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Gavin,
I think Urate is a byproduct of Uric Acid. It isn’t the same thing. Urate is the salt that comes from Uric Acid and forms up in the joints.
Quick questions for you guys, I go to Italy in 4 weeks time for a week and there will be a lot of walking involved. Given that the medication may bring attacks on when I start to use it Iโm thinking of deferring it until I get back, just wanted your thoughts?
Many thanks
My suggestion would be to talk to your Rhuemotologist about it. I’ll tell you what I do…I asked my Rheumotologist for a standing prescription for Methylprednisone (or Z pack). It’s a 6 day dose of antibiotics that aid in reducing pain from an acute Gout attack. Couple that Colchicine and your Allopurinol and you should be OK.
You can also go to the upper right corner and Google custom search for “Gout pain management” and Keith has some info there also I beleive. But that’s how I usually deal with a severe flare up.
Don’t defer your medication for another month. With your Uric Acid at 8mgs, you’re already in the “Acute Flare Up” zone. You may trigger an attack tomorrow, who knows? Get started now, and deal with potential attacks later.
Oh and one other thing, I was wondering if it was effective to take my daily Allopurinol dose with a cup of milk rather then water, I tend to have a coffee latte in the morning with breakfast? I mean does it have to be water?
Thanks again guys!
JamesYou can take your meds with anything. Milk is beneficial for Gout sufferers. So is coffee. Take your meds with whatever you feel like.
Great thoughts, Patrick. But how do you become a salad guy in the States?
Maybe itโs better on the West Coast. But, down South, the nearest thing to salad is ketchup on your fries! 😮
Dude, I’m a West Coast, southern California guy. Salad is a staple food here. Everybody eats it, that’s how we keep our beach bodies (sarcasm intended..) But we also have In and Out Burger here. I treat myself to that once in a great while.
DQ–to your question. Yogurt, fruits and vegetables, chilies, etc., from all I’ve read should be no issue. Some nuts and beans can be problematic (per SOME studies) but you have to take information you gather from the internet with a grain of salt. Most info is old, outdated and downright mythical.
Here is the cold hard fact. Get in full control of your Uric Acid, which includes getting and maintaining it as low as possible, and you SHOULD be able to lead a very normal life. That includes eating habits. But remember, as a Gout sufferer you are always in danger if you don’t make at least some wholesale changes. In no way am I saying you need to lead a “meat free, booze free, sugar free, vegan lifestyle” but everything in moderation. That’s the key, buddy.
Man, great dialogue on this thread. It should be a must read for the entire forum. Not much to add, but I will say this DQ (and I’m not nearly the Subject Matter Expert as Keith) but as a “regular Joe” here are a few things I do to protect myself.
First off, I eat sensibly. Animal proteins in moderation with lots of vegetables. I never thought I’d ever be such a “salad guy” but I am. It helps with keeping excess weight off, which in turn helps with your overall health and well being.
Exercise…even it is just a walk with your significant other, or with your dog. Get your heart rate up and keep it up for 30 minutes. Also, hydrate. Limit your sugar intake, which includes Fructose and Sucrose. Drop the Cokes and Energy Drinks and substitute water with lemon or cucumber. Alcohol in moderation.
As for Gout and Gout management, here is what I do. I had been going to get my blood screened every 4 to 6 weeks. Since my labs have been stable, my Rheumotologist has scaled that back to every 12-14 weeks now, but every blood test includes a kidney and liver function test, as well as my Uric Acid screen. I also keep a 6 day Methylprednisone pack on hand. Just in case. I travel a lot, so if I DO get a flare up, I kill it immediately with Methylprednisone, Colchicine and my regular 300mg of Allopurinol. More often than not, it’s gone in 2-4 hours. Again, I only keep the 6 day of Methylprednisone as a precaution. I haven’t needed to use them in over 8 months but one can never be too cautious.
That’s my remedy and it works for me. You may choose other ways. Keep up the great dialogue and good luck.
Ryan,
That’s awesome. It’s the first step towards getting on with your life in a normal fashion. If you are put on medication, be patient. As you probably have read on this site, lowering your Uric Acid is not going to happen overnight. As you stated, you are a young man (at 34) so while you may not have to undo as many years of Uric Acid build up as most of us, you STILL have to undo potential years of Uric Acid build up. It takes time. Do NOT get frustrated by the process. You may still have recurring Gout attacks while starting and continuing the medication treatment. Stay the course.
Continue to eat smart and exercise. Throw in some of those other things you talked about like Cherry Juice, milk, yogurt, coffee, and hydration. Remember, you are still a young guy, so the quicker you stop the destruction of joints in your body, the longer you will be able to enjoy them later in life.
Keep the group posted, and good luck
If I’m not mistaken, we had a poster here a few months back talking about this very topic. It might be in the archives of topics. I’m not familiar with it, but after reading it, I Google searched it and found it very interest…..but very expensive. Try searching the topic archives to see if the thread is still there.
