- This topic has 6 replies, 2 voices, and was last updated 12 years, 8 months ago by
.
-
Posts
-
i,ve tried cherries and juice but, they're expencive. i dit'nt notice much difference.
my doctor wants me to start on 900mg.of allopurnoil but,ithink that is too much. i'll take 600mg. at this time ,my uric acid is at 9 thats high but,i have did everthing that i know and nothing works.
I know I occasionally moan about doctors, but sometimes they must get really frustrated.
Your doctor has prescribed 900mg (the maximum dose) for a reason, and that dose will be recorded on your medical records.
If 600mg fails to be effective enough, your doctor, or any other medical professional who consults your records, cannot advise you properly.
Find out your doctors reasons for prescribing 900mg, and discuss with him the possibility of lowering the dose to 600mg.
If his reasons surprise or confound you, please discuss them here.
It seems to me that, absent a past history of gout that was treated with high doses of allopurinol, your doctor has overprescribed.
The standard of treatment is to begin with 100 mg and titrate UPWARDS and the standard is also for a maximum doseage of 800 mg. For most people, even 600 mg. is too high. THe problem is that allopurinol useage can have unpleasant side effects and these side effects are dose dependent…you DON'T want to take more than you need.
I'm not disagreeing with goutpal, just presenting the view of somebody who prefers to act as his own doctor and starts off with the assumption, until proven otherwise, that most doctors are ill prepared to treat ANYTHING except hypertension.
(I'm in complete agreement with your headline: Cherries really ARE too expensive for daily use.)
the allopurinol at 600mg. is really playing havic with my stomach i have loose bowels i will try this for a few days if it doesn't stop i'll have to call the doctor .i have been reading all the infomation i can get on gout .i have it on all my hands and feet my elbows knees .i have been trying a lot of other things plus the allopurinol it is not coming out for the last year so i taught i was doing good . but; i caint seem to get my uric down . i try to watch what i eat but the uric acid just willno't budge .what else can i do.
Don't worry about all the stuff you read about high purine foods. All you need to do is maintain a healthy weight. A simple measure is BMI, and you should aim for low-normal.
Obviously, there is a lot more to weight control than that. Key points are to include plenty of fruit and veg, and eat frequent small meals rather than bingeing and fasting. Plenty of fluids is important.
That's 4 Key Points:
- Maintain low-normal BMI
- Plenty of fruit and veg
- Frequent small meals
- Plenty of fluids
If you have only just started taking allopurinol, it is far too early to start looking for something else. Uric acid lowering treatment comes in too phases.
Phase one is to get uric acid crystals out of your body. Anything under 6mg/dL should allow the crystals to dissolve. Most practitioners aim for 5mg/dL. Phase one lasts until all the crystals have gone – signified by 3 to 6 months of no gout flares coupled with continuous low uric acid. This can take many months, but it is important to persevere because it is the only way to get the uric acid crystals out. If you don't do this your gout will get worse until it totally cripples you. Uric acid levels need frequent monitoring – at least once a month.
You will need pain relief during phase one. Discuss the choices with your doctor. (Gout Pain Relief Guide coming soon)
Phase two is to maintain your uric acid level at a maximum of 6mg/dL. Usually, you can reduce the dose slightly, but make sure you are getting frequent tests – at least once a week. On no account must you allow uric acid to rise above 6mg/dL.
Allopurinol does not last long in the body, so it is important not to miss a dose – ever.
If problems taking allopurinol continue, there is a new drug, febuxostat (sold as Uloric or Adenuric), which appears to be a valid alternative. Clearly, as it is new, it does not yet have the track record of allopurinol.
By the way, how often do you take the allopurinol? Guidelines say only take 300mg at a time – higher doses to be split 2 or 3 times a day.
matt,
Another alternative route is to use uricosuric drugs (probenecid, phenylbutazone etc) that dump large amounts of uric acid out through the urine. Some people use alone or use them them along with allopurinol to get astoundingly low serum uric acid levels…like 3.0 mg/dL.These drugs might be of even more use to “underexcreters” who have less benefit from allopurinol (which deals solely with OVERproduction of uric acid.)
What could be happening if you have loads of deposits all over is that your serum uric acid won't go down much until a lot of the deposits are reduced. Take it from me, it can take YEARS to get rid of a tophus.
Ask your doctor about probenecid.
- You must be logged in to reply to this topic.