doctors may work harder to make sure your symtoms are really gout before prescribing it.

The way you talk about colchicine, you’re taking it as a kind of painkiller. But it acts slowly and prevents attacks from coming back. It’s better to take it before you start really hurting.
If you’re feeling better but your symptoms aren’t completely gone and assuming you did not experience serious side-effects from your last colchicine pill, I’d recommend continuing to take a little for at least a couple of days. You didn’t say how much colchicine there is in your pills and I’m not your doctor so I can’t tell you how much you should take exactly but pills taken during the night ought to be effective for at least part of the following day.

[Gavin Robinson]

Hi @nobody

Yes, the doc gave me 12 x 0.5 mcg pills and said to take 1 as soon as an attack shows signs, if it hasnt improved after an hour then take another – no more than 4 a day. I did take another one last night at 10pm and another this morning at around 9am.

Foot was great yesterday, probably better than it’s been for 3 weeks I would say, even after that really bad attack on Friday night. If I could maintain it at that level I could definately be starting to exercise again. (at the moment just walking seems to bring it on). I was also taking 400mg Ibuprofen with each meal 1600mg in total over the day which I think is probably quite a lot!?

One odd thing that has happened is I now have a rash around my eyes (including the eyelids). I dont have a rash anywhere else. I’ve looked it up and it seems it could be a side effect of the Colchicine or the Ibuprofen. I’ve now stopped taking both until I see the doc at 10am tomorrow morning. I had a little bit of sick feeling yesterday for the odd 30 mins but nothing major, that could also have been down to the lack of sleep as I actually feel fine today. Not had any other issues than the eye rash so I will defo be breaching the option of preventative use with the doc tomorrow.

[nobody]

Colchicine did give me itchy eyes a few times after starting the pills but not an actual rash. That went away after a while even though I was continuing to take the pills.
Another thing: it’s sometimes recommended that people on colchicine be careful not to touch their eyes with dirty hands and such because of the way the drug hampers your immune system.
If your rash gets worse, consider not taking colchicine anymore until you’ve reported that to your doctor. The drug remains in your system a while so some side effects may not go away immediately.

Colchicine often gives people diarrhea, especially at higher doses. I’ve experienced that but it seems others also got stomach pains and such. Stomach pain is something I got with Ibuprofen instead.

I don’t think 1600mg Ibuprofen per day is a very high dose but I’d say it’s still more dangerous than 1.0mg of colchicine a day (but everyone is different).
Ibuprofen can also cause increasing damage over time. Some people are more sensitive than others so I think you ought to get blood tests for that if it’s the first time you’re taking that much every day for weeks on end. The same goes for Naproxen.

If walking causes foot pain, I personally recommend finding another way to exercise or simply to get a hot shower because you need to get your heart pumping and your blood flowing a bit. Some people also get hot foot baths to make their blood flow in the foot specifically.
If you can’t walk much, I think it would also be wise to carefully make your foot move while you’re lying down. It doesn’t matter much if you’re only hurting a few days but not making your foot move and bend in every direction for weeks on end can cause damage which won’t heal fast.

With about 1.0mg of colchicine a day, you might succeed in getting rid of gout symptoms completely within 2-4 days. Some people use more for a limited time but I’d recommend trying a moderate dose first.
If your foot has been painful for weeks though, that may have caused damage that won’t heal that fast no matter how thoroughly you get rid of gout symptoms. Gout can also be triggered by mechanical damage which might initially be masked by gout.

[Gavin Robinson]

Hi all

Bit of a brief update this time. Went to doc’s again this morning. Spoke to him about how I should be using the Colchicine, turns out the pharmacy printed the wrong instructions on the label! It should have read – Take 2 daily but no more than 4 – but actually read to only take them when needed!

So anyway, he said to take 2 per day for the time being until he has a chance to check my UA level via lab test then we can work it out next steps from there. Based on how its gone last few days I think I may be able to get away with 1 per day, I discussed that with him and he said if you can then even better. So my plan will probably be 2 per day this week then try 1 per day next week and see how it goes. As I said I want to get back on the exercising (I have a cross trainer at home!) so that’s the immediate plan and maintain the diet of course!

