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With your high SUA figures AlloP is a good route to go.
You're? getting cautious treatment from your Doc in line with your limited number of attacks and a slow start on a split dose wouldn't be a bad thing- for a week or so esp. as you'll be on Colchicine for a while, anyway.
Just confirm with your Dr.- unlikely to oppose this.
A herbalist friend brought me round some Ground elder [Gout/Goat weed] last year when I was suffering. It had no effect. Don't use Elder- it's loaded with toxin btw and looks similar.
I took to using Elderflower cordial as a wine mixer with some success [ ie: Not beer , at least]- it's rather nice.
I can well imagine the syrup being useful, on this background- but as I don't need it now will see what other reactions you get to this idea.
I reckon Meta will try it- as he's being hit right now and he's a big fan of holistic/ natural remedies.
Maybe you didn't give AP a fair trial last time?
Coming off it gave me worse flares than going on it, but using another UL med, Sulfinpyrazone, caused only repeated minor flares lasting a couple of days or so when starting out on it- so maybe you are worrying overmuch.
Doing nothing will be worse, as you know. If AP is finally successful you probably wont need the Colchicine anyway, unless you stress your system by overindulgence in the wrong things. It's not a long term med, really.
The less meds , the better for me- but sometimes?unavoidable. Good luck!
Hi- a quick reply You need to push treatment as your attacks are well established as diagnosed gout.
Heavy doses are not automatic on UL meds . I get by on 100 to 200 mg Sulfinpyrazone without attacks now on a gout friendly diet and low alcohol. Don't be put off dealing with this- meds that don't suit can? be stopped or changed?and a suitable regime established in good time.
Forwarned is forarmed! 4.9 SUA?is low for gout but you need more tests as swings easily occur daily, never mind yearly.
Colch: Given you have an SUA meter and take an interest in what is happening- it could be worth a try.
Colchicine is an old medicine and has a low threshold for causing serious side effects. I don't think there's much in the literature about how to monitor low level?doseages, as it's all over in a day or two,?when used? as an attack stopper in larger amounts.
I doubt you would need a heavy doseage and a 2 a day regime has been used to inhibit attacks- as I remember.
I wouldn't like to take it for longer than a week or so, anyway as it can suppress the immune system too.
This is probably why your medic doesn't do it!
Your situation seems half way- so it's the old trial and error, if you do try some Colchcine. many find themselves in this situation in early days gout.
If your twinges stay manageable,?you can adjust diet, water & alcohol?etc -but, in the end, a big attack will decide a lot for you, given the pain. You could avoid this for a long time, if lucky.
Lets cut to the chase π
If you get a proper attack [from Hell] you will pray for a few twinges as relief, many here?would agree.
If we knew all the processes properly, as to how urate removes or deactivate, we may stop it better in the first place. The blood indicates a mean level of SUA, not strength of urate depositions, unfortunately!
To see the body simply as a repository is not good enough- it's more a chemical factory under seige by all and sundry.
Bottom line- decide on how much pain you want and factor in the treatment to keep you safe before that kicks in!
In the meantime you can get advice on the likelyhood of your condition being something else.
Colchicine usage is an A1 indicator for gout, if successful in easing, and though a fluid sample would be great, short of an attack or two- it's better? to catch this one as ?early as you can. Some time in 'no-mans-land' may be unavoidable.
There are few guarantees with untreated gout except pain and worry, I'm sorry to say.
Well for a 'newbie' you sound like an old hand at all this!
Great that you have a meter and have got some useful results.
This doesn't mean you have gout, as we know -a needle sample would prove that possiblity.
In the meantime it strikes me that you have to accept that earlier beer sessions etc may have laid down enough deposits to trigger low level gout.? In this case, if true, you are already in the gout 'box' but can easily manage this with your approach. Under treatment flares occur at lower than 6mg/dl SUA.
Many sufferes wait far too long [as I did] before twigging the cause and that makes treatment more protracted, but after years of this -once Urate Lowering meds were used things came readily to hand with a few? minor flare ups on the way.Your choice is to micro manage this or go for meds if advised so.
