walking/driving and gout

[Al O’Purinol]

hi my name is Ray from london. i am 42 years old. i have had gout since 17 years old. usually i only get gout 2 or 3 times a year but recently i have started a job which includes lots of driving and i seem to be getting atacks once a week, going from one place to another. big toes, ankles, back and front of kness, top of centre foot and index finger.  if i take more than 200mg of allipurinal then i get chest pains! any advice and can anyone tell me why walkig or driving trigures a gout attact?

kind regards,

Ray

[Keith Taylor (GoutPal Admin)]

I've also noticed similar effects when driving extensively. The only way I could reduce it was to take regular breaks, and include as much exercise as possible. drinking plenty of fluids and keeping meals light also helps.

I've always assumed that this is from maintaining the same position for long periods.

I've also found the oppositr to be true. Extensive exercise, such as strenuous walking can also trigger an attack. This coulld simply be overexertion boosting cell metabolism leading to excess uric acid production. It might also be blood flow restriction from overtight clothing and footwear. Another effect of exercise can be dehydration through sweating, or simply not drinking.

Finally, your allopurinol dosage needs reviewing by a rheumatologist. It should not cause chest pains, and you may need a different uric acid lowering treatment. In any case, it is vital that the dosage of whatever you take is enough to lower uric acid levels below 6mg/dL. Anything else is a complete and utter waste of time.

[Keith Taylor (GoutPal Admin)]

a few weeks back my doctor change my tablets to Sulfinpyrazone (anturan) tablets. 200mg each day, but i have had so many attacks recently that i haven't had a chance to see how well they work. however they did  make me urinate much more frequently. after 25 years of gout my doctor has never sent me to a rheumatologist, maybe i will go to a private one. also can anyone give me advice on the home uric acid test machines?

kind regards

Ray

[KeithTaylor]

Alllopurinol reduces the amount of uric acid your body produces.

Sulfinpyrazone encourages your body to excrete more uric acid.

The objectives for all uric acid lowering treatments, including these two, follow 2 phases.

During Phase 1, the blood uric acid level must be maintained below 6mg/dL. This allows gout crystals in the body to dissolve, which removes the source of gout pain. This phase can take a year or more, during which time you may get gout flares, which should be treated by appropriate pain relief. The end of phase 1 is signalled by no gout flares for a given period of months.

During phase 2, uric acid level must be maintained below 7mg/dL.

Dosage and frequency of testing needs the input of someone with experience of effective treatment of gout. That is why I recommend a rheumatologist, because with proper treatment and monitoring, you should be living a life free from gout pain.

It is vital, once you start uric acid lowering therapy, that you do not stop, unless advised by your doctor. For anyone planning to start uric acid lowering therapy, doctors usually advise waiting until a gout flare recedes before starting. However, and I repeat because this is important, once you start, do not stop.

I have used a uric acid test machine very effectively at home. This is not a replacement for frequent testing by your doctor, but it is very useful for reassurance between visits. Don't forget that, during Phase 1 in particular, if your uric acid level rises above the limits, then you risk undoing all the good work you have done.

There are no half measures with uric acid lowering drugs. Either you take the right dose to lower uric acid levels properly, or you waste your time.

[Keith Taylor (GoutPal Admin)]

thanks for your answers to my question and i have some others but i will make a new topic for them

kind regards

ray

[Keith Taylor (GoutPal Admin)]

rae66 said:

thanks for your answers to my question and i have some others but i will make a new topic for them

kind regards

ray

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ihi again. i went for a blood test to how well the new tablets ( Anturan) are working. my serum urea level was HI at 10.6 and my serum creatinine was high at 131. i am not sure how long it takes for the drug to work. i have been on them already 1 month.

kind regards

Ray

[Keith Taylor (GoutPal Admin)]

Anturan is a brand of a uricosuric drug called sulfinpyrazone (or sulphinpyrazone).

It works in a completely different way to allopurinol in that it encourages the body to excrete more urc acid, whereas allopurinol prevents the body from producing uric acid.

However, the aim of all uric acid lowering therapies is the same. Lower blood uric acid levels below 6mg/dL until the gout patient has had a 3 month period at this level without any gout flares. Dosage can then be adjusted to maintain uric acid level below 7mg/dL

If your levels are above this, then you are wasting your time. Now this may be a temporary situation whilst your dosage is adjusted to the correct level. If it is not, then your doctor is wasting your time, and the taxpayers money. See a rheumatologist.

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