de-crystallization

[gary lowe]

First let me say that I am so happy to be able to communicate with  you folks now.  I had a dickens of a time trying to login but Keith cleared it up. Secondly, Keith is very humble about his contribution…the info here has really helped.  I am more knowledgeable about gout now then my MD. Keith, you deserve a huge pat on the back.

I am (was) an active 70 year old going on 36 until 2 montha ago.  I have had one or two gout attacks for about 15 years.  Initially they were only a couple of days and then vanished and I ignored the cause and didn't worry about it. I am in good shape, work out regularly, feel 36 years old and on no meds…until….a few months ago when I got two good attacks about a month apart. The diagnoses was accurate and I have been on 300mg of allopurinol for a month and a half after the last attack cleared up.

After the first two weeks on allo I felt totally normal and was back in  my exercise routine…then minor and major flare ups began to occur with maybe a few days of reliief.  My MD put me on 300mg allo without any UA testing and I had to insist that it be done.  First lab test in middle of a flare up was 250 umo/l or 4 mg/dl.

Because my MD is limiting me to only 3 lab tests (paid for by my medical) I ordered  the uric acid home test kit which wound up costing close to $200 u.s. and I took my first reading today with left foot swollen but I can still limp around ( had to take ibuprofin regularly to relieve pain and swelling…and got 330 umo/l or 5.5 mg/dl.

So my question is…is the allopurinol at 300mg dissolving the crystals?  I have had previous gout in both feet several years ago and the toes have some deformity both left and right…over the last two weeks the mild flare-ups have moved from my right knee and right ankle (completely normal now) over to my left foot.  I understand that many allo users become disillusioned at this point and conclude the allo isn't working and quit.

I eagerly await your conclusions and hope the allo is working as the pain and discomfort isn't so bad …I can keep this up until more stabilized relief is achieved by the allo.even if it takes months.  It sure has stopped my work-outs.

If the allo is disolving the crystals and I up it to 400 mg for a while, will this speed up the recovery process?

I am grateful to any responders

Thanks  Canadagary

[esabogal]

Normally when starting Allopurinol colchicine 0.5 or 0.6 bid is also prescribe as a prophilactic to avoid new flares due to “de-crystallization”. Colchicine normally should be taken at least 2 months, my MD prescibe it for 6 months.

Higher doses of allo may speed the process but also may trigger more flares.

[zip2play]

Gary,

Yes, the new pains are caussed by migration of urate/uric acid to new sites. This will diminish with time as the easiest to dissove deposits will be gone and those hidden away will mostly stay hiddden.

I  think your plan to go to 400 mg. allopurinol is a good one, the lower your SUA the less likely the redissoving crystals  will find a happy home.  In fact 400 mg. is where I started for the first year or so and then settled on 300.

[Author]

Posts