[nobody]

I do take colchicine for flareups but I don’t think it’s the best way to use it because it acts slowly.
So far as I know, it’s typically used as a way to prevent flareups (by taking a pill every day) but in my experience it can also disrupt them. It might bring a little relief but shouldn’t get rid of ongoing symptoms on the first day. But see if the swelling improves over the next few days.
I don’t know whether colchicine would help but I think it’s worth trying. Knowing that it doesn’t help would be a clue as to what’s causing your ongoing symptoms.

Some people can fix gout by tweaking their diets, losing weight and so forth.
There’s a definite connection between gout and lifestyles. But if you strongly predisposed to get gout, you’ll get it no matter what. Lots of males get gout way younger than you did so taking care of yourself as you did may have given you many medication-free years.

If you only got one blood test since you’ve been on 200mg, I’d get another. 5.7 mg/dl is kind of borderline and there are variations in test results. If your UA was lower than usual when you got 5.7, it could be too high much of the time.
And some people recommend aiming lower than 5.7 in the first place. Opinions vary but I suspect my doctors would tell you to lower your UA further if your symptoms don’t go away after a while.
Sometimes there is a medical reason not to take more than 200mg though.

[nobody]

Hello,

My understanding is that full recovery from a gout attack typically occurs in less than 2 weeks.
But I have had symptoms which lasted for months before I started taking colchicine in sufficiently large amounts. Others have experienced long-lasting symptoms as well.
Your situation is not typical to begin with. Some of us have experienced ongoing symptoms after lowering our UA (be it through drugs or diet).
If you haven’t yet tried colchicine, you might want to talk to your doctor about it. There are other drugs such as corticosteroids which might help put a stop to your ongoing symptoms.
I don’t know when you’ve started taking 200mg but if your dose change was recent, I wouldn’t worry about your foot not healing just yet. If you’ve been on 200mg for a while, it’s possible you would benefit from taking a bit more.
It’s also possible your last attack did some damage to your foot that explains (some of) your symptoms. In that case, drugs may not help much. Aside from the injuries that serious swelling can cause or contribute to, gout seems to contribute to the development of other conditions such as osteoarthritis. If your foot doesn’t improve, you might have to ask your rheuma to take a closer look at it.

The information you’ve just given would lead me to guess that you’re going to have a long term relationship with allopurinol. If you have a problem with allopurinol in particular, there are other drugs and remedies you could take instead. But you’re most likely have to take something or other. You could try to optimize your diet and lifestyle but I don’t think that would be sufficient to keep you safe in the long run.
There’s little harm in trying different things as long as your are monitoring your uric acid closely. There’s also evidence that people can quit allopurinol for a little while without ill effects. But I would wait until you’ve been symptom-free for a long time before attempting anything of the sort. The longer you’ve been taking allopurinol, the safer it would be to take a break. To be clear, I’m talking years.

[nobody]

Typically, untreated gout as you say never really goes away.
I’m not comfortable with all the assumptions being made. If you do have gout, you might have had too much uric acid for most of your life regardless of how much you were drinking. In that case, drinking would only have made you develop obvious symptoms quicker and quitting alcohol would not be sufficient to cure your gout. There’s no way to know if you never got tests for uric acid. In order to know to what extent kindey function is to blame, the amount of uric acid in your urine can be tested as well. There’s no need to rely on assumptions.

[nobody]

Gout typically goes dormant for long periods bewteen attacks, especially during the first years. In hindsight, I’m not sure my previous message was clear so: when I said “under control” I was talking about cause of gout (uric acid crystals), not about pain or other symptoms. Once the pain and swelling completely goes away, you will be able to use your foot more confidently but gout will continue to work silently.
Then again if they are such wankers, maybe the gout diagnosis isn’t to be trusted in the first place… do you understand on what basis it was made?

[nobody]

Alcohol is usually only a contributing factor to gout.
At this stage it’s impossible to tell how dangerous drinking will be for you in the long run, especially without knowing your test results and so forth.
Generally speaking though, once gout is under control, alcohol consumption need not be much more harmful than it would be for someone who never developped gout. But as long as your problem isn’t under control, you are taking chances by drinking. So provided you are not currently addicted to alcohol, it would be prudent not to drink at all for a while.

