[d q]

Thank you so much for that advice @nobody !

I’ve never ever tried taking it at different times actually or with a full or empty stomach. I presently take it on an empty stomach as soon as I wake up (would that be the most concentrated way? or could I achieve better results taking it after lunch or breakfast for example going by those studies/tests?

Assuming any changes to the above causes a drops in UA by another 10 or 20 to say 330-320 would there still be a case to try 90-100mgs..?

Yea, I thought I would reserve the colchicine for the potentially bad days too.

Thank you so much mate. Thanks

[d q]

My opinions and Keith’s differ in some respects so I thought it best to let you discuss your issues with him since he was (unusually?) available.
Totally true. Besides you know how much I value both your opinions. In most cases I seek no further opinion. You and Keith have been absolutely fantastic during my troubling times even though Keith goes missing sometimes and leaves us to deal with the boards 🙂 and you both continue to be, so thanks mate.

Yes, the blood medication seems to have been and continues to be a total waste of time. I think I’ve been dealt the placebo with no way of telling until around May next year which is approximately when the unblinding occurs and if I am on the placebo I’ll finally be given the genuine drug around then too (hopefully). So I guess it’s going to have to be a XOI’s for the foreseeable future.

Yep, I think your advice is spot on, I’ll try 100mgs from next week so to time with my next blood test in about 2 weeks. I really really hope I can return to 80mgs at some point. Just a few questions;

1. How long would a fair trial of 100mgs be before attempting a return to 80mgs?
2. Would another option be alternating between 80mgs on one day and 120mgs the other (or similar)? Otherwise its going to have to be pill cutting again.
3. Would you recommend a tablet of colchicine nightly during the first 2 weeks or so? or have the numbers been low enough for long enough to not really worry too much?

@nobody – Believe me your posts definitely encourage me. 🙂 For that matter I don’t really know where I would be without your sound advice about this subject at times. It’s been a steep steep learning curve with bad bad times.

@Keith – anything to add sir?

[d q]

That’s great and potentially something to try but;

Have you considered dealing with the underlining issue of why you are getting gout attacks in the first place?

[d q]

Thank you so much @keith 🙂

I’ll do a little question answer session with my next appointment with the rheumatologist. p.s. He doesn’t hate you at all. If anything he loves you because I’ve ultimately treated myself with all the information I take to him so he has less work 🙂

The current uric acid levels situation is another story which I will post in the catch up thread.. it’s an interesting one and I’ll be sure to need your input in that one!

p.s. sorry for waking you up! 🙂

[d q]

Hello @keith

Haha ok!

So did your subconscious wake you up up then? 🙂

In general how is long term inflammation treated? Is it left to go alone itself?

Cheers mate

[d q]

Hi @keith – I vaguely remember reading somewhere maybe even a comment on this site saying something like leaving inflammation long term or sticky inflammation can actually cause harm or damage to the site and should be tackled with anti-inflammatories if it drags along too long (whatever long means..?). I wish I can find the reference to it. Is this true? Thanks as always @keith

[d q]

I’m happy to act as a private information exchange
Sounds good. I’ll drop you a message at some point so you can relay it to @nobody.

Have you considered adding a brief note of your uric acid test history to your profile
I will most certainly look into this. It’s just my present situation is a little elastic (until we find the maintenance dose anyway).

Uric acid over 6.5 mg/dL – almost certainly new crystals.
Uric acid below 6 mg/dL – almost certainly old crystals dissolving.
In between – consider temperature and 12 hours food intake.

What a simple yet extremely helpful scale. Thanks!

As for the calf pain, you didn’t mention that in your original post. Did it develop as you limped through your day? Because I’ve had that.

Actually the ankle pain and the calf pain both set in at the same time. Literally together. The bottom of the ankle joint is painful and slightly inflamed and the calf muscles also hurts. I’ve started a short course of Naproxen (250mgs twice a day) to see if it helps. I’m two days into this and will probably continue for another two days. It ‘seems’ to be a little better but I will watch it. Both my GP and Podiatrist do not think it’s gout and more to do with prolonged standing however my Podiatrist said ‘see how it goes for another few days’ and to get back to him if there is no recovery. He also mentioned to avoid the Naproxen course if possible and just stick to a few topical solutions like Deep Relief gel first. Maybe I’ll take Naproxen for one more day then try the gels.

Colchicine is anti-inflammatory in the sense that it limits the spread of inflammation. But pre-existing inflammation needs NSAIDs or similar to actually reduce swelling. Unless you wait for it to disperse naturally.

Thanks for this, just out of interest, if one was to wait for inflammation to disperse naturally should a time limit be set on how long to wait before using drugs? Does playing the waiting game cause more harm then good after a set period of time?

Thank you so much @keith

[d q]

Bumped into my GP on the way back from work! Mentioned the situation to her and she said its unlikely related to gout if the pain is also in the calf muscle. I asked about DVT and she said my calf muscle would be super stiff if it was that.

