[Paul]

Thanks Keith. One more question, should my allopurinol dosage ever be reduced now?
Merry Christmas to you, thank you so much. I will donate to the site when I get to a safe portal.
Still can’t believe it’s going to be alright!

[Paul]

Hang in there Ayman,
You’re in the right place for help and advice.
I’m not the right person to offer that advice but the forums experts will be along soon I’m sure. My limited help is this, you will be alright with the advice you receive here. It’s all about getting the right treatment plan for your condition. Gout can be controlled to a point where you will be able to live a normal healthy life again.
I feel your pain, we all do. Help is just around the corner, I look forward to seeing the forum experts response to your pain.
Paul.

[Paul]

Blood test results: Uric acid levels now 0.31
It’s been 9 weeks since starting allopurinol. I couldn’t be happier.
Doctor said to stay on the 300mg dosage and that my levels were now safe. He still maintains I should not binge drink alcohol but agrees a pint here and there will not hurt. I’ve asked when I should return and he said unless I was suffering and kept taking the pills, not for a year.
I feel amazing. I’m going to stick to the diet, less meat, more veg, lots less alcohol, plenty of water. I’m also gonna be less paranoid about diet and alcohol.
Thank you Keith for all of your advice. I’m not sure if this journey is quite over yet but I’m pretty sure I’m heading in the right direction. That has a lot to do with your help and I’m forever grateful.
I reckon you’re going to advise to keep on with the pills and get back to the doctor for a blood test a lot sooner than a year later. Trust me I will but for now, I’m off out for a pint.
Merry Christmas friends, I feel your pain but as today suggests, it’s gonna be alright. 🙂

[Paul]

Update. Had another gout attack. Feared the worst but it was actually ok. Took the usual pills and the pain subsided within three days! This is the least amount of time it’s ever lasted.
Had blood test on Friday. Will post results next week. It’s a really weird feeling to have an attack and yet feel pleased it didn’t last so long.
Could it be the pills are working? I really hope so.
Merry Christmas everyone.
Paul.

[Paul]

Hi Keith, Once I’m attack free we should have a pint in the pav tav for old and new times sake. Brighton is indeed a great place to live.

Thanks for the link. I’ll try and trawl through it later.

Does it make any difference that I haven’t yet posted my uric acid levels since starting on the allopurinol?
Blood test next week, results on the 11th. I’m kinda hanging on to this date for some positive news. In my mind any decrease in uric acid levels will be a good thing, but what level should I realistically hope for?

I will ask about upping the dosage on the 11th as well.

Thanks again, Paul.

[Paul]

p.s. can you link me to the British Rheumatologist Guidelines please, I can’t find them.
cheers

[Paul]

Hi Keith,
Thanks for the response but how do you know about the ‘Pav Tav’? You’re scaring me now as I was only in there the other day!

I’m kinda unsure where to go now. As much as you say my doctor is ‘stupid’ and/or unknowledgeable about the subject of gout, I actually like the guy and trust him as much as someone I’ve never met but only communicated to online. I do respect what you say and your feelings towards the medical profession but I’d rather work with both of you to get results and I hope that is the way I’m heading. It’s very difficult to say to your doctor, ‘Do you really know what you’re talking about?’ as, well they are a doctor.
I will try and explain your point of view to him, I may edit your response above and show him if you don’t mind? I’ll look for the notes you describe and give him a copy if he wants them. I don’t want to swap doctors but ultimately I will if no improvement of my gout happens. I’ve yet to post any uric acid readings taken since my allopurinol course started, so hopefully I’ll have better news at the start of December when I have a blood test. (does this change anything?)
The alcohol intake is beyond just abstaining for gout purposes now, so I’ll enjoy the odd pint here and there anyway. When I reach my goals I’ll definitely hook up for a pint with you.
Thanks again for your help, it really is appreciated. As confusing as the whole subject is, I want to achieve my goals and know that it is your goal to help.

Cheers, Paul

[Paul]

Hi Keith, glad you’re well.
Blunt is fine.
So I’m confused again. I still feel the alcohol accelerated the attack, perhaps due to dehydration like you said. I’m less paranoid about it after what you and Ron have said though. My doctor has still insisted that I stay away from booze.

Missing work? I had no choice, my foot was killing me and I need to walk around for at least 5hrs out of 8 hr shift. Even with Naproxen I still couldn’t walk? What other painkillers are there?

Uric acid levels. Can you advise what is the comparison between the two scales in America and England for me please?

My gout is six weeks worse? This really does upset me and I don’t understand. The level has gone down, not enough, but down, I am on allopurinol that is doing nothing for me? Do you mean at the current dosage? If the levels are down even slightly is this not a good thing? I can tolerate allopurinol? If I can but it does no use then what’s the point?