[nobody]

Based on the molar mass, the factor should be 16.81 (do tell if I picked the wrong molar mass or something!). So by my count your values in mg/dl are 8.07 and 6.89.
0.41 mmol/l is well within the normal range but the normal range is irrelevant. The value is still too high for a gout patient which means the allopurinol dose should indeed be increased if you are tolerating it well.

Since you’ve had high uric acid for a very long time and just started allopurinol, dissolving crystals could well be propping up your test values. In that case, test values would trend down over time even if you didn’t change your allopurinol dose.
In my experience, test values can have a lot of noise in the 0.3-0.5 range even when you aren’t taking drugs so I wouldn’t make much of a single valu and I think you need more than two tests to know what’s really going on.

A warning: increasing your allopurinol dose quickly could also temporarily increase your risk of going through a violent attack. It’s for a good cause because in the long run you’ll be better off for the dose increase. But be prepared.

[nobody]

Not entierly surprising.

The way I see it, you have a few choices:
-see your regular doctor next week
-see another doctor such as a rheumatologist (the specialty dealing with gout)
-start by assessing the seriousness of the situation yourself, using your uric acid test results

Without knowing your test results (if you only have the one, I recommend getting another blood test next month), I can’t tell you much more except for the following…
Staying off booze is of course not bad advice at such but it’s at best incomplete when it comes to gout. Very lazy on the doctor’s part.

[nobody]

Considering you’ve been given an antibiotic, it’s evidently too early to conclude you have gout. Antibiotics weren’t even considered when I had my first flare.
A wheelchair at 40 isn’t a common outcome for gout in any case. Don’t worry about that.

Indo usually works well to relieve gout symptoms quickly if you take enough of it but sometimes you need something else to put the flare to rest for good. I never took prednisone pills (I take something more specific to gout) but I guess that should do the job.
You might want to ask the doctor if it would be safe for you to take a bit more indo next time.

It’s good to hear you had blood tests. Is that the only test you got so far?
Unfortunately, blood tests are often not conclusive for people who are having their first flare. If the doctor is still unsure about the cause of your problem after seeing the result, you might want to ask about less common (and more expensive) tests so as not to delay treatment in case you indeed have gout.
I recommend you ask whether the amount of uric acid in your blood had ever been tested prior to your flare. The results might be illuminating. It would be best if you got your results printed but you could also simply write down the exact value(s) for your uric acid test(s).

[nobody]

Hi!

You apparently need a quick answer since you’re seeing your doctor tomorrow. So here goes…

Unfortunately, I very much doubt your doctor will have a quick fix. Gout is slow to develop and slow to cure. I fear that many doctors in this situation would tend to go with something like this: “your condition has improved and I expect it will keep improving, come back if you have another flare and in the meantime let’s do nothing”.
So my opinion is that the most important thing you need to do is to make it clear that you want to get to the bottom of this but that you are not demanding quick results that your doctor can’t deliver. If you indeed have gout, it will silently damage your body while you do nothing about it. So I recommend you don’t take “let’s wait and see” for an answer to your very serious symptoms.

About strictly medical stuff, the first step is that there are tests that need to be done to confirm that you have gout.
You didn’t say if you’ve had any tests. It doesn’t matter if you don’t type well but it does matter whether you are communicating all the revelant facts (like: the drugs you took have names).
You may have to do some research, stay on top of your test results and take charge a bit in order to make sure you are receiving halfway decent medical care.

[nobody]

I doubt there’s much controversy about exercising in water. I never hurt myself that way. The water holds your weight and slows your movements so your joints are protected.

I’d be more worried about microbes on uncooked food than about anything gout-related. I’ve been sick enough times that I prefer eating well-cooked food when eating out.
I don’t know for a fact that you’re especially vulnerable if you take colchicine for a short while but I would be especially careful with food if I was taking colchicine.

I have no idea how “dairy-free milk” is made.
Everything else is fine as long as you take enough allopurinol. I’d go easy on grapes and other very sweet fruits though.

