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My name is Jared. I am 27 years old and have been suffering from gout for a few years now. I am currently suffering from my 4th gout attack in the last 2 months. I havent even recovered fully from my last attack. My attacks always happen in my right ankle where I had severeral repeat sprains when I was in highschool. Except for my 2nd attack in this series was my left ankle for the first time ever.
After doing much research it seems clear the way to get rid of this terrible affliction is to lower my uric acid levels below 6mg/dl over a prolonged period of time. What I want to know is can this be achieved without prescription medication? I have no health insurance and the idea of frequent blood tests sounds impossible to me. I am barely making ends meet as it is. Not to mention the missed work from being almost completely imobilized by this terrible disease.
I am also concerned by potential side effects. I've taken colchicine, but after just 2-3 days the stomach cramps and diarrhea hurt worse than the gout pain. Ive also tried indomethacin, but that threw me into an epic depression ( I do have a history of depression and to me it is worse than any physical ailment). I have read and heard that the allopurinol has some potentially dangerous side effects and with my track record of gout meds I worry that I will be one of those 1 in 1000 people.
I have read a lot of the alternative treatments, but will they be able to rid my body of uric acid crystals like the allopurinol does? I am going bonkers with these repeat attacks, since the end of August I have spent more time dealing with pain than I have without. Your help is very much appreciated.
-Jared
Allopurinol is the cheapest, most effective medication for lowering uric acid.
Medical alternatives are much more expensive.
Non-medical alternatives are not only more expensive, but much less effective.
I know I bang on a lot about the importance of uric acid testing, but if it is a deal breaker, then I would compromise and reduce the frequency.
Try 100mg to check for serious reaction. After 1 week of no serious reaction, increase the dose to 300mg.
Finding the right dose is hard without a uric acid test (any idea how much this costs wherever you live?). After 3 or 4 weeks, do everything you can to get one test. It is not the ideal way to go, but you could probably manage with one test per year. Surely this has got to be cheaper, and certainly much, much healthier than all the money on pain meds?
Thank you for your quick response. I am currently looking into state medical assistance so I can treat this properly. I just have a question on when to start taking allopurinol. I thought I remember reading that you should take it after a flair up and not during. Could you adivse? Should I start on it right away? Thanks again for this wonderful resource.
– Jared
Jared,
I have not seen your Post #3 yet so I'll just address Post#1.
Since you claim no health insurance I assume you live in the land where anything is available to the rich and the poor can go f%#k themselves.
I appreciate that multiple visits to check on uric acid can cost $THOUANDS$ without health insurance. I suggest you go ONCE to a doctor and get an Rx for allopurinol 300 mg. x 90 WITH 4 refills….demand that,,, and fill it at Wallmart, Costco or Target. Three months of allopurinol will cost you $10 at these discounters $40 a year.
Alas, you will need to pay the doctor ONCE…becasue they own the game and we cannot write our own prescriptions (unless you live close enough to Mexico to buy WITHOUT prescription…but then you won't get the wonderful discounter price.)
No, there is no dietary substitute for allopurinol or probenecid.
Jared: I no this is not want to hear but there are hundreds or cures for gout. Just look on the net. Celery seed, cherry juice, baking soda. The problem is what works for one may not work for another and what is cheap to one is exspensive for another.Allopurinol is the best we have. I have more than 1 MD and it always amazes me how they disagree. ! says stay away from allopurinol another says take 300mg daily. In the end it is your body. I personally belive there is a cure for this somewhere and its not from the drug companies. So I keep reading and learning. Sites like this help greatly. By the time you leave a doctor office they have forgot who you were. They have 30-50 pataints a day but people who live with gout will keep serching.
It is generally advised to wait until a gout flare has finished before starting on allopurinol.
Everything I have read points to this being a psychological benefit rather than a medical one. Allopurinol might prolong the attack. If you wait until it is over, it might start another attack (though also, it might not – I will try and find some percentages). Doctors believe that you will not take your allopurinol if you link it to failing to cure pain, but I cannot understand the logic behind this.
I believe the reason why so many people fail to continue with allopurinol is lack of understanding about what it is actually doing. It’s benefits suggest to me that the sooner you start taking it, the better.
As for Dan’s point about disagreement amongst doctors – that is because many of them have not been trained how to deal with gout. Send them to zip2play for some lessons.
hey guys,
Just my 2 pence worth..
I've been suffering for a couple of years, 3-4 attacks a year. Very painful. Started in big toe (left foot), then to the other foot, then ankle blah blah..
Went to the quacks and started a course of Allopurinol. 100mg per day (hoowever I must admit i sometimes forget to take the bloody meds).
Anyway, my point is that after a couple of weeks of taking them, I had a huge flare-up in my left knee!!
So beware and brace yourself if you do start on this course of action.
Mark said:
Went to the quacks and started a course of Allopurinol. 100mg per day (hoowever I must admit i sometimes forget to take the bloody meds).
