pH Testing

[aviator]

After one of my worst flare-ups in years and being immobilized for the past 3 weeks, I've decide to get serious about monitoring my health and controlling uric acid levels.  I've have never monitored my urine pH, but routinely monitor my hot tub.  That got me to thinking, why not use the pool test strips to measure urine pH?   

Using the hth brand 6-way test strips that I had purchased from Walmart for the hot-tub, I initially recorded values of 6.4 upon waking to 6.8 & 7.0 in the afternoon.   Wanting to increase my alkalinity, I decided to take 2 tsp NaHCO3 twice daily and I'm recording values of 7.0 upon waking and 7.5 to 7.8 after a few hours into the day, after 1 day.  This seems to provide a nice correlation between the BS and urine pH readings.

My question is this:  These pool test strips appear to be giving me plausible if not correct urine pH readings.  Besides providing me with the assurance that I have no free chlorine or cyanuric acid in my urine , are they an acceptable tool to accurately measure urine pH? (range is 6.4-8.4 which seems adequate for urine pH) or should I purchase litmus paper specifically for measuring urine pH.  My gut feeling is that pH is pH these strips are working just fine although they may be a bit more expensive at $0.15 (USD) each.

[zip2play]

Aviator,

I like your innovative self help…a man after my own heart. (Note we can assume that everone on this forum is a MAN…funny and sad.

Anyhoo, I would think that the pool tester is just fine becasue pH is just pH and I doubt that any tes srtrips made specifically for urine are any cheaper than $.15 each. (I'm going to tty to cop a few at my gym but they may use those bottles and droppers and might not want me peeing into their equipment.) The range of the pool strips seems narrow enough to get a good valid reading around 7.0…just the range you'd want.

Why not give colchicine a try…I see no reason to suffer 3 weeks with an attack.

[aviator]

>> I see no reason to suffer 3 weeks with an attack.

Inexperience I guess.  I'm 54 and have had about 6 attacks of various severity over the past 15 years in the same big toe, usually with over a year in between.  I've always gone to a GP who simply puts me on a course of Indomethacin and it usually subsides after a week or so.  I've not really researched it in depth before because of the infrequency of the attacks.

Here is what happened:

I recently had some issues with hypertension so the LPN in the office started me taking a thiazide diuretic.  Although the gout history indications were in my record, she didn't connect the dots and I didn't know any better. Based on my research, I now believe that this was probably the trigger to the whole episode.

Moving forward…  I went on a caribbean cruise in February which rekindled my love for Rum. After returning home I continued moderately partaking which did its part in helping me dehydrate during the night. (you see where this is going don't you).

What were rare and relatively controllable episodes of joint pain flared up into the mother of all big toes that simply got worse and worse to the point of tears in the middle of the night, several nights in a row. This is the first time that I've had to use a cane to walk in my life and it really was a wake up call.  I went back on the Indo, stopped the diuretic, started drinking plenty of water and quit the alcohol.

My serum uric acid level was 7.5 last month at the lab, but it was only tested once and this is the first time that I've even had it checked.  I've purchased the UASURE to keep better track of my levels and I'm waiting for it to arrive now.  I also have an Omron digital BP monitor just because I like to keep track of that stuff myself and it's cheaper than going to the doc and using a lab.  I'm still going to have to tend to the hypertension after this flare up is over so better knowing my uric acid levels will help me make a better informed decision about how to treat the hypertension moving forward.

Obviously, I'm not in as bad of shape as others that I've read about on the site.  My heart goes out to you.  Just doing a Google image search for 'gout' is enough to make me thankful and make some lifestyle change choices.

>> Why not give colchicine a try?

I'm a bit concerned about the side-effects and think that my dietary and lifestyle changes should keep this under control but I'll research it a bit more and consider taking it if and when another attack occurs. Thanks.

I've had very good improvement over the past 24-48 hours where I can actually walk without a cane! I have movement back in my toe and the swelling, redness and pain has subsided about 80%.  I hope to be back in shoes by tomorrow.   This episode will have lasted about a month if it continues to improve at this rate.

I've been taking 1 tsp of BS, twice a day trying to keep my urine pH between 7.4 and 8.4. (I know the hypertension implications so I am also monitoring my BP)  Don't know if the BS is this cause for the improvement, because I'm also drinking 4 qts of water/day (I'm 235lbs), 12-24 oz of Black cherry juice (don't know how helpful this actually is but it sure tastes good!) and 50mg of Indocin 3 times a day with lots of rest and elevating my foot.  I suppose they all do their part to help.

[zip2play]

Hmmm, 6 attacks in 15 years…I might agree with your desire not to get on a lifetime of meds. But you'll have to be alert to any increase in frequency or severity. For example, it's probably not tenable to suffer a month a year of debilitating pain. Gout tends to get more, not less severe.

Yep, thiazide to a gout sufferer…some doctors cannot connect the dots even if there are only TWO!

Hypertension:

Here's my experience (yep I monitor daily with my trusty LUMISCOPE…cheaper than the OMRON!) Another fact that many doctors cannot comprehend is that there are TWO types of hypertensives  V-type and R-type. (V for volume, salt-sensitives<25%> and R-for Renin driven<75%.>) Again, I think many doctors after med school read NOTHING except blurbs from pharmaceutical companies and their monthly financial tallies.

If you are an R-type you will do very well with ACE inhibitors and ARB (angiotensin respeptor blockers) At the risk of repeating myself too often, there is ONE ant-hypertensive drug, and only one, that is uricosuric and that is losartan (Cozaar.) Try it…if it gets your BP down enough, well and good. If you can take an ACE inhibitor without coughing and get good BP control, well and good.

But if you are a V-typer hypertensive, you NEED a diuretic, sad but true. Thiazide is just impossible for us but lasix (furosemide) not so bad. I take a combo of Lasix and Cozaar daily and I get good control without retaining uric acid. If you MUST take a diuretic, take Lasix with Cozaar.

If I had to rate thiazide and rum;s contribution to gout it would be Thiazide 97%, moderate rum 3%.

In reality, I think you can look to a future with daily allopurinol but you will know when the time is right.

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