We also spoke about the rash around my eyes, he said nothing really to worry about but its a trade off vs. the agony of the flare ups. So I think I’ll take that. As I said in a previous post I’ve not had any of the usual side effects like being sick or diarrhoea (or not yet anyway fingers crossed).

Just to add a bit of humour he was also telling me how he was still ‘hanging’ from a stag weekend in Dublin. Copious amounts of Harp Lager and Jameson’s Whisky?? I’m like, you’ll be next mate!! 😉

Next milestone will be blood test on Sat morning.

Again, thanks everyone for your replies/support!

[d q]

or simply to get a hot shower because you need to get your heart pumping and your blood flowing a bit. Some people also get hot foot baths to make their blood flow in the foot specifically.
If you can’t walk much, I think it would also be wise to carefully make your foot move while you’re lying down. It doesn’t matter much if you’re only hurting a few days but not making your foot move and bend in every direction for weeks on end can cause damage which won’t heal fast.

Hi @gavin, I can definitely vouch on that statement. Try a foot bath and some Epsom salt. That was like striking a gold mine solution with regards to the pain. The pain subsided soon after and to be honest I think my foot healed a little quicker as a result.

[Gavin Robinson]

Hello all

Appreciate that I haven’t posted for a while and I wanted to give an update on my situation as things have moved on significantly.

My gout diagnosis has now been confirmed, I’ve been taking 100mg of Allopurinol since early May and (luckily) haven’t needed to continue with my Colchicine dose although I have some in case of emergency. Touch wood, I’ve had no major symptoms since I started the Allopurinol.

I’ve had 2 lab blood tests over that time averaging around the 0.37/39 mmol mark. Both tests matched my Benecheck meter prick test which I was really pleased about so I can use this as a viable way to monitor my UA levels going forward.

Bought myself an activity watch, sorted out my diet significantly and I’ve so far lost just over a stone of weight and I’m exercising 6 days a week. Last month I did the BHF May marathon and managed 52 miles (over the whole of May).

All of the above seems to be working for me. I even had my first steak since last year on Monday night and doesn’t seem to have caused me any problems. I’ve been limiting my alchohol intake but I have been drinking, mainly sticking to dry (less fructose sugar) cider and slimline gin and tonic. Again I haven’t had any significant symptoms nor have I really seen an increase in UA levels after consumption.

I’ll continue to update on progress, hopefully this will be useful to other/new members of the forum. Again thanks to everyone who’s provided input.

[d q]

@Gavin – good to see your back up and fully functional. Success stories are exactly what we like to hear so well done to you. Just make sure you keep a benchmark blood test for liver and kidney before starting allopurinol and a blood test shortly after starting allopurinol to compare livery and kidney functions and to confirm everything is ok.

Secondly, may I ask what sort of exercise your doing, is it just the cross trainer you have at home?

Finally, which brand of prick test monitor are you using?

Thanks

[Gavin Robinson]

@d_q Hi! thanks for the response.

Prick tester I’m using is a Benecheck device, here’s a link to the supplier I bought it from in the UK: http://www.millermedicalsupplies.com/diagnostics/cholesterol-meters-strips/benecheck-meters-strips/benecheck-plus-multi-monitoring-system-with-carry-case-lancing-pen-and-lancets

It also does cholestrol and glucose but I’ve not tried those so cant really vouch for it being any good for those. As I said in previous post, personally I’ve compared 2 UA tests with the Lab and both matched to 2 decimal places (a little confusing as the NHS seem to use mmmol where as the tester is ummol but just a question of shifting the decimal place)

Exercise has been mainly the cross trainer, which I have at home. Quite a lot of walking (Sunday week I walked 17 miles!) and a bit of swimming too.

Hope that helps.

[d q]

@Gavin – Exactly the info I needed, thanks mate 🙂

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