Newbie-gout story ,any advice?

[Funkmeister]

Hi everyone,

Ok I'm 40,male,130 kilos, on pariet (stomach acid reduction) low grade hypertension meds (was on thiazide for 2 years not now).

1st Gout attack was in right ankle about 6 years ago(when I was on thiazide), was the one you guys describe as “from hell” as I thought I'd just twisted my ankle at 1st so didn't get to a doctor till too late.

Indomethacin sorted completely within only 4 or 5 days. didn't have one for 2 years after that. I am not a big drinker at all and have been dieting and exercising with good results and then get thwarted by very mild level big toe in right foot attacks.

Have now had about 5 or six big toe attacks in last 3 years. All bar one were the result of mildly rolling or twisting my foot in some way. I am usually on to them as soon as I get the slightest “tingle” indomethacin usually sorts them reasonably quickly IF caught right from the get go.

I am currently in toe attack right now, I kicked a soccer ball really hard in the wrong way with my right toe. as it hurt instantly I figured I'd just done a little soft tissue damage so didn't think anything of it and went for a big walk the next day. after that I got that “gouty feelin…”

so hit colchicine and indo for 1st day. Then just indomethacin. No massive pain as per usual. Slightly swollen and I mean slightly and a tiny bit red if at all.

On 2x indomethacin 3 times daily and it's just lingering around and not getting any worse but not getting any better in a hurry. Been on indo for 11 days now. This happened on my last similar attack in september last year. pain in bottom of toe lasted for weeks.

Blood tests a year ago revealed only level 4.9 uric. did follow a low carb diet for a few months last year and was told by doc that this raises uric levels due to ketosis.

I have never had a bad attack since the 1st one many years ago, only ever low grade but they hang around forever with just enough pain to make me walk a little funny and roll onto the outside of my right foot.

Doc seems hesitant to put me on allopurinol as uric levels not too high. Problem is every lingering mild attck completely throws my cycling for fitness and walking and diet efforts. I fall into a depressive indomethacin zombie staet and put weight back on.

As I am pretty sure that my weight is the real issue I want to really get on with that issue and am motivated to do so. Can Allopurinol be slowly decreased in the future due to uric acid levels falling with regular and consistent substantial weight loss?

Also I have never had an extraction to test for crystals so gout diagnosis is reliant on 2x doctors thinking so.

I am aware that many posters here are having far far worse episodes than I am having but I still felt the need to post as I think I am really getting depressed about it now.

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Any help or advice would be much appreciated!

?

cheers,

funkmeister

[trev]

Hi- a quick reply You need to push treatment as your attacks are well established as diagnosed gout.

Heavy doses are not automatic on UL meds . I get by on 100 to 200 mg Sulfinpyrazone without attacks now on a gout friendly diet and low alcohol. Don't be put off dealing with this- meds that don't suit can? be stopped or changed?and a suitable regime established in good time.

Forwarned is forarmed! 4.9 SUA?is low for gout but you need more tests as swings easily occur daily, never mind yearly.

[Funkmeister]

Thanks Trev,

Much appreciated, I think you're right I've had enough attacks now .Although they haven't been that intense, they are taking consistently longer to go away, so I think time to start treating it.?

Cheers

[Author]

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