[Often, only?after more than one attack]
Beleive me- staying short of an attack from hell is the main thing and very worthwhile aim- but don't let the knowledge of gout get to you more than needed. You sound very capable of coping from here on.
I get good results on 100mg of Sulfinpyrazone daily [there is a 500mg version!] after many bad attacks really became too hard to bear and given the? damage possible to joints etc. not worth tolerating, whatever your resistance to taking lifelong meds.
Hi RTK- sounds like you have the low circulation 'add on pack' to gout, we've touched on here in the past. π
Fortunately, you are 'gout aware' and taking treatment.
At the SUA level you post you're not quite in clear grounds to be trouble free as you've found and may need a higher dose of AP.
Further, with the cold feet your SUA in that region will be more prone to crystallizing, esp. at night.
No kidding- wear bed socks- heavy wool ones and stick a pillow at the bed foot under the covers and get stuck in there :)?
Pay attention to your footwear and wear soft trainer/fabric breathable?walking boots with good socks.Sandals when it's warmer [you're old enough not to care now :]
Don't overstress your? foot joints or over use them in exercise- after winter is a well known time for gout to surface after sedentary winter months, too.
You probably just have a combination of? marginal factors all?working at once -so attend to them all and you should get better results, maybe without the dose increase.
Let us know how it goes..
?and of course keep up the H2O.[PS: I nearly forgot- have a warm foot soak before retiring, if not bathing]
Raven- as OP you should know better π Read Zips treatise above again and see that 6.8 is NOT acceptable for an established gouty and inform your Doc with confidence.
Print it out if necessary- he'll never forget the lesson π
You will have to get used to this 'training mode'when dealing with Drs.henceforth – they are not likely to know UNLESS they are gout sufferers,and as most are under 45 on average {qualifying at? age 25 and retiring at 65] they are unlikely to qualify on this vital factor. [more commom after 50]
Hans is also right to point out that you must insist on a supportive attitude from your Doc [God]- I argue a lot -and still they?persist?with?unsuitable meds, with a weary professional smile. Another Doc will agree with me readily.
Be firm, it's for life
Yes Bill- the readings do seem too random for comfort.
I use the Kernel meter and my beef with that one is that the date gains slowly?over time and this makes me wonder -if they can't get that right , how accurate is the other bit? [2 meters- the same fault]
However, on accuracy I got better readings than yours except going high when sample site not dry enough or I spat on the strip?edge to get it to beep π . That DID read high?
Are you allowing the alcohol prep to evapaorate off well first?
Seeing your report it looks like you have taken pretty good care to get a good reading- so don't give up just yet, it takes? a while to get 'in the swing' and even then,?a spurious reading can be expected time to time.
The main thing is to get an average?'working level' SUA?to gauge effects of diet,lifestyle and meds. Once meds kick in you will use the meter a LOT less , most probably, as you gain control of SUA levels -which can vary up to 2 points throughout the day, anyway & remember ? we're all different.
Well 2CV- looks like the 'self medication' isn't a plus! π
On the pain, early stages can be just niggly, maybe for years- but if you noticed this after drinking booze like I did-? it's a dead giveaway for gout.
More like just stubbed your toe and it's a bit red and not quite right- next few days clearing .
With your liver, best get it looked into more and view gout treatment? from there, taking the best advice you can get. I think Liver problems are taken more seriously, but there may be a connection to the often?less regarded Gout in that the pathways are all involved together -and people react differently in different scenarios.
Stopping over use of booze is a 'good thing'- the occasional glass of wine is reckoned?'OK' once everything is more settled, and keep the water intake up- 1oz/Kg bodyweight can be done daily, but even half that is good.
[ie: 6 glasses a day]
SDG- have you got a better handle ?? π
On your results, your SUA during/after attack was high enough to indicate possible gout.
Your next reading will tell you more- better?some weeks clear of flare ups.
