doc suggest i up my doseage

[Keith Taylor (GoutPal Admin)]

Hi all, I've been on here before and received what appears to be very good advice so I thought I'd come back to question my doctors advice.  About 4 months ago I started taking 200mg of allopurinal but went back to my doc to check my levels, he's told me its 0.47 and suggest i up my doseage to 300mg a day !!  What would be your suggestions because since I've been taking 200 I've had absolutely no problems with gout ? 

While getting my uric acid test also asked for a cholesterol test which also come back high at 7.4, could there be connections between the 2 ?  I'm a 30 year old male if that makes any difference,

thanks in advance

charlton

[Keith Taylor (GoutPal Admin)]

I’ll start with the cholesterol. As far as I know, there is no link with uric acid or gout. Unless anyone knows different, I ‘ll leave it at that.

Your uric acid at 0.47 (mmol/L = 7.9 mg/dL) is in the high risk range, and too high to dissolve existing crystals. Generally, I would agree with your doctors advice. However, I do not know what your gout history is – i.e. severity of attacks, when did they start, which joints affected, any tophi or skin abnormalities.

My best guess is that at the moment you are in a “steady state” where old crystals are not dissolving, and new crystals are not forming quickly enough to promote a gout flare. They may however be increasing slowly to cause problems in future.

If I am right, increasing allopurinol as your doctor suggests, may cause a few twinges as old crystals dissolve – but this will not last long, and your joints will end up much healthier.

[trev]

Further ,I would like to add that your blood lipids being high will add to your risk of the cursed added dimension to gout- Hypertension, an added risk factor which I struggle with now.

As your age is young for high levels of risk for both these- the genetic, inherited factor is a big one.

Being overweight is in the same territory- as an added element of risk.

The good thing is people are getting on top of these co factors early- so though you  are somewhat unlucky to be looking at these issues relatively young, you have a good chance of 'getting in first' as you are doing.

By the time they threaten any chronic disposal in your life [and concommitently also,as happens so much as you age], you will be an expert in all these conditions- and hopefully have better drugs and protocols than arrived over the last 50 years.

Doctors have mentioned to me that they prefer if more people' took an interest' and discussed more fully their concerns with them.

The web has made some, if far from all, patients less overawed by medical professionals.

Passwords:  BMI< 25 , Good Diet & Regular Exercise.

Oh, While we're at it- Try to be born to the right parents

[zip2play]

Let me add a possible connector between high serum lipids, hight uric acid and perhaps even high blood pressure: excessive meat eating. Perhaps you can even throw high weight into that equation.

 But massive dietary change is tough so we have the aids like allopurinol, Lipitor (and the statins) and a zillion BP drugs.

So I presume you are going onto a statin. Make it work for you and choose atorvastatin (Lipitor)…it's the only one proven to be uricosuric. For BP choose losartan (Cozaar) becasue it too is uricosuric. NEVER take a thiazide diuretic.

It sucks to face taking drugs for all these conditions but a lifetime of plenty has forced it on some of us who cannot live an ascetic existence with a crust of bread and a boiled potato for dinner…pass the Chateaubriand a some more of that delicious gravy…ohhh, creme caramel for dessert! Ohh, honey, you forgot that  sweetbreads pate' appetizer…we'll have it while we watch TV!

gouty,

Yes, I think your upping the allopurinol to 300mg. is a good idea. For one thing it COMES in a cheaper 300 mg. tablet and your costs willl be even lower. The average dose is 300 mg. so its been well tested at that dosing.

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