She said its probably over exertion from all the standing and uncomfortable sitting from the hospital and if it gets worse take some anti-inflammatories but it should clear up in a few days. Does colchicine constitute an anti-inflammatory in these cases or is it predominantly used in gout related inflammation cases only?

Crystals should form quite slowly and shouldn’t form at all if your SUA is low enough most of the time. Don’t worry about that.
I really hope this is the case @nobody because the next stage is upping the dose

(p.s. keep an eye out for the email exchange thread)

[d q]

I was wondering if you ever managed to do a blood test before a few pieces of broccoli and after a few pieces of broccoli to back that statement as I would really be intrigued to see your results. 🙂 It would be far and few before you find anyone that has a UA problem as a result of eating too much of a problematic vegetable.

Exorbitant facts can sometimes cause paranoia which can lead to depression which is far more dangerous then just eating all vegetables in moderation.

nobody, take my answer with a pinch of salt and relax ey 😉

[d q]

I always thought purines from vegetables didn’t make ‘much’ of a difference with regards to UA levels when compared to the benefit gain. I have broccoli almost every other day! From what I’ve read that stuff does wonders for you!

I was under the impression you’d have to be farming that stuff in your 4 acre backyard and eating kilos of it to make much of a difference to UA levels on an ongoing basis ..? 🙂

In all honesty food will at best give you a 15% +- affect on UA levels (not including fizzy drinks, alcohol or cow spleen and lambs brains, etc. as that has a big impact). If your on the edge of control then sure you could go ahead and modify your diet but you need to balance that with commitment and maintenance. Can you commit? Or can you commit better to a very low dose of UA lowering medication more?

[d q]

Fair enough – good news!

I took one colchicine tablet last night as a precaution which didn’t seem to do much but as I say the pain is generally bearable (so far).

However (maybe for general knowledge sake) is this normal during the healing part of gout or is this not normally the case or not normally common?

Thanks buddy

[d q]

@Keith – Rock on! Thanks mate. It’s amazing cream by the way! 🙂

[d q]

@nobody – LOL..! A true comedian.

[d q]

@keith – excuse the ignorance but I am not too sure what you mean :)..?

I don’t believe any crap like that. I’m just asking if Urea in Allpresan may have an impact on UA levels in someone with gout since the cream is absorbed directly into the base of the feet..?

Cheers

[d q]

Thanks guys, yea I decided to delay it a few days.

I figured with the new medication and the fact that I am still ultimately searching for the ideal maintenance dose (and the fact that I have very few of these steak meals) it would probably be better to keep things in check dose wise for a few more weeks. Once a reliable trend figure is established I’ll be more comfortable with seeing strange figures from the odd meal.

I’ll update you both on the latest results in a few days.

Thanks

[d q]

Hi Margaret, I’m sorry to hear about your situation.

Before getting into a detailed response, what medications do you actually have allergies to? There are a few options out there.

[d q]

Hi, thanks for taking time to post your concerns.
In all honesty @nobody has answered most of your immediate questions spot on however what can be added is as follows;

1. The question here is how long you have had high uric acid prior to your first attack? Your first attack is just a precursor that you have indeed had high uric acid for many years.

2. It’s next to impossible to predict if you’ll have to live with the pain for the rest of your life because; you have only just started treatment and uric acid is toxic to both joints and muscles. The only way to get an indication is by watching if your symptoms are improving or not with time on lower UA levels. As uric acid leaves the body the associated risks are also removed. Your body is incredible at healing itself by the way. So in short, time will tell.

3. Joint damage is a result of neglecting treatment options. If you treat fast you minimise damage (if any). If you live it late, joint damage sets in. Remember, joint pain whilst uric acid levels are declining (below saturation point) is not necessarily a bad sign. It could be that these pains are actually crystals dissolving and your body is simply reacting to the crystal demobilisation [Do you have light inflammation?]. Think of it as a wound, every time you scratch the same location the pain strikes and lingers but every night you go to sleep the body is healing it.

4. This is fully answered by @nobody.

5. See 4.

6. I cannot emphasize enough how important it is not to put too much strain on joints that have had attacks. When uric acid is dissolving anything exertion can mobilise crystals and an attack can follow. If you can get your heart rate up (cardio) avoiding the affected joint that should be good. At least until your symptoms settle.

7. Make sure your shoes are comfortable. Maybe see a podiatrist to keep weight of affected joints whilst they recover using insoles – you shouldn’t have to limp or change walking habits for too long after an attack.

When you reduce your uric acid levels you are more then just dissolving crystals. You are also cleansing your muscles which are saturated with the stuff. You need to maintain low UA levels for months and possibly years to really detoxify. As levels stay low, you will become more acquainted with what pains will probably stick with you and what pains will disappear.

p.s. If you have old blood test results check them to compare what your general history was like.

Good luck.

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