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What I meant is something that affects mechanical properties as opposed to something that acts through the nervous system for instance.
If you already tried to up your fiber intake and it didn’t help, you also know you have little use for something that works like fiber.
That would leave you with a number of popular options. Best ask your GP or a pharmacist…If you do notice bowel movement trouble, my recommendation is not to wait any longer and take something that “mechanically” helps with transit. There’s no sense in making the febuxostat dose increase harder on your body than it needs to be. And it’s harder to restart transit than to keep it going. In doubt, ask a pharmacist of your GP. You will likely only need a small amount so don’t start with the generally recommended dose.
Yes, according to mainstream thinking, gout is unlikely given your hospital test.
But it would be worth repeating the test after a few months if your symptoms persist, just to make sure the first professional result wasn’t a fluke and that your uric acid does not vary seasonally.It is also correct that a blood test is insufficient to diagnose gout while finding crystals in joint fluid is a much better basis for diagnosis.
Unfortunately, it is not the easiest test to perform and a negative result doesn’t rule out gout.Jean here has significantly higher uric than you do, Yafeng.
I need to take a drug which lowers uric acid in order to get a test result similar to yours and Jean is probably in the same situation.
Whether the test result is “normal” or not is irrevelant as gout is much less likely when people test at the low end of the “normal” range than when they test at the high end of the same range.There are many potential causes of join pain, especially if the problem is limited to a single joint in which case it might indeed be caused by something like a bunion. Untreated gout on the other hand often goes on to affect other joints.
If your GP doesn’t help, best get a specialist to examine your foot in person and investigate possible causes for your symptoms.361 ought to be fine as long as the results are consistently around 360 (or lower) as opposed to randomly switching between 360 and dangerous values.
I’d assume a two-day break is no big deal but your body seems not to work like mine so who knows what a break might do in your case?
The dietary changes I’m talking about were primarily done to reduce abdominal pain. I think it’d be best if you tried various things for yourself but I would first look at anything that can possibly cause “mechanical” difficulties (anything that causes significant gas, whole peanuts, oats that aren’t well-cooked and so forth). But maybe a low-grade food allergy of some kind is contributing to your pain for instance so I’d just try a bunch of random changes over time. What would it cost you?
About that ER visit, it was an infection so I guess the proximate cause was immune response. Anyway, antibiotics probably saved my life. Nothing to do with any side effects (or at least nothing I’m aware of).
Hi Jean!
“If you remain symptom free, why would you treat with drugs that have bad side effects for many users.”
Because, once the symptoms come back, they will probably not go away as soon as you restart allopurinol (or an equivalent). And for many users, the drugs used to treat the symptoms have even worse side effects.
The costs and risks involved in infrequent but regular blood tests aren’t negligible but are in comparison quite small. If you can pass the blood tests with a careful diet and natural preventatives such as cherries, there will be no need for you to take allopurinol or Uloric.My understanding of these SUA references values is that they’re designed to flag abnormal values in the general population (cancer could cause your SUA to increase for instance), not values that would be too high if the patient was prone to gout.
I’m not suggesting your diet may have caused abdominal pain. But I adjusted my diet a bit since taking febuxostat. It’s as if I couldn’t digest some foods as easily now that I’m taking the stuff. Your problem might of course be completely different…
I was in the ER because of a pretty advanced internal abdominal infection with swelling and stuff. Like, I would almost pass out when standing up. So I had some unusual blood test values as you might imagine.
Hi!
There seems to be a consensus about what SUA number you should aim for: 350 to 360. I guess 390 might be low enough if your are very patient and as long as you consistently test under 400. But curing gout by lowering your SUA to 500-ish? My opinion: forget it!
Some crystals could dissolve at 500-ish. Trouble is: crystals would likely build up in the colder parts of your body at the same time.
What 20mg febuxostat could do for you IMO is:
1) make your gout milder in the long run and more importantly keep the worst long-term outcomes at bay
2) possibly allow you take some drug that boosts excretion (because the risk of kindney stones would be lower), the combined effect of the drugs hopefully being enough to bring your SUA down to the recommended valueAs to what you perceive as side effects:
1) as long as you can’t substantiate them with objective data, there is a chance they could be (partly) psychological or simply unrelated
2) you don’t mention what you’ve dried to make them go away (very different diets in terms of fat, fiber, gluten and so forth, drugs that help with digestion or digestive pain in various ways, whatever else you can think of)
3) my experience has been that the non-gouty side-effects get better over timeYou always have the option of trying allo again.
But I think you should stick to febuxostat (and preferably to a dose higher than 40mg at that) if the side effects are bearable and there is no objective red flag like crazy liver function numbers. All your suffering will be for naught if you quit the drug before you obtain conclusive data.My urea was only tested once that I know of, in the ER. The value was a bit lower than yours but they might have used a different scale and the value might have been out of whack seeing in what sorry state I was in. Certainly other test results were out of whack. My SUA wasn’t tested at the time and might have been out of whack as well.
