Do I need to get on Allopurinol?

[redterror]

Male, 38, obese according to BMI.  had gout since late 20s.  I get it about 2-3 times a year.  my mom gets it, so its genetic.  love eating steak & meats, but try to avoid them (not easy).  I think I don't drink enuff water, been trying to change it.  Do I need to get on Allopurinol?  I think I will try fasting for a few days too.  yes I have gout right now.  its been on/off for 3 weeks now.  seems like I am getting immediate feedback from whatever I eat, ie it's going straight to my toe! 

I've gotten indomethanol for it before. but haven't been to the dr in years.  now when I feel a “tingling” I know to go on a drinking binge (water), this usually reduces the amount of pain I will get when it strikes. I've read about keeping it warm.  do u recomment tiger balm on the joint?  will try the black bean soup & baking soda.  do u recommend drinking distilled water?  1 of my fears is drinking myself to death.  do I need to avoid certain drink (too much minerals)s?  any hints appreciated. I quickly found out I could not possibly drive a stick shift car while any sign of gout was present.  sold my 3000GT VR4 =(

Nick

[zip2play]

tiger balm?

No, becasue although linaments and unguents may produce the SENSATION of warmth they are not changing the temperature (of the foot presmably.) Use a heating pad to keep the area ACTUALLY warm so the urates remain more soluble. When going out in the bold, insulated socks are a good idea.

Don't overdo water because messing up your electrolytes will only give you other problems. Staying out of dehydration is enough water. Distilled? A waste of money unless your tap water iis polluted.

I too had an attack when I owned a stick shift…forget it! 😉

Nick,

 best hint is to take allopurinol and enjoy the steaks and some drinks (maybe take Lipitor too?) I, of course take all 4.

[Kvalhion]

Yeah, you likely need to get on allopurinol.  Gout attacks bring the idea of gout and prevention to the forefront since the attacks are painful and long lasting.   When researching Gout, it quickly becomes apparent that avoiding gout attacks is not the only goal.

You need to see your doctor and have your blood tested to see what your uric acid level is.  Im assuming its going to be over 7 or 8 if you are getting pretty frequent attacks.  Stopping the pain with indomethacin or home remedies like black bean cure and baking soda is all well and good, but you need to address the underlying condition of hyperuricemia.

Allopurinol should help you get your urc acid level to around 5mg / dL or below.  From there you can focus on avoiding triggers and staying healthy while not having to worry about getting attacks.  Even if you do not get attacks, hyperuricemia can contribute to other factors such as heart disease, high blood pressure, renal failure, obesity, etc.  Its basically an enabler that can be deadly if not treated.  So do not ignore or avoid your uric acid level.

Good luck and let us know how you are doing 🙂

[Keith Taylor (GoutPal Admin)]

I have now had gout for 12 years, (since my nephrectomy).  Additionally, I have high blood pressure for which I take Diovan HCT and high Cholestorol for which I began to take Crestor recently.  Since the Crestor, I am experiencing very strubborn and painful gout, now in the baby toe.  It really hurts.

i do have high Uric Acid in the blood and my doctor did address it at the last meeting suggesting Allopurinol.  My research on allopurinol (all google) suggests it has harmful side effects if used in  the long term..  I know that the high Uric Acid also has harmful side effects.  Is there nothing, pharmaceutical or natural that can lower the uric acid and not give the substiute side effects?

Another thing crossed my mind.  Could the Crestor have the effect of raising the Uric acid by weakening my one remaining kidney so that it does a poorer job of excreting the uric acid that my body is producing.

I like to eat, am a little overweight (10%) and have to get the pounds off.  It may be the answer.

My current bout with gout is not responding to indomethicin (50 mg) nor cherry juice, nor water with one teaspoon of baking soda and not cochicine.  The colchine gave me a massive headache and slight fever, coating (yellowish) for one day on my tongue and did not help the gout.  Will time eventually do it?

For me, I think it is overweight and kidney function that need the help.

[zip2play]

dgalati,

Crestor and Lipitor are slightly uricosuric so they will increase uric acid excretion.

