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How much have you managed to lower your uric acid by so far? By which I mean, what are your uric acid levels over the 5 years you’ve been trying to control uric acid through diet?
Will Malic Acid help your Gout?
Hi Clayton,
I know that people adopt vegan diets for various reasons. But, if your main reason is for gout management, then you are right to be wary. However, I hope you read my paragraph in Why Vegan Diet is Worst for Gout:
If you are vegan, there is a lot you can do to make your diet gout-friendly. The report proves certain gout diet principles that we know about. It proves that some animal products are very good for gout. But, if your personal situation prevents you from consuming animal products, we can plan your diet around that. This is why I emphasize the need for personal diet planning. It is why I provide free personal gout diet plans. To get yours, you just have to ask in the forums.
Before I knew about this study, we discussed veganism and gout in the old gout forum occasionally. As it was never a popular topic, we never reached any great conclusions about the best vegan diet for gout. But, one positive factor did emerge: vegans tend to be skinny. So, since low weight is associated with less gout, vegans have at least one advantage. Furthermore, if we can supplement a vegan diet with those nutrients that help gout, a vegan diet could be very good for gout.
But, all of that is averages, and general points. None of which helps you as an individual gout sufferer, Clayton. So, if you want to become vegan, I can help you make a vegan diet gout-friendly. On the other hand, if you prefer vegetarian or omnivore, I can also help with other gout-friendly eating plans. Because, I always start with what you like to eat. Then, I find ways to incorporate your favorite foods into a healthy gout diet. Because, that approach is the only way to find a personal gout diet that you will stay with.
Statistically, vegan diet is worst for gout. But, individually, it’s easier to make it gout-friendly than many other eating styles.
To conclude, Clayton, how would you like me to help you avoid gout pain in future? Either a vegan diet for gout? Or, just improve what you like to eat now?
Gout pain is actually a complicated process, Julie. Because of that, some people do not get the painful immune system response that average people get. So, in some ways that’s a blessing. But, it also means you get a huge uric acid crystal burden before you get to treating your high uric acid.
However, it seems like you have a good idea to start allopurinol. So, let’s hope that idea becomes a good plan. If you need help with planning your allopurinol therapy safely, just ask.
Hi Robert,
I’m intrigued to know which pain relieving patches you are using for your gout pain. Also, what is the active ingredient(s) that help you recover from a gout attack.
But, most of all, I’m concerned that you are ignoring uric acid crystals. Because, those crystals increase every day, even when you have no gout pain. So, eventually, your burden of old uric acid crystals becomes so big, it will break you. Then, as you get older, it becomes harder to recover from gout.
Therefore, I strongly recommend that you start a plan to get your uric acid safe, as soon as possible. So, your doctor should help you with that. But, if you want extra help, just post here whenever you want.
Let’s learn to control your gout.
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.
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?
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?
In my experience, walking gives faster gout flare recovery. So, I believe you are just getting repeated attacks because your uric acid level is in a bad place. But, your next uric acid test results will provide better information.
“did you titrate on your doctor’s advice or just because you did your own research?”
A mixture of doctors advice and my determination. Because 3 doctors were happy to stop titrating once I reached average. But, I like to think I’m better than average. Then my fourth doctor was very supportive. So once I’d got to 300mg/day with no ill effects, I rapidly went to 600, then 900mg allopurinol per day. The doctor prescribed colchicine to take for 2 weeks at dose change. But, on the whole, I relied on max strength ibuprofen and paracetamol.“Also what did you get your uric acid levels down to whilst being on 900mgs for those years?”
I recall it was less than 300μmol/L. But, I can’t remember the exact figure. So, I’m going to try and get my history when I see my doctor after Easter.“Did you suffer any side effects?”
No“Finally suffer an attack after attack on 900mgs for a few months?”
No, attacks were very rare, and I was prepared for them. I feel all my preparation was worthwhile. Because I knew exactly what to ask my doctors. Also, I knew that my best chance of least-pain recovery was to get as low as possible, as fast as possible.“Thanks, Keith, you’ve been fantastic in helping me.”
I think you’ve helped me more! Because I cannot run this forum unless people like you are brave enough to discuss their health in public. So, you should be proud d_q! Because thousands of silent readers benefit from your questions and our discussions.I would get the uric acid test irrespective of the timing of gout attacks. Because, I don’t think it will make any significant difference to your treatment plan. For example, if your level was temporarily reduced from 380 to 370μmol/L, you’d still to increase allopurinol dose.
On the other hand, if your results showed a surprisingly low figure, you could easily arrange a follow-up test in two weeks. So, overall, from memory of your uric acid test results, I think the sooner you get uric acid lower, the better. Because, it seems to me that your current level is causing the dreaded Gout Hell. That is, repeated gout flares as old crystals start dissolving, then re-form.