I also think Keith knows about it and can probably speak a little to it, if I recall correctly
Parsons,
Your story is probably shared by most of us here. Your lifestyle sounds a lot like mine. Your Gout flares started EXACTLY like mine. I will tell you this…they will get worse until you get your Uric Acid under control.
Make an appointment to get your blood drawn immediately. Don’t mess around with a bunch of elixers and “diet fixes” or other internet fodder. The only REAL thing that is going to help you is medication. But before you can be prescribed the medication, you need to find out where your levels are. You will also need a liver and kidney function test. These are standard. By your earlier post, I take it you are in Europe, since you posted your original results in umol/l (in the states its mg/dl). Regardless this is the first step and the most important.
My rhuemotologist, for some reason, was hesitent to put me on Allopurinol. I spent a year trying the diet, cherry juice, no meat, no alcohol, no sugar lifestyle. It didn’t work. Gout, for the most part, is inherited. Somewhere in your family tree you were probably predisposed to it. Lucky you. Me too. Combining medication theropy with a healthy lifestyle, exercise, and proper hydration is the key to leading a normal, pain free life. Keep the group posted on your progress.
Great info guys. The thing is that all bodies cope with things differently. Kind of like Keith’s example of “normal”. Everybody has a differnet machine. My body may cope with issues differently than Keith’s or Andre’s.
Example: If you have European ancestory, you may have a precursor to high cholesterol. Germans and Dutch specifically. Your Cholesterol, through ancestry and DNA, may be high per the FDA (above 200) but you are a normal, healthy person. For me, 200 may be a giant Red Flag, and my doctor may want my to go on Lipitor or some other Cholesterol reducing drug.
I think this is the same for Gout and Uric Acid. If you have a family history of Gout, or are predisposed to it, than a Uric Acid reading of….lets say 6.0 is going to raise a Red Flag. But if you don’t have a family history or any prediposed history of Gout, than you may walk around the planet with a Uric Acid of 6.0 with no symptoms or flare ups.
The word “safe” or “normal” are misnomers. It’s a guideline and that’s it. Try and get your Uric Acid below 5.0 and the chances of having Gout attacks are lower than they would be if your Uric Acid is 8.0. That’s the reality. There is no such thing as “safe” or “normal”.
Again, just my opinion.
Oh brother Chris, do I feel for ya man. I was there also. Pay attention to the advice given on this site and the remedies. They work.
If you haven’t already, go get your Uric Acid checked. Like immediately. The sooner you know where you are at your levels, the sooner you can get working on lowering it. If you have had Gout diagnosed, are you taking medication?
Keith has some great plans on the right side menus. Visit “Personal Gout Diaries” or “Structured Gout Help”. The can be very helpful.
Like you, when I started to feel a gout attack coming on, I never assumed it was going to be either mild or severe, I treated it as a Gout Attack, period. I would hit it hard immediately with a 6 day Methylprednisone pack (I keep a prescription handy from my Rheumotologist) and 0.6MG of Colchicine twice a day. This should really cut the pain down to near zero pretty quick.
But Chris, the attacks will keep coming and they will become more frequent and more severe if you don’t get your Uric Acid under control immediately. It starts with medication and a few lifestyle changes. Once you get the Uric Acid under control, you can tweak the lifestyle changes a little. But remember, it won’t happen overnight brother. Good luck buddy, all of us can relate to what you’re going through.
Ryan,
With no labs done prior to being prescribed Allopurinol and inducin, how can you be 100% convinced they caused the damage to your liver? First off, that is extremely irresponsible of your doctor to have even done that in the first place. I would hazard to say that a Day 1 med school student would even know that you should NEVER, EVER prescribe medication to a patient without having blood work, or personal data to eliminate any contraindications that patient may have. That’s just stupid and/or lazy.
I’m in no way a rep for a drug company, but some questions….how old are you? Are you in good physical condition? Do you have a family history of liver disease or liver problems (i.e. cirrohsis, hepatitis, hepatic issues)? Without data or blood work to substantiate underlying liver issues, it’s difficult to be 100% sure if Allopurinol/Inducin did that to you. It’s possible, don’t get me wrong, but if you had damage prior to being prescribed the medications, you should never have been given them in the first place….and that falls squarely on your doctor. Shame on him or her
Regina,
The only way to properly diagnose if you have Gout is to get a blood test and have your Uric Acid measured. It sure sounds like a Gout Flare, but without the data of your Uric Acid results, one would only be guessing.
Once you get your blood drawn, schedule an appointment with a Rhuemotologist (a General Practiconeer might be hesitant to diagnose Gout) and have the Rhuemotologist go over the results with you.
