[Benedict]

Hi Keith

Hope you’re well. Thanks for reply. I’ve started updating my profile – its a good place to monitor my progress!

To summarise, my uric acid was at 7.7 a week after my last big attack (november). This reduced to 5.5 with four weeks of diet changes. I started taking 100mg Allopurinol and this dropped to 4. Increased dosage to 300mg and the tests (after being on 300mg for 2 weeks) placed my uric acid level at 3.1 .

So I guess it looks like it is dissolving the crystals. I don’t mind the discomfort as long as I avoid a flare-up (wishful thinking!)

Take care

[Benedict]

Hi All

Just a query and some advice please if available…

As mentioned above I have been on 300mg of Allopurinol for the last 4 weeks, plus colchicine daily which I’m trying to reduce the colchicine from 2 * 50 daily to 1 * 50 to 0. I’ve noticed if I don’t take any at all then I start to get twinges (at the site of my original attack plus other sites, e.g. have felt like mild gout like pain under my ankle for the last few days). Unfortunately, I’ve got a dose of man-flu at the moment with a sore throat etc so I know I shouldn’t be taking colchicine. Also I don’t want to completely stop taking colchicine and risk a flare-up! Currently, I’m trying to survive with a 50 mcg colchicine every two days, plus paracetamol. ( I cannot take ibuprofen as it bothers my kidneys)

So is there a way of knowing if the pain in other sites is the tiny dissolving crystals getting lodged? And will these dissolve further with the allopurinol?

Any thoughts/advice much appreciated!

[Benedict]

Just to add my 2 pence worth…I’m 37 and had a nasty Gout attack last November (I’ve had minor attacks for the last 12 years). After getting it under control I started on Allopurinol 100mg and Colchicine 2 * 50 daily. Initially, my uric acid levels were about 7.7 mg/dl but have now dropped to 3. I increased the Allopurinol to 200mg a month ago and am now on 300mg daily. Every now and then I felt twinges, slight pain at which point I’d have Colchicine 2 * 50 to stop any pending attack. Although now I am wondering with my uric acid levels quite low whether the twinges are crystals dissolving away, or in fact damaged joints (caused by the crystals) – the twinging increases after a lot of walking or exercising. I’m going to try and stop the Colchicine (I’ve been on it daily for a few months now) as it’s not good for my immune system and only take it if I get pain that’s more than twinges.

Anyway sorry, I started waffling. All I would suggest is continue with the Allopurinol (with some colchicine and NSAIDs or paracetamol) and slowly reduce the latter two. Otherwise, a build up of uric acid crystals can cause very serious health issues besides gout. It is a long term strategy so please read case studies and work with your doctor and the knowledge people on this forum to design a plan suitable for you.

[Benedict]

“Hey: maybe that?s the answer when starting Allo during a gout flare-up ? enjoy a little of what?s bad for you in moderation so as to not allow the UA levels to drop too quickly!!”

haha I like it! I better order that steak!
Are you recording UA values daily? I have a diet app which logs my my weight daily and works out a trend, it might be worth doing this for the UA if you’re not doing already.

I’m in a similar position. Have been on Allopurinol for a week now but luckily no flare-ups, just bits of pain in different parts of both my feet but nothing major- am hoping its the loose crystals slowly dissolving away. My last attack was a month ago. I am taking 2 * 500MCG Colchicine daily alongside it.

Interestingly, my bloods after my flare up showed my kidney function had dropped to 40 (50 and above being the safe number). I tried it again two weeks later but this time avoiding Ibuprofen and it had risen to 70. My doctor says my kidneys must be sensitive to Ibuprofen and not to take any.

As I’m currently on 100mg Allopurinol and 2*500mcg Colchicine, if I start getting a flare up will Ibuprofen actually stop or recede the attack or is it simply to reduce the pain (by reducing the inflammation) i.e. should I just stick to the Colchicine until my Uric Acid levels are lowered?

[Benedict]

Hi Keith

Regarding point no.2 “Pre-screening for certain ethnic groups at risk of hypersensitivity.”, I’m from an Pakistani background – is there any prescreening I need to get done?

[Benedict]

Hi Mike

Hope your pain has receded. I’ve had a similar experience. Had my first uber-painful gout attached 11 years ago (at 26) and since then only had minor attacks which quick consumption of pills sorted out. Had a major painful attack a few weeks ago (in my big toe again). Colchicine and ibuprofen got rid of the attack after a few days, although I had a painful one a few days later but took the meds as soon as I noticed which helped.

Regarding meds, I’ve been taking Colchicine twice daily (500mcg), and ibuprofen 400mg a time whenever I feel pain. I’ve been feeling twinges, bits of pain every now and then in both feet but particularly when I bend the joint in the ‘gout’ foot – this could most likely be silent gout attacks with the colchicine stopping the white blood cells from attacking the urate crystals and causing the pain (i think thats how it works…)

Did you stop the colchicine because of stomach issues? As i’ve been taking it continuously and I would only stop if I got another infection…

Am seeing Doctor tomorrow about starting Allopurinol, will ask for 100mg initially. Then increase it after a month depending on uric acid levels – mine is 9mg/L at the moment.

I was thinking of getting a UA testing kit but decided against it as you need to be very disciplined with the testing and measure the trend. And you would (I assume) get better results from your GP if you requested monthly tests to monitor your levels.

Anyway sorry for the ramble, hope it all gets better soon.

[Benedict]

Thanks for the advice Keith, much appreciated.

[Benedict]

After reading various websites, I think you’re absolutely right that the priority has to be to reduce the uric acid levels long term. Am going to speak to my doctor to get me on allopurinol 100mg initially) as soon as possible.
In the short term, I bought some 1000 mg vitamin c tablets but noticed they have magnesium stearate – must be for the capsule shell. They’re vegetable capsules. I know magnesium stearate is created using stearic acid, which as you’ve said research shows could be a trigger for a flare up. So my question is whether these capsules are safe to take in the shortterm.

What do you think?

Many thanks for your advice.

[Author]

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