If you wanted to design a course of action with the best chance of inducing a gout flare, that would be it.
Allopurinol is intended to lower uric acid. Mis-use it, and you will almost certainly suffer the consequences.
I have been taking allopurinol for 14 months now with good results. I had a month long flare up when I started, but my UA levels were down to 4.0. This was most likely due to the dissolving of the UA crystals in my joints. I have been able to eat everything in moderation, still stay away from red meats and limit alcohol. I have missed at most a one day dosage here and there. My prescription is for 300mg and my levels stay constant at 4.0. I am happy with the results, but my ankles and feet constantly are aching especially when I first stand up, or wake up in the morning. I have a constant limp because of this pain. I do not want to take ibuprofen constantly so I deal with the pain. Lately my joints have been crunching when I walk and continue to ache. Is this a side effect of the UA dissolving still after a year? I have been to Orthopaedic surgeons who have done xrays and everything looks fine. Also, my rheumatologist says my joints are fine. What is this pain from? Now that I have been free from gout attacks for 9 months, why am I still in such pain? I cannot find any answers to this problem. Has anyone suffered from similar symptoms? Do they eventually go away? Any info would be appreciated.
You don't say how long you had gout before the allopurinol regime. You may have had quite extensive uric acid deposits that are still dissolving and causing the discomfort.
Best advice I can give is to stick with the allopurinol and keep checking uric acid. It might take a while longer, but you are doing everything right.
I had gout for 4-5 years before I started on the allopurinol. Went on a strict vegetable diet and used alkaline minerals and wheat grass during my 2nd year with gout. I felt great, but it was not possible to keep up that strict regimen. As soon as I went off of the diet I began getting gout flare-ups again. I have tried everything; chiropractic, homeopathic, diet, herbal, cremes, footbaths, indomethicin, cherry juice, etc… For me allopurinol has given me the best results. Gout diets are near impossible to follow, and once I thought I knew what my trigger was, something else would trigger the gout. I believe that in my case I produce too much UA, and my kidneys do not flush it out fast enough either. I was having 2-3 flareups a year, lasting a month each. I am a teacher, and would go to work on crutches and transfer to a wheelchair. Allopurinol has saved my life in a way! All of my doctors have been stumped, even my current rheumatologist who seems to be the most knowledgable. He assures me to stick with the allopurinol and get my UA levels checked periodically. This is what I plan on doing.
That's a good plan.
To anyone else who is in a similar position. Even if you believe you can manage without allopurinol, the uric acid testing part of the plan is vital. As bagodonuts says, “Gout diets are near impossible to follow, and once I thought I knew what my trigger was, something else would trigger the gout.”
The only way to manage gout is to manage uric acid levels – you cannot rely on the incidence of gout flares, because these can happen when you lower uric acid (though much less frequently than when you raise uric acid levels)
Hi Jared
Try coffee… it worked for me. See Coffee and Gout.
I use powdered instant coffee – three teaspoons. It needs to be strong and drink lots of water after that to flush the system.
Cheers.
This is a good resource to explain meds used in gout. I'm taking Sulfinpyrazone which is not available in the US.
The only contentious point is they recommenend ice during attack, which isn't encouraged here -usually.
The warnings on drug use and mixing are apt -and I hope it's useful and stays open to be read long enough! [It's a sampler]
http://books.google.com/books?…..mp;f=false
PS: They do stress keeping Colchicine to 6 mgs max per day -and not mixing long and short term use, as risking overdose!
I use this limit- and prefer to just use occasionally in attacks too, rather than prophylactically -which I don't need..
Gout diets are near impossible to follow, and once I thought I knew what my trigger was, something else would trigger the gout. I believe that in my case I produce too much UA, and my kidneys do not flush it out fast enough either.
Allopurinol has saved my life in a way!
Amen brother,
Sounding biblical I say: “Blessed are they that see the light early for their feet shall stop hurting!”
To the post that has constant pain after so long without an attack, I can relate. I spend all day on my feet, frankly, if I sit down, it hurts worse. I stumbled on this site by accident. What I’m finding is I’m not alone. Tried colchicine, only made me sick. Allopurinol is the only thing that helps. Tried dietary regulation, it works for about six months. Cure? I doubt it. But hey, without dreams, what do you have?
Welcome, @everett-morris1, you’re never alone with gout – at least not here.
Have you joined this forum because you want to control gout without allopurinol? If so, you need to start with your uric acid level. Something I’ve just finished is very relevant. Please take a look at my Uric Acid Levels Chart. I’ve just done 4 sub-pages with general advice for gout patients who are at different levels.
You’ve given me an idea that I could maybe do some similar pages to advise what to do if you are in that situation but want to proceed without pharma.
You can’t just leave it, or you end up crippled or dead. First step is posting uric acid levels, but please start a new post because this is 5 years old!
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