Can you have gout with normal uric acid levels?

[Jean Clyne]

So I have uric acid levels within normal range from 308 umol /l or 5.18 mg/dL. I have been told by a hematologist and my family doctor that uric acid level measurement has very little to do with whether you have gout or not. I have a history of it from both sides of my family and symptoms mostly in feet and hands. Vegetarian diet for last 18 months and started on allopurinol over 2 months ago.

What will it do to my uric acid levels and how low should they go? Anyone else like this?

Allopurinol gives me heartburn, headaches and loss of taste. As well as more tired than usual. My dose is now 300 mg per day. Was gradually increased to that.

I am also wondering if as I get used to this drug will the side effects reduce or go away? Am also on 100 mg Celebrex anti-inflammatory every 2 days.

Any suggestions for me?

[Keith Taylor]

Hi Jean,

Uric Acid Levels

So I can answer you properly, please can you clarify something for me?

You say your uric acid is at 308μmol/L. But, what’s your timeline of results and allopurinol treatment. I’m assuming that results were higher when you started allopurinol 2 months ago. But, what was your result then? Also, how long have you had excess uric acid. It usually takes at least 6 months for old uric acid crystals to dissolve. But, that depends on how long you’ve had high uric acid, how high it was, and how low you get it now.

Uric Acid and Gout

uric acid level measurement has very little to do with whether you have gout or not

I absolutely do not agree with that statement. Because, uric acid level is the main factor for gout diagnosis. To clarify, I’m not saying uric acid level is the only factor. But, it’s much more significant than “very little”. So, I can’t see how that statement can be justified. More importantly, it raises significant doubt in my mind that the medics saying it actually understand gout.

Which factors confirm your gout diagnosis?

Allopurinol & Heartburn

You might be able to reduce heartburn by experimenting with different times, relative to food. For example, before a meal, with a meal, or after a meal. Maybe try each option for a week. It’s not unusual to feel tired when you start uric acid lowering therapy. Because, your body has to deal with lots of changes. It’s usually tiring to recover from any disease.

Anti-inflammatory Gout Pain Relief

Finally, that’s a really strange dose of Celebrex (celecoxib). So, is there any reason why you’ve been prescribed that dosage, Jean?

[Jean Clyne]

Uric acid levels given were when testing wasfirst done last winter and then in the fall, hasn’t been done since starting on allopurinol.Celebrex dose was 2 per day during initial attack and did same when starting on allopurinol but have been able to cut dose down without any additional pain, can’t cut it to nothing or sore, swollen toe returns. I have been tested for rheumatroidarthritis, toe has been x rayed, other blood work shows up good. Symptoms of pain, aching, pins and needles always showed up several hours after eating meat, especially beef in different joints of fingers, knees, feet, toe or ankles, usually a different joint, that has occurred for at least 10 yrs, just never made the connection to gout caused by what I was eating. My delay in starting allopurinol was because uric acid levels were relatively normal so I wondered how much actually taking the drug would help but I was told the only way to get the uric acid out of my joints was to use it.
Last winter when the gout symptoms got really bad for the first time even eating a small amount of beans, lentils, chickpeas etc. with amounts of vegetable purines in them would affect me. Eating anything sweet would cause symptoms in minutes although that does not seem to be bothering me now.Gaviscon works for the heartburn, hardly ever had it before this, am just hoping my system will get used to the allopurinol.

[Keith Taylor]

Jean, it certainly sounds like you are on the right track. Because, everything you say supports the usual occasional gout symptoms during the first few months of allopurinol (Allopurinol Medication: Why It Hurts To Get Rid Of Gout).

So, I think the best thing is to arrange another uric acid test. Because that will confirm your uric acid levels remain low enough to dissolve old crystals. Then, you know that your gout recovery is working OK. You might continue with occasional symptoms for a few more months. But, you should find that gout attacks get less frequent, and less intense.

After that, you should still get tested once a year to make sure your uric acid stays safe.

[Author]

Posts