I’ve been back to my doctor who has stated that the 0.34 target is a safe level that will mean I do not have gout attacks if kept under this level. I asked if he would increase my allopurinol dosage and he said not to. He was concerned about side effects, (I have had none btw). He also stated that he wanted to see how the uric acid levels had changed on this dosage (300mg) daily. My actual levels were 0.69 in April, 0.63 in july and 0.52 in sept. All were measured before my course of allopurinol started. September level was after abstaining from alcohol. I have another blood test on the 4th of December when I will have been on allopurinol for 9 weeks. I will post results. I will also see my doctor again around this time.
I need some advice on what to say to him if I need to increase my dosage which is what I think you are telling me.

My long term goal is to never have an attack again.
My immediate goal is to reduce the chance of having an attack and to be able to work if I do have an attack.
My alcohol intake has reduced dramatically and I will still enjoy the odd pint or two here and there despite my doctors advice. I believe you when you state it’s not down to the alcohol. The benefits of not drinking currently outweigh the desire to get p*ssed.

Thanks for the advice again. Hope to hear from you soon.

[Paul]

Hi Austin,
You have been badly advised I’m afraid. Probably best if I leave it up to the forums expert Keith to answer, but needless to say ‘just live with it’ is possibly the worst advice concerning gout that I’ve ever heard. The meds do work and not all side affects will show themselves to everyone.
Diet is very confusing and still confusing to me. In essence you need to lower your uric acid levels to avoid gout attacks. The process can take a while but as most here will agree is definitely worth doing. For my story read ‘my gout story’ on this forum. I still suffer now but this forum has been of great help. I just hope, Keith or Ron will get back to you soon. If not I will endeavour to help but I’m definitely no expert.
You do not need to suffer as much as you are currently suffering and I feel your pain, we all do. It can be cured and you’re in the right place to start, just hang in there.
Paul.

[Paul]

Cheers Ron your response is welcomed. Still can’t get past the alcohol and gout attack being linked but I’m a little less paranoid about it. Doctor again tomorrow. Gonna ask for allopurinol dosage to be increased. Will report back. Hope Keith is ok. Talk to us buddy. It may help.
Paul

[Paul]

Hi Keith/All,
So I had that drink….
or two..
All was OK
waited a week, had another, just one…
All OK
waited a few days
until..
my birthday.

Many drinks later…
gout 🙁

Yes it’s back. Been off work. Gutted.
The attack hasn’t lasted as long as before. I’ve stayed on the allopurinol, (300mg). Started back on the colcicine and taken naproxen for pain.
Got doctors again next week. Acid levels went from 0.66 to 0.52. Doctor target 0.34.
Asked about upping my allopurinol dosage to 600mg.

So Keith, was it the booze? Was it likely to happen anyway? It’s now 6 weeks into the allopurinol.

[Paul]

Hi Bob. I’m sure someone will answer your question soon. Hang in there. This forum is actually helpful. Paul.

[Paul]

Defo update the format of the site please. It’s brilliant but really clunky.
Hi Mike J, good luck!

[Paul]

Cheers Keith. Thanks again.
My plan is now to visit the doctors in 4 weeks time, 4 weeks ahead of when the doctor told me to. I’ll discuss the uric acid level results with him and try and gain more of an understanding where he wants me to get to.
Why is it that all gout advice apart from here states avoiding high purine foods is the best course of action?
You also mention stress as a cause? Never heard this one before. I also read an article on gout in Japan. Link: http://www.dailymail.co.uk/health/article-3269842/For-clean-teeth-try-gargling-tea-Tannin-s-antibacterial-properties-reduce-build-plaque.html (SCROLL DOWN). Interesting?

How long after I’ve started taking allopurinol will it take for me to be fixed (on average). I’ve been on it three weeks now and am looking for some sort of timescale to judge results on. Also been three months with no alcohol. I’m having a pint this week though, can’t take much more abstinence. I’m blaming you if it goes tits up and I have an attack btw.

[Paul]

Hi Keith,
Thanks again for the advice. Your help means a lot to me. It’s becoming clearer the more we communicate and I thank you for that.
I’m now two weeks into the allopurinol pills and have stopped the colchicine for 3 days now. I’m slightly paranoid about stopping the colchicine as I’ve been taking it for two months now with no ill effects and no gout flares. I plan to stay off the booze until the end of the month at least. I must say I’m really tempted to have a beer but I’m also paranoid about it. I think I’d like to see how I am with just allopurinol without the colchicine for a couple of weeks first. You’ve made me less paranoid about food but I’m still steering clear of high purine rich food wherever possible.
I’m going to go back to my doctors sooner than he suggested to speak of what I’ve learnt here but I’m still going to leave it until start of December.
Thanks again. I’d love to hear your opinion on this post.
Cheers, Paul

[Paul]

Hi Ron, cheers for the encouragement. Much appreciated. I hope I’ll be able to enjoy alcohol again and all the food I’m avoiding now but want to eat again. I’m confused about acceptable levels of uric acid. You say less than 5 but Keith says zero should be the aim, I think. I like also to know which food stuff to avoid. I know it’s different for all but there must be some generic advice for all.
I work in casinos Ron so maybe we’ll meet for a beer in Vegas one day!
Cheers, Paul.