This is truly the only way to tell if you have Gout. And the reality is, that if you DO have Gout, and this is your first attack, it will probably NOT be your last. Do yourself a favor, if only for piece of mind, get your blood checked.
Rita,
I think the correct name of the drug you are taking is Furosemide, or the common name Lasix. It’s a diuretic, like you mentioned. The fact you are taking Furosemide more than likely be causing some Gout flares because the drug rids your body of excess fluids. If you are not properly hydrating, than the drug can make you dehydrated, which can lead to Gout flares.
It’s really a double edged sword for you. Take Furosemide to rid the body of excess fluid, but stay hydrated to help fend off Gout attacks. I’m not sure about the connection between milk and Gout, but maybe Keith might have a better answer for you.
A better question is why did your doctor prescribe you Furosemide in the first place? Do you have Congestive Heart Failure? Do you have Kidney problems? These are the most common reasons to prescribe that medication. It’s certainly not a anti seizure medication.
There actually might be a connection with certain health issues related to your medication, than with milk or milk products. Maybe
Boomer,
I was lucky and never got the side effects you did. My buddy takes 300MG of Allopurinol and had horrible side effects of GI problems and digestive issues. From what i know, the sh*ts is quite common.
I’m not that sure about the dizziness, but dizziness is a common side effect to many prescription meds. I would presume that as your body gets used to the Allopurinol, the bouts of dizzinesss may subside. If they don’t, consult your doctor as this may be attributed to something else. He may also prescribe you Ativert (a Vertigo/Dizziness med) or he may titrate your dose.
The GI side effect can be controlled with over the counter stuff like Pepto, but the dizziness, if persistent, should be talked over with your PCP or Rhuemotologist. Hope this helps
The FDA gave what is now Takeda a license for monopoly supply of colchicine, branded as Colcrys.
Guys, thanks for the responses. I guess my post was more of a rant instead of a question, but I truly appreciate the answers.
Stephen, I can’t move to Canada, so I suppose that solution is out of the question. But it’s crazy to know that our neighbors to the north pay so little for the exact same medication.
The quote I highlighted Keith is the root of the problem. When drug companies have a monopoly on the market, just like anything, they can do as they please. I need to look no further than the absolute ROBBERY that Mylan (drug co. theat produces Epi-pen) did to the public here in the U.S. with the Epi-Pen. 600% increase in cost in 3 years is criminal.
A $50 co-pay is not going to kill me, but it’s awful that an insurance company has to pay out that ridiculous cost. I will look into a generic equivilant, but until then, beware U.S. consumers.
Is it best to take allopurinol as a precaution or just accept the occasional bout?
William, personally I don’t take Allopurinol as a precaution. I take Colchicine as a precaution. Allopurinol is prescribed for one reason only…..to reduce Uric Acid in your body. That’s not a precaution, that’s a cure. Colchicine, on the other hand, can be taken as a precaution because it helps with inflammation, which comes as a side effect/result of excess Uric Acid. See the difference?
I will give my PERSONAL opinion. Do NOT accept the occasional bout. If your bouts are anything like mine, then can be debilitating. Living with pain is not a way to go through life. For me, I’m lucky. I don’t expereince the side effects of Allopurinol that some people do. I’ve taken it for almost a full year now and it has worked wonders for me. My Uric Acid went from a high of 9.6 to 4.7. I occasionally get a minor flare, but with the knowledge I have obtained here and other places, I know exactly what to do to combat it and I can easily kill the flare in a day.
Gout and Uric Acid can long term health problems to your joints. Do yourself a favor and live pain free. For me (again, personally) I’d rather risk the very minor side effects of Allopurinol than spend one day in Gout pain.
Bob,
The answer is yes. You are 60 years old, and you’ve probably had Gout for more years than you think. I hazard a guess that it has been more than 20 years, but you only “started” getting flare ups a few years ago because your Uric Acid hit the threshhold.
As Keith and others will tell you, undoing over 20 years of Uric Acid build up, even with 400mgs of Allopurinol is going to take time. And by time, I mean years. Keith has the formula, but it’s going to take awhile. I’m 48 years old, and up until 5 years ago, my Uric Acid was above 8.6. I just had my 3 month blood work done last week and I’m down to 4.6, so the last 3 blood tests have been—4.8, 4.7, and 4.6. But guess what? I still occasionally get a flare up. I manage it just like you do. Hit it with Allopurinol, Colchicine, and a Prednisone pack and within a day it’s gone.
I eat beef occasionally. I drink a few beers, occasionally. I eat fish and shrimp, occasionally. See what I’m saying? Manage your Uric Acid the right way like you are doing, brother. Keep it below 5, like your doing. Treat yourself occasionally, but be vigilant. It’s going to take a long while to lose all Uric Acid and years of damage. But it sounds like you are on the right track, buddy.
Also, go out and exercise if possible and get your blood tested quarterly.