Allopurinol and Joint Pain
Hi Sandeep,
I really need to know your uric acid levels. Because without that information, I can only give you guesses. So, my best guess is that allopurinol is working as it should do. By which I mean, it is causing old uric acid crystals to dissolve. Therefore, if the stiffness is too much, you should take anti-inflammatory medicine, as advised by your doctor. In fact, you need a good pain control plan for a few months, until allopurinol has caused most of your old uric acid crystals to dissolve. If your doctor cannot suggest a good plan for gout pain control, then I can help you.
Allopurinol Side Effects & Joint Pain
As for long-term side effects, I am not aware of any for allopurinol. But, there are concerns about long-term effects of febuxostat on the liver. For that reason, febuxostat patients should always insist on liver function tests at least every three months. You can use my search box near the top of each page to search for more information about febuxostat and liver.
Febuxostat Allopurinol Search Results. What will you search for next?
From Cindy, High Uric Acid with high blood sugar:
Thank you Keith for your good heart & hard work in keeping the website! Truly I’ve learned a lot in treating my husband’s high uric acid & the non-stop gout flares since Oct. last year. We are happier now because we know at least this illness can be “managed”.
Cindy, it’s great to read that your husband’s allopurinol treatment is going well. So, I’m looking forward to reading more about his successful gout recovery in the next few months.
Especially thanks for your kind words. Because that’s another quote for my Testimonials collection. Which makes it all worthwhile.
How do you test for high uric acid and high blood sugar?
OK John, here is your new gout diary. It’s up to you how you organize it. But, if you need help, just ask. If you want me to respond to any of your topics in your forum, please check the box that says “This is a support topic” near the submit button.
I’ll respond to this topic without it being marked for support.
1. Colchicine slows inflammation getting worse. But, it does nothing for existing inflammation. So, you should have started naproxen earlier. Also, it should be taken at maximum strength as advised by your doctor/pharmacist. OTC dose is only good for mild gout attacks. In worst gout cases, naproxen can be supported by acetaminophen. So, ask your doc/pharmacist about that too. With the right pain control, you should never need time off work with gout.
2. Gentle exercise is good for gout. So, do as much as your pain relief allows. In my experience, walking helps resolve gout pain below the waist much quicker than resting. But, avoid strenuous exercise. Because uric acid crystals weaken tendons, cartilage, etc. Wearing boots is good, as they support the foot and ankle better. But, make sure they are large enough to take your swollen foot. Then wear extra socks for cushioning and comfort.
3. I cannot find any references that mention raised uric acid or gout in respect to amitriptyline. But, you should mention it when you discuss pain control, as there could be interactions there.
Hi Joe ( @joe-montorio-2 )
When you say “I can’t seem to lower my uric acid levels”, what have you tried? ❓
Your wording suggests a random approach. But effective gout control needs a proper plan. In your case, I think your first decision is the type of uric acid lowering therapy you prefer. So, do you prefer drugs, herbs, or diet? You can mix and match from all 3 types if you wish. But, most gout sufferers have a preference.
To begin with, I suggest you take a look at GoutPal Plan for Gout Seekers. Then, start a plan, or I can help you start one.
Let’s control your gout before it gets more serious.
@d-q if we could isolate a single gout attack, I’d say 5 to 7 days to resolve it naturally. Also, I’ve recently learned a little bit about how we might reduce that to 3-5 days. Because what we eat can influence how quickly inflammation subsides. So, as we learn more about efferocytosis, I’ll probably get a better idea of numbers of days for natural gout flare resolution. In any case, it’s good to be aware of factors we can manage to avoid lingering gout.
But, if you don’t get uric acid below 300μmol/L (or at least below 350, i.e. 6mg/dL), you are likely to get another attack. Which is likely to happen before the previous one resolves. Therefore, the Gout Hell scenario that I mentioned earlier seems relevant now.
So that’s why a good plan is essential. Because you need to get through the Gout Hell risk zone as quickly as possible. Also, nothing I’ve read recently persuades me that my personal plan is wrong.
Firstly I learned to control gout pain so I could stop an attack within half a day. Usually, around 2 hours, max.
Secondly, I safely titrated allopurinol up to the max. Which is 900mg per day in the UK, 800 in the USA.
Also, that allowed me to do 2½ years on allopurinol. Then, 3¼ years without meds (but I think I’m pushing it now!).In conclusion, I guess I just like to get on with it. Because I spend far too much time procrastinating before I act. Maybe, other people like to start quicker. Then, edge forward at a slower pace.
Hi Peter,
I hope you will post your uric acid test result numbers when you get them. Labels like “high” are pretty meaningless. So, I prefer actual numbers. Because uric acid numbers allow you to have a safe gout recovery plan.
Doctors rarely have enough time to explain things properly. So, you never get the best treatment plan that matches your gout. If you want some structured help with a gout recovery plan, start a new topic explaining what you expect to achieve. Then I can advise you in a step-by-step manner.
Hi John,
I hope you’ll return and post your uric acid test results. Your best next move would be to start a gout diary. That way, I can help you prepare pain control for any future attacks. Because, there is no way you should allow gout to interfere with your work. Then, when you’re happy with pain control, we can set a plan to stop gout ever returning. Also, I can help you with the healthy eating.
Be kind to your future self 🙂