[Paul]

Hi Keith,
Most important to me:-
Allopurinol usage and levels
Uric acid levels, what to aim for?
Diet, what to eat/avoid?
Alcohol, good bad or OK when controlled?
Time scales? How long treatment should take?

Cheers, Paul.

[Paul]

Hi Keith, I am not offended by anything you have posted.
I have no kidney problems as far as I’m aware. Are you saying that the uric acid level to aim for is Zero? Why didn’t the doctor start me on a lower dose of allopurinol? Its a good thing that I’m on 300mg per day or is this too little?
I think the point of aiming for .34 is to be able to achieve this level, of course if my doctor had said I should aim for zero, I would have just accepted his advice as I’m no expert. A bit confusing I’m sure you’ll agree.
You talk of diet and I’d like to ask if there’s any foodstuff that should be avoided at all cost? I’ve heard/read shell fish and offal should be avoided?
Do you think I should see my doctor again before three months as recommended by him and ask to go on a higher dosage of allopurinol? I know it’s difficult for you to judge at times without medical records but I appreciate your opinion as you seem far more knowledgeable than any doctor I have dealt with. Interestingly enough including my sister! (the doctor).
I guess what I need is a few home truths on best advice for gout treatment in a general format, i.e. what is good advice for all sufferers. I know you advocate an individual plan and I accept that but going against my doctors advice is a dangerous thing to do, at least in my mind it is.
Thanks for your comments and thanks for the site. It could be the best gout advice forum around, I’ll let you know if/when I ever have this horrendous condition under control.
For now, I’ll carry on without any alcohol and keep you updated on my progress. I’m sure I will need some more advice soon.
Cheers, Paul.

[Paul]

Keith, interesting. I am indeed in the UK and my knowledge of the uric acid level measurements are not particularly good. I have just posted what I thought the doctor told me. He didn’t talk specifically about the measurements used, just gave me numbers.
You say 0.34 is not low enough in the first few months? How low should it be? Also to consider increasing the allopurinol dosage? Is 300mg not enough? I thought it was a quite high level dosage or am I wrong?
Can I also ask about colchicine? My doctor has stated I should stop taking it after 14 days of taking it alongside allopurinol. I’m slightly worried by this as for the whole of the 8 week period leading up to when I could take allopurinol, I was taking one a day to stave off an attack. I’m worried that stopping taking it could result in a flare up? What do you think?

The whole alcohol as part of your complete diet, I get. I just wanted to point out that for me, giving up was one of the best things I ever done. I do want to drink alcohol again but found the positive benefits of giving up were truly amazing. It’s been 10 weeks now and as much as I could murder a pint, I’m also inclined not o as I feel so good. I will however drink in moderation after a couple of weeks on the allopurinol. My doctor made a good point when I asked if could drink alcohol again. He said to me, ‘You’ve come into my office and just told me that after stopping drinking, you have lost weight, not had an attack of gout and feel better in general. Now you are asking if you can drink again?’ It was a pertinent question that made me consider why I wanted a drink. He then told me pretty much what you have said, that having a couple of drinks will not affect my condition but excessive use would. It’s worth noting that I have changed my diet as well. Trying to eat two vegetarian meals a week and I’ve cut my portion sizes down and tried to eat less red meat.

Thanks for getting back to me, I hope this help more gout sufferers deal with the confusion that gout can cause.

[Paul]

Giving up alcohol in order to get onto the allopurinol is my suggestion. Hopefully this means that once the gout is under control you (I) can go back to drinking alcohol in moderation.

[Paul]

Hi Keith, As I’ve found out all cases are individual. I believe you state once your gout is under control that sufferers can eat and drink almost anything ‘in moderation’. I hope this will be the case for me in the future. I do however believe that the alcohol can make gout a lot worse than it needs to be. The benefits of not drinking for me have been amazing. Not only is my gout, so far, under control but I sleep better, have lost weight and feel better generally all round. I wasn’t a heavy drinker but definitely drank more than the recommended amount.
Do you Keith, think that alcohol intake should be controlled or not? It was your thread on drinking alcohol that lead me to this site BTW; and yes…I copuld murder a pint!

My acid levels were at 6.6 and my new doctor has stated he wants to get below 3.4. I am now on Allopurinol 300mg daily and I have one more week of taking colchicine before he has told me to stop taking it. What do you think about this?

[Paul]

Colchicine and Naproxen works for me.

[Paul]

Give it up Phil!
No alcohol is the way forward.

[Paul]

Hi Phil, I’m drinking loads of water but I haven’t tried the cherry capsules yet. Cheers for the advice. I’ve given up drinking alcohol and to be honest this has worked really well. Difficult to do but ultimately rewarding. I’m on Allopurinol now and I’ll be interested to see the effects on my acid levels after three months.
Good luck and I hope you can take the allopurinol soon.

[Author]

Posts