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Uloric also not ready to sell in my country Turkey. I cannot find? expensive and possible side effect medicine (uloric).
I am 4 years gout?patient? and i was always taking Allpunirol and careuful about what i eat and drink. Last gout attack was about 2 years ago but i feel new one is coming because i stop to taking allpunirol. it caused liver enzyme -ALT-?120 after years of taking allpunirol.
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Here are my levels; I checked ALT and Uric acid 1.week of december. ALT was 100, uric acid 6, then i stop taking allpunirol by doctor wish and start to colcichuim although i know that it was bad effect my liver . 2 week later uric acid raised immediately 9.9, ALT 120, i stop colcichum and drink few dozage baking soda and some vegetable juice during 2 week and i dropped ALT 95 uric acid 9. I stopped everything. I checked yesterday (again 2weeks later)?uric acid 9,5 ALT 95 and feeling with something bad my foot finger.
Your suggestions highly appreciated instead of Allpunirol, Colchuim and Urolic..
Hello Cantaner- I hesitate to say welcome, as most people don't want to be here really 😉
Due to language difficulty [possible] make sure you discuss all advice with your Dr. Here we are all sufferers with different ideas and many similar- but as you have a medical issue ,apart from gout, this must always be considered in that context.
No surprise [@9.5 SUA]?you have toe? discomfort -and you already know what that may mean.
My feeling is that shock alkaline diet moves won't help much now, and may get a bad name with you- if they trigger an attack, by altering your system balance at a tricky time.
You really have a job to do to replace the AP after so long. A rebound is unavoidable. You don't say if you are continuing with a lowered dose of AP, but probably not. If you stopped 2 years ago you have been lucky to escape so long.
Can you ask your Dr about a Uriscoric drug?? I take Sulfinpyrazone, which has been around a long time. If your kidneys are OK,? [a good GFR] this will?stop SUA?staying so high. Diet is still important as purines are still bad news.
If you do use this method do remember to take lots of fluids [water best] to help clear uric acid out.
Thanks for your reply.
I was not so lucky by escaping gout without Allpunirol. I stoped taking it only first week of December only 6 weeks ago. my UA level raised quickly to 9.9 from 6.5 in two week.
Your advise highly appreciate. I used Sulfinpyrazone during my first attack by direction of my Dr. some days long. You are right about kidney. It can make kidney stone. Kidney pain is worst than gout pain.
Any herbal treatment that can be suggest?
Why not keep going on the SulfinP ? Kidneys can be monitored along with your liver- and with plenty of fluid, stones are not a certainty to occur. Urate stones are apparently easily passed at the small stage, too.
Forget herbs at this stage- in my exp. you need to be a lot lower in SUA to make any difference. Plus- they are very much a hit and miss event- though my view is they can be useful in the right context.
Not yours, though, I'd wager, only in early day approaches [where not full blown attacks]!
What is your kidney GFR result ?then- it may be an issue with uriscoric use. [See first?? above]
Hi cantaner,
Stopping allopurinol and rolliing uric acid up around 10 will cause you SUCH an attack you'll wish you weeren't born.
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Now, what to do about it:
A doubling of ALT is usually not serious and can be caused by MANY things.
Mild to moderate elevations of the liver enzymes are commonplace. They are often unexpectedly encountered on routine blood screening tests in otherwise healthy individuals. The AST and ALT levels in such cases are usually between twice the upper limits of normal and several hundred units/liter.
One of the most common cause of mild to moderate elevations of these liver tests is a condition called fatty liver. In the United States, the most frequent cause of fatty liver is alcohol abuse. Other causes of fatty liver include diabetes mellitus and obesity. Chronic hepatitis C is also becoming an important cause of mild to moderate liver enzyme elevations.
http://www.labtestsonline.org/understanding/analytes/liver_panel/test.html
SERIOUS liver problems usually give ALTS that are 10 times the upper level of 56. The fact that your ALT did not quickly come back to normal is evidence that perhaps the allopurinol was NOT the cause of the elevated level.
If I were you I would go back on the allopurinol and just keep an eye on the ALT. You REALLY don't want a full blown attack. Perhaps you have forgotten how AWFUL the attacks were 2 years ago. In an ideal world we would all have perfect liver function numbers…and neither would we have gout, but our world is not ideal.
Sort of related but not…
Has anyone every found evidence that Allopurinol effects Liver Function ??
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I know it (Allopurinol) MIGHT cause a Kidney issue, thus the claim why Uloric is better IF Allopurinol makes your Kidney wacked out, or if you have reduced kidney functions,? etc.
Cantaner- would not a 24hr UA excretion test help?
This would indicate more which treatment may be best for you -even if there are attendant risks with any med.?always likely to be present.
Also, what is your age,?weight &?height?
Dear Zip..and Toofast..Thanks for reply.
One of the reason why i say ALLP. allergic for me is itching on my boddy. When i use ALLP more often one month it become..it might be called rash which is my DR. ignore but when i stop it more than 1 month it is gone..so I link bettween ALLP. usage to ALTS and itching-rash..
Dear Trev,
I am 40 years old, 1.70 cm, 85 kg.. i now im fat..i need to loose weight but loosing weight is not cure gout because i loose the weight by 7 kg 3 years ago..i have gout 5 years..
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You are right about the UA, i check UA level in 2 week now. not daily..i need to find UA testing and today i order to find in pharmacy..
Are u using all time SulfinP ?? i heard that it should not be used often like ALLP…
You're not as overweight as me, if that's any consolation Cant! Even with 7kgs off you're still over the ideal though.