[nobody]

You’ll have to experiment with colchicine and see what works for you. There are different ways to use it. But it works best if you don’t want until it revs up which is why some of us take colchicine on the first signs an outbreak might be coming rather than when it’s clear a serious outbreak has started.
If you’re planning to take both colchicine and NSAIDs during your next serious outbreak and you have never used colchicine, I recommend trying a pill of two of colchicine without NSAIDs first in order to see see what side effects (if any) you get. A good time to try colchicine might be when you have slight symptoms you figure might be the beginning of a proper outbreak.

I don’t know what’s up with your “restless legs” but it sounds like a nerve might be involved. Powerful pain for a few seconds for no obvious reason also sounds like a nerve thing.
Back when I was lowering the amount of uric acid in my blood through diet, I had strange nerve problems which seemed to involve a particular joint for a while and was sent to a neurologist who didn’t detect enough damage to explain the symptoms. I suspect inflammation might have been interferring with my nerves, for instance by creating pressure at some locations. Or maybe it was something else entierely…
See what your doctor thinks.

Unrelated: you probably are aware of this but it seems there is an interaction between levothyroxine and milk (and possibly dairy more generally). It’s apparently recommended not to eat or drink dairy for several hours when you take levothyroxine. It’s not a big deal but might result in inconsistent effectiveness of the drug, as if you were randomly lowering the dose.

[nobody]

Having 10.5 mg/l of uric acid in the blood is dangerous.
Unless you are doing something very wrong with dangerous supplements, I don’t think it’s realistic to expect to fix such a serious problem by changing your diet. Hence taking a drug.
There are alternatives to allopurinol your doctor should be able to provide you but perhaps you could first try to repeat your experiment with allopurinol and see if you start retaining water again. For how many days did you gain 5 pounds a day? If you do indeed gain weight very fast on allopurinol, it might be worth investigating why that is with your doctor.
It’s important that get your uric acid in control, whether it be with allopurinol or something else. Whatever you do, don’t ignore the problem.

[nobody]

Vegetarian diets are basically gout-friendly because they’re not vegan diets.
You know the research suggesting vegans have higher uric acid. You know that not consuming dairy is correlated with having higher uric acid. That may be the most significant difference between vegan and non-vegan diets as far as uric acid is concerned. But you also know that some plants contain problematic amounts of purines. Yet you have decided that these purines are not a problem. Talking about unreasearched statements, why would purines affect the body differently because they’ve come from a plant?
In many cases, yes: dietary purines are a distraction. Certainly purines from plants isn’t the first thing one ought to look at. But someone who can’t tolerate meds and has uric acid test results that high may benefit from an unusually strict diet.

Unrelated but in case you didn’t know, Stephen: Brad is correct about drinking water. In my mind, that’s not filed under “diet” so I forgot to mention it.

[nobody]

You could list what you eat and in what amounts.
Or we could start with the general principles.
It’s your call…

It would be helpful to know if you are overweight and if you have other health issues which impact what you should eat (cholesterol, diabetes and so forth).

A warning: diet alone is unlikely to be sufficient to fix your gout. But of course it’s better to work on that than to do nothing.

It would be worth reviewing every medicine (whether “natural” or not) and recreational drug you take for a potential impact on uric acid. If you consume alcohol for instance, you should quit.

[nobody]

If you find ice is helpful, that’s great. It won’t prevent the problem from returning though.
Cherry juice might help to prevent the problem from returning but is likely to be insufficient unless other measures are taken.

Have you been diagnosed with gout?
Has your blood been tested for the amount of uric acid in it?

[nobody]

Results are sometimes off during flareups which is why doctors often prefer running tests when their patients are feeling well.
My opinion is that she should still have taken your blood though.

I’m not sure what staying off red meat and beer is supposed to accomplish. That may skew the data. And an effective gout diet would be a bit more complicated than that.

Has the level of uric acid in your blood been tested before?
If it’s never been tested, you might want to insist on getting it tested before changing your diet.

Do you already have a reliable gout diagnosis?
If you don’t, a strange test result during your flareup might be a useful clue so that might be another reason to insist on getting tested now.

If you are confident you have gout and have had uric acid tests before, you could try a more serious gout diet if your old test results suggest that dieting might be a realistic solution.

[nobody]

It’s not that simple actually.

[Author]

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