Diovan is a good drug, an ARB (angiotensin receptor blocker) but will have either no effect or an adverse effect since almost all anti-hypertensives act as diuretics even if they aren't billed as such and the HCT component is HIGHLY causative of gout, perhaps the worst drug around.

That said there is ONE ARB that is uricosuric, losartan, sold patently under the name COZAAR. Trouble is it is NOT a very good anti-hypertensive and really needs to be taken twice a day becasue it is short lived.

You really need to get rid of the hydrochorothiazide though. I find that Lasic (furosemide) works just as well and the literature says it is only abvout 25% as likely to cause hyperuricema. I use Cozaar and Lasix for my hyoertension…ask your doctor what he thinks.

So I guess what they about one kidney working as well as two isn't completely true, eh?

Don't let internet squawking keep you from allopurinol, the dangers are overstated. It really is among the most innocuous of drugs. In fact, if you read up on Crestor you'll find it called the most dangerous drug since thalidomide.

[Keith Taylor (GoutPal Admin)]

dgalati said:

i do have high Uric Acid in the blood and my doctor did address it at the last meeting suggesting Allopurinol.  My research on allopurinol (all Google) suggests it has harmful side effects if used in  the long term..  I know that the high Uric Acid also has harmful side effects.  Is there nothing, pharmaceutical or natural that can lower the uric acid and not give the substitute side effects?

---

It seems to me that this is a question of balance – balancing the side effects of high uric acid (painful gout attacks, kidney stones, bone erosion) against the side effects of allopurinol.

Long term effects of allopurinol seem to depend on where you look. For example, a site selling a “natural cure for gout” cites:

skin eruptions, inflammation of the blood vessels, and liver toxicity

Whereas the Australian Rheumatology Association state:

Allopurinol can be taken for long periods to manage gout. There seem to be no long term side effects.

It is important to drink plenty of fluids to avoid a build up of the by-products of allopurinol (oxypurinol). Other than that, unless you fall into the tiny minority that cannot tolerate allopurinol, the risks are very low.

When administered properly, you start with a low dose that will identify any sensitivity. This will allow you to balance the risks based on your own experience. Because of your kidney history, I expect that your doctor will monitor oxypurinol levels, though the Journal of Clinical Rheumatology reports (Feb 2008) that “high levels of oxypurinol did not appear to relate to higher prevalence of adverse reaction.”

[tinabb]

dgalati,

I too have had a nephrectomy; 7yrs ago. I also have high cholesterol and did take Lipitor, and YES taking Statins can cause flares, in 2 % of patients. I am taking Lovaza, (prescription fish oil) I've just started a couple of weeks ago, so Im not sure if its helping yet or not.  I am a 42 female, and have gout for over 10 yrs now. I was told when I was just 22 that some day I would have gout, because of my high uric acid, which currently is above 9, and has been forever. Just in the past 2 mo I have had 5 flares and just in the past year at least 15 if not more (I lost count).  I have been on Allopurinol for 5 yrs, and just recently visited a Rheumatologist actually 2 days ago.  She told me that my management is not sufficient, and that I need to be taking more Allopurinol, I am currently on 300 mg everyday, and take indomethacin as needed. Because of the one kidney I am scared to take too much of the indo, but she told me I need to take the full amount when I first notice an attack, 2 25 mg 3 times a day, and then has added Colchicine 2 times daily, she will be increasing the Allopurinol when my kidney function comes back.   She also wants me to take prednisone for flares, because of the side effects, she has told me that I could just take 60 mg the first day of an attack, and that should stop it.  I am so hoping that this treatment will work for me.  So I would suggest you and everyone with recurrent gout should visit a Rheumatologist, or some other healthcare provider that actually knows about gout, because I was being treated the “old fashioned” way.  I realize that some home remedies work for others, but not for everyone, and usually what you eat is only a small portion of an gout flare.  One more thing, Allopurinol helps protect the kidney's (KIDNEY), from stones, and damage.

I hope this will help you 🙂

[zip2play]

Tying in with the last post it is important to remember that before allopurinol and probenecid were developed, gout was a death sentence…and death came usually from destruction of the kidneys.

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