Maybe something else can give you a more useful answer about their urea tests…Thanks for this update.
This italian pill seems to have enough of an effect on uric acid that it could be used to treat some of the obese gout sufferers who get side effects from allopurinol and febuxostat. If this was the first published study about this, I hope it won’t be the last!
One problem with these pills is their price. Allo is of course much cheaper but, based on the prices I see on the web, even febuxostat is cheaper.Based on the data I’ve seen, there are not enough bacteria in regular yogurt for them to be a problem in terms of uric acid. I assume kefir doesn’t have many more bateria but I don’t know that for a fact.
Even if your kefir was a problem in terms of uric acid, 3 months is a short time to develop gout. People often have dangerous amounts of uric acid in their blood for years before they start developing symptoms.Kefir could also be a trigger for gout and other auto-immune problems if it contains things which excite your immune system for whatever reason.
But if you are experiencing gout symptoms, the root cause is uric acid rather than the triggers. Solving your uric acid problem (if you indeed have one) would allow you consume triggering foods without experiencing gout symptoms.I think it’s too early for you to worry about food. As I understand it, you never had a blood test showing that you have a uric acid problem.
If you did have too much uric acid in your system, the following basic recommendation would apply: inasmuch as your other health problems allow, get much of your protein from dairy (preferably skimmed milk and yogurt made from such) and eggs. Comsume plant-based protein sources for variety and for the other nutrients they contain. That said, beans and such are preferable to animal flesh or substitutes made from single-celled organisms or mushrooms.
Kiwis are fine as long as you do not eat ridiculous amounts. Depending on the variety, apples might contain twice as much fructose per weight. And since apples are often larger than kiwis, you’d need to eat quite a few kiwis to get as much fructose as you’d get from a large apple. Kiwis also contain a lot more vitamin C which might help with gout.Gout does damage bones and X-rays are a diagnosis tool. But it’s not the best way to diagnose gout. My understanding is that gout damage will only show in severe cases, when gout has been allowed to fester.
X-rays could reveal something other than gout though. That would make gout even less likely.Whatever the X-rays show, your blood test results should be revealing.
I recommend testing yourself before the profesionnal blood test (the less time between the two tests, the better).Uric acid in the blood testing above 13 mg/dl seems quite dangerous. That could damage more than just your joints.
Unfortunately allopurinol is not a quick cure. You shouldn’t quit the drug or adjust the dose based on the symptoms you get after a few days or even weeks. You simply have to stick to it if you want to be cured. Blood tests will tell if the dosage is appropriate.
If you’ve had gout for ten years, it could take a year or more for the cure to work. And that might be a hard year because cures such as allopurinol are known to trigger gout attacks during the first months.
There is unfortuntely no superior alternative to allopurinol in most cases. In some cases though, a combination of UA-lowering drugs or a more radical and very expensive intravenous therapy might be appropriate.
Taking enough allopurinol is critical however. Increasing the dose slowly is usually recommended. But the final dosage is insufficient, you may be putting yourself through hell for nothing.What many gout sufferers need to take along with allpurinol during the first months of the therapy is a drug that suppresses the immune system’s reaction to uric acid crystals. One such drug is indomethacin but it is a dangerous drug to take in large doses and on a regular basis. Possibly you could take a larger dose or a safer relative to that drug for a limited amount of time after restarting allopurinol. Colchicine is another such drug (which may in some cases be combined with the likes of indomethacin). There are other anti-arthitis drugs people use to control symptoms.
Colchicine is not an inherently expensive drug. If you’re asked to pay a lot of money for it, you may have been given the wrong prescription. If you can’t get your doctor to write you a prescription for the cheaper brand, see if you can get a load of the stuff across whichever border is closest to you (in many countries, colchicine is dirt cheap). If obtaining colchicne is not practical for you, ask your doctor about an alternative which isn’t a NSAID (hint: remove the N from that acronym).Best get your uric acid tested professionally. If the result agrees with your own test kit, great. But I wouldn’t recommend simply assuming these results are accurate.
If the results are accurate, I guess gout is unlikely. It’s not impossible to have gout with such results but your symptoms aren’t typical either. Maybe they’ll become more recognizable later though.If you symptoms persist but diagnosis proves difficult, consider seeing a rheumatologist.
Gout symptoms often stop on their own after a few days.
Symptoms may become more frequent but less serious and even a bit weird after initiating a drug such as allopurinol.Best get your uric acid tested after a while on 100mg to make sure that dose is sufficient in your case.
I used to get little patches of skin redness on a regular basis.
If you don’t have much UA in your blood, small deposits which come in direct contact with the blood could melt away before they have a chance to cause swelling and pain.
If your skin redness is gout-related, considering your UA level it should stop occurring before long.
