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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.
Sorry Steve – I love Manchester really, and spent many happy years working there. I still enjoy the occasional good Manchester night out when there's something good on at the MEN arena. Any city that gave us Joseph Holt can't be bad.
So far, I've found that Garra Rufa therapy has become available in the USA and Canada. Note that some states (Texas, Arizona, Oklahoma, Tennessee, Mississippi, and Washington) have banned the treatment and the International Nail Technicians Association disapproves of it. Concerns about maintaining sterile conditions in a colony of live fish appear to be the issue here. I can find no sign of this treatment being available in the UK.
Understanding uric acid crystals and how uric acid causes gout pain are two foundations of learning how to manage gout. Understanding these processes does not directly help your gout, but it does help you understand how different treatments can work. You also need to understand how lowering uric acid can cause gout pain, albeit on a temporary basis if you lower uric acid properly.
Seeing common symptoms of gout in a similar way to 'flu helps understand some of those symptoms better. Feverishness and pain are due to your bodies immune system trying to fight inanimate uric acid cells just as they would a virus. I believe the pain is worse with gout because the inflammation is concentrated in a relatively small area.
Whether your experience was a relief of symptoms, or a removal of cause is something we may never know, until the treatment is studied scientifically. The only evidence I can find relates to psoriasis, and the researchers cannot identify where the benefits derive from. The good news is that the studies where carried out in Turkey, where the fish originate. A much shorter flight for you.
You might find the garra rufa report interesting, but I don't think it answers many questions.
Steve Carter said:
Now Im sure there are those amongst you who thing Im stark raving bonkers
Well you did say came from Manchester 😉
[Explanatory note for readers outside UK, possibly outside North of England. People from Manchester are mad, known everywhere as Mad Mancs. It's probably to do with living on t'wrong side o' t' Pennines. None of this has anything to do with gout, and I apologise for abusing my authority]
On a more serious note – anything that works for you, is OK by me.
There are many areas of gout that are not fully understood. Nobody is clear why one person can live with high uric acid but never get gout attacks, whilst others have severe attacks at much lower readings. Also, the mechanism of gout pain is still something of a mystery. Why does inflammation vary so much between people, and between attacks in the same person?
Another name for Gara Rufa is “Doctor fish” [see – you've sent me off on a new research path already]. There is plenty of evidence that these fish do help sufferers of many conditions – why not gout?
We have a few visitors from Kuala Lumpar here at GoutPal.
Perhaps someone in Malaysia has more information.
Remeber that untreated acute gout attacks often go away in a few days by themselves.
Many gout cures are often coincidence.
Obviously, if anything makes you feel better, then continue with it, but remain aware that the only true way to overcome gout longterm is to reduce uric acid levels. Keep uric acid below 6mg/dL, and gout attacks will eventually cease. You may need natural or medical help with pain until uric acid deposits have all dissolved.