70 kgs is better for your height. That may help tip the balance, especially if you get the right management with gout too. Better for your heart as well :)? but don't take off weight faster than a few pounds [or 2+kg] a week.
I take 100-200 mg SulfP daily, a low dose- I'm wondering if a break would be good actually, but afaik- it can be continued some time. It lowers SUA well enough but doesn't help like the Urate lowering meds with deposits , I suspect.
On your tests, SUA testing is good- but I was really referriing to a UA excretion test saving your output over 24 hours in the fridge and getting your? UA output rate assessed. I may try this myself soon- as still looking into best meds for myself too.
Ok, so clearly in this case a rash is a “somewhat common” side effect of allopurinol.? Still don't understand the Liver related issue, but clearly Allopurinol is out.
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For me Uloric (in case you ever do have access, be very careful)? actually caused some bizzare Liver functions…it wacked my Billirubin levels…Doctor said it was in no way related…although for 42 years my Liver was perfect…then 2 weeks of Uloric issues, then off Uloric Liver goes back to normal.
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Good luck!
Cantaner,
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I was on 40 MG and I was not able to get below 6.5 – that took about 3 weeks, for the next 4 weeks no change, still around 6.5
I started with almost 10, so good, but not great.
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I was suffering some pretty significant side effects, so the doctors recommended up to 80 MG was a absolute NO WAY for me.
cantaner,
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Once you have determined that allopurinol is causing a rash, you are correct that you cannot take it for fear of a very dangerous reaction. Your choices then become the frightfully expensive Uloric, or one of the two cheap uricosurics?( make you pee out more uric acid.)
Your sensible choices become probenecid or sulfinpyrazone?with a goal just like allopurinol, to keep your serum uric acid below 6.0 (or better, 5.0.)?
zip,
sort of unrelated…however your response made me think.
since I am an over-producer – any reason to think it might be heathier for me to take a uricosuric like you mentioned above to simply help me pee more uric acid? – why is Allopurinol better ?? (just trying to continue to learn)
toofast,
I think all three drugs are worthy of consideration. How doctors? view them may have come down from? past history with a large dose of heresay.
Both uricosurics are associated with potential for forming urate kidney stones and back a couple decades (before lithotripsy)?these stones often had to be dealt with through surgery. I also remember the two uricosurics as having cross allergy with penicilling and sulfa drugs.
Allopurinol was always considered the SAFEST of drugs. Now however with the internet and the competition from pricey ULORIC, the potential for problems with allopurinol has been amplified, perhaps OVERamplified, how better to sell a pricey competitor.
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For your case, it would seem the logical treatment that for someone who PRODUCES too much uric acid the logical choice seems a drug that causes less production, but the consensus seems to be that alloprinol is the best choice regardless of over or under production.
(The?most effective?of all the drugs is benzbromarone, but it's manufacturer stopped selling it in the U.S. and most other countries after evidence of liver toxicity.)
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I feel that taking everything into consideration that allpurinol should be tried first and if not effective enough or it causes side effects, then probenecid or sulfinpyrazone should be tried, perhaps heeding the warnings about cross allergies to choosee betweeen them.
For tophaceous gout or really high urate levels the combination of allopurinol + uricosuric works really well to give VERY low uric acid levels.
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I've never tried a uricosuric?let me take that back, I DO use daily losartan, albeit a weak uricosuric.
cantaner said:
Thanks for your reply.
I was not so lucky by escaping gout without Allpunirol. I stoped taking it only first week of December only 6 weeks ago. my UA level raised quickly to 9.9 from 6.5 in two week.
Your advise highly appreciate. I used Sulfinpyrazone during my first attack by direction of my Dr. some days long. You are right about kidney. It can make kidney stone. Kidney pain is worst than gout pain.
Any herbal treatment that can be suggest?
?
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I have been having gout type symptoms now for about 3 years. My uric acid levels have not been high. My ankle would swell and lock up. It would change from one ankle to the other, always in a differnt place/muscle in my foot. when my feet would hurt, my hands and wrists would also hurt, but not as bad as my feet. I would have to get? out the crutches when it would hit my feet. My knee? swelled up and locked up once. I had fluid buildup, and a lot of pain. I had determined that tomatoes had something to do with my gout, or psuedogout. allopurinol would not help any. 1200mg of ibuprofin would help a lot. colcasine (sp) would help, but about as much as the ibuprofin. I started noticing that the home remedies that some people would post on some of these forums had something in common. the things that they said helped, also helped detox the liver. i decided to try to detox my liver, so I googled it, and found that 'Milk thistle' was the most recommended liver detox out there. I went to Wal Mart and got some milk thistle from the vitamins rack. It is 1000mg per capsule. I took one in the morning and one in the afternoon for 5 days. After the first day I was pain free. Now I just take one capsule a week, or, if I eat the wrong foods,I might take one if I feel any kind of soreness in my knees or ankles that isn't normal. It had been about 6 months since a flare-up. do a study of the liver, and how it filters the crystals our of the bloodstream. It was an eye opener for me. Hope this helps someone.
Sounds interesting and worth investigating; I wouldn't swop my Allopurinol for it though
But maybe a good supplement to consider to combat the effects on the liver of any long term medication. Fortunately, here in the UK, we will still be able to buy it, as the government has just decided to give the finger to proposed EU legistion banning supplements and herbal remedies. No doubt, the fact it's a multi million pound industry had something to do with it, rather than their faith in complementary medicine.
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