How To Track Uric Acid

[Al O’Purinol]

Hello All, I have had gout for about 5 yrs, but just got diagnosed last week. I did not know it was gout although my family and friends were say, “its probably gout.” Last night was the second attack within 3 weeks. Basically it started 3 weeks ago, last few days was walking better, but yesterday’s walking around at work triggered something, plus Mondays drinks probably did not help as well.

My Uric Acid was at 9.4 last week, I have been reading this site for about four hours now and feel, better informed. About 5 in the morning, with the pain I was asking my wife pretty much all the questions that have been brought up here.
I will be getting some blood work done on Friday, which is one week after I took my last blood test.

The Question that I have is how often can I get blood work done once a week, twice a week what would be acceptable?

And what is the cheapest way to check Uric Acid levels?

I want to track this UA and bring it down to 6.0 if I can before I hit the meds.

Thanks for all your advice for the gout

Phoenix

[Keith Taylor (GoutPal Admin)]

The only way you will get uric acid down from 9.4 to 5 is to get uric acid lowering therapy NOW.

Please don't do what I, and many others, did and try to get it down through diet and lifestyle changes.

Let us look on  the plus side of that strategy for a moment. Yes, there is evidence to suggest that weight loss and diet can help. Gradual weight loss is the key – one pound a week and two at the most, otherwise your uric acid levels will rocket. Diet must be calorie-controlled with low iron (basically low meat).

Now, the downside. It takes time to adapt your diet to something that you can live with, and it takes time to lose weight. Every day you are trying to get healthier, the uric acid crystals are building up. You will not notice every day, but those crystals are forming. Your immune system locks them away, but they can still eat away at bones and tendons. Occasionally you will get a flare, take some pain killers and continue. During all this time, your gout is slowly getting worse and worse, and you are moving further and further away from any chance of controlling it through weight loss.

The time for the meds is NOW. If the weight loss / lifestyle improvement strategy does work, you are protected while you get it in place. Your regular uric acid tests will tell you when the meds are no longer needed. If it does not work, you have saved yourself considerable discomfort.

If allopurinol, or some other uric acid lowering medication, is prescribed properly, the doctor will be monitoring your uric acid. At first, weekly to get uric acid level down to 5mg/dL. Then monthly to ensure everything is OK for 6 months. After that, every 3 months or so is sufficient, but anytime you change dose or make significant lifestyle changes (new exercise program or new diet), you need to increase the uric acid test frequency again.

If this level of medical supervision is not available to you, you can check your uric acid at home with a meter, but the priority has to be getting on uric acid lowering treatment ASAP.

[zip2play]

I concur 100%.

Once you have had several attacks you will NOT get your uric acid to safe levels without medication.

Ask your doctor if he is well versed in treating gout and if he says no have him recommend someone who is.

The only limit placed on how often you should have your uric acid tested is your insurance comany's willingness to pay.

Phoenix,

Siince your uric acid is so very high I recommend starting with 300 mg. allopurinol. If it turns out that is too much (which I doubt) and get's your uric acid into the 4's you can always attenuate the dosage down and even supplement with “good living” habits. But if you let that 9.4 hang around very long you are going to be in unremitting misery.

THere's a wonderful old protest song called IT ISN'T NICE…that can translate to allopurinol vs. “good habits.”

“It isn't nice to block the doorways,

It isn't nice to go to JAIL

There are nicer ways to do it

But the nice ways always FAIL

It isn't nice, it isn't nice

You told us once, you told us TWICE,

But if that is freedom's price it's okay”

[Keith Taylor (GoutPal Admin)]

thanks guys for your advice, I am going to take my blood test tommorrow mornig and it will be ready in the after noon, that will tell me where I am compared to last weeks 9.4.  I will take the results to the doctor. Last week he said he wanted me to wait a week, because I had high level indicators that my liver was bang up.  Proably, because previously I was taking some other anti ingfflamatory medicine and not eating when I took the pill or drinking enough water.

The pain seems to get a little better, but I still cannot walk i am sure you all have been there.

tommorrow,  I will ask the Doc to put me on the allopurinol, like you say I can at least lower my uric acid immediatly.  See I am 5 foot 6 and 230 pound, 37 year old person so there is a lot of room for improvement.  So I need to make adjustments to my lifestyle.

Here goes another question, if I lower the weight and show a consistancy in my diet, can I slowing ween myself off the allopurinol as long as i maintain UA levels?

Phoenix

[Keith Taylor (GoutPal Admin)]

Phoenix Rises said:

Here goes another question, if I lower the weight and show a consistancy in my diet, can I slowing ween myself off the allopurinol as long as i maintain UA levels?

---

Yes. But you need to keep up the uric acid testing. Of course if your gout is due to other factors, eg genetics, then the weight loss might not help – but you will be generally healthier.

[Keith Taylor (GoutPal Admin)]

Gout Pal,

  I would like to thank you and this web site, a few days ago I was lost and frustrated, because this theme was an unknown.  Even when reading all the web sites, was not good, they all said the same thing which is basically a big site's of defintiion.  Gout Pal .com not only give relaiable advice, but there are so many stories that resemble what each of us is going through one way or another. 

Last night I read a part in the achillies section and the person explain almost exactly what I amgoing through,

     So most importantly, I do not feel Alone.

                                   Thank You

I had my blood check done today and the UA was 8.2, which has gone down from last weeks 9.4.

I aslo have the Allopurinol perscriprion already and will begin taking it on Sunday.  The Doc did not proscribe that colchicine, I know I will get a flare up once I start taking the Allorpurinol.

Do I really need the colchicine, and can the indomicne help as well?

I know I have to buckle down

good Luck everyone

Phoenix

[Keith Taylor (GoutPal Admin)]

Thank you Phoenix for your kind comments. These are not due to me, but to all the people who contribute to this forum. Especially the top posters, pulled from todays stats:

zip2play – 388

trev – 140

vegetarianGuy – 66

metamorph – 63

cjeezy – 59

Tavery – 41

The numbers show each time they have given something to all of us. Thanks are due not just to the top posters, but everyone who contributes. Even good questions often motivate us to find out more. And please note that all contributors are just regular guys and gals who seek to make gout life easier for themselves or a gouty friend or family member. You are all inspiriational.

Gout flares with allopurinol are not a certainty, but happen often enough to be prepared. Colchicine is usually the best as it is so effective. 2 pills at the first twinge are often enough.

Indomethacin, and other NSAIDs like ibuprofen and naproxen, are also very good. They should not be necessary for lengthy periods, where most of their risks lie. New studies are ongoing about IL-1 blockers, comonly used in osteoarthritis and rheumatoid arthritis. Some doctors seem to prefer steroids like prednisolone, but these should be avoided at all costs.

[zip2play]

Phoenix,

Yes,

You really DO need the colchicine, even if you never take it. Having it in your medicine chest is the very best thing you can do to avoid a BIG attack. IF you have a flare after starting allopurinol, and I give the odds at 50-50 on that, and then you have to bear it for a few days and then see your doctor and THEN get a Rx for colchicine it will be FAR more dire than if you popped two little pills the first moment of the first morning  you felt foot discomfort. That's when colchicine does its best work and you cannot use it that way if you don't have it.

I think EVERYONE with gout should have an emergency supply of colchicine on hand. The singular differentiator between colchicine and ALL other treatments is that colchicine STOPS the attack and ALL the others merely treat the PAIN from the attack…”more morphine please doctor!”

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