If it goes up to 8+ or more then you will be more prone to future attacks. try to watch your alcohol/ purine intake till then to get the lowest daily running SUA possible, both out of policy and also to help with your best?'max' reading.
You have posted your full blood figures, so if inviting comment, I would say the few figures out of normal suggest less fry ups [ use an emulsive spray, if you can't do without] to keep fat intake down and evaluate whether alcohol or medications are pushing your liver a bit hard. [GGT]
Hi Reismann- I've seen your post tick along [being a low coffe taker]?and just thought I'd add my usual caveat that there's no reason why you can't have both RA and Gout.
If your bloods are steady now why not get on a Uriscoric like Probenecid to see if the bad attacks go- and just long term symptoms remain?
A low dose lcould well bring you below the reqd 6mg/dl , which is where you need to be to have any hope of nailing it.
I don't think you would normally be put on AP without a firm diagnosos initially,?so there?are still strands to be combed out- before you can be sure. A lot of gout management seems to be hit and miss in the early stages.
I realise that, but I remembered some connection and checked- it's a positive one, like for MS- and SUA? being high in these cases is a 'good thing'!
Maybe as all the 'bad'?protein gets mopped up in the brain?- as urates grab the action?
Funny how urate, chloresterol and even haemachromisasis can put deposits in the iris.
[NB: Optic nerve is brain tissue].
Makes me ask- is urate deposition involved in Alzheimers?- it's gettting so common, just like gout is increasing…
Sorry about the blurred image. I post it as there are so few pics of reactions possibly due to AP.
This shows the broad extent of a lesion on my middle left? finger , last knuckle joint.
There is still? now 6 months later,a raised red area there -with no pain or infection.
I think it was an unspecific reaction to AP.
The main issue at onset was the?pain [like a joint burn from urate] and the lack of healing to red area shown.
I stuck it?for about a week or so, before stopping AP. The soggy bit/red spot?was unusual in not healing over.
Once AP was stopped this cleared up- to a degree similar- but now to a knuckle just?'fixed with'?urate, .
When shown to Docs they just looked interested?but non-committal, not acknowledging?the patients ?worry of extreme reactions once AP started?-now they have? maybe shifted from refusing to prescribe, for probably that very reason. Side effects are regularly discounted in all meds use, in my experience. One said it wasn't normal.
Also,?the Doc who prescribed the AP sometime earlier, had left the practice.
[Also a gout sufferer and AP user]
I've since used Sulfinpyrazone daily [100 to 200mg] with good success, keeping under 5 mg/dl SUA..
?
Picture August 2010 [Edited to show less red]
?
Green Toe and? island- You really can't hope to manage SUA on your own without frequent testing of blood level.
With the best will in the world and a fair wind behind you,? don't assume a SUA level of under 6.5 if you've had even one gout attack?-even if?trying very hard with diet etc. to remain attack free.
The ability of?natural methods?lower by an amount greater than daily variations due to diet and?lifestyle is not proven anywhere for LONG TERM relief in established gouties -? and I have tried.
That's to say, diet can help by 1 or 2 points on the scale, but that can only?balance daily variations- so say you need 7 mg/dl to cause attack, then your average may only drop to 6 which will just extend the period between attacks. Possibly, if you are really thorough and only one or two attacks in, then you might succeed. Docs often try this route, initially ? so it must have some historical justification. Records just don't get kept!
I did get some success using Lasix and Losartan together [getting SUA as low as a 4mg/dl on occasion]?-but these are still long term meds, as was pointed out on here earlier and have their own downsides!
At best, what you learn by testing will allow you time to learn a 'best lifestyle' for yourself -and possibly await newer?or better gout drugs to help, but you will always risk misjudging the?'long term negatives' of high SUA-?if working from the?medium time scales between attacks.
You might fool yourself- but not Mother nature!?
Get an SUA?self tester [and use it!] It's a good route for the determined gouty if you can thereby gain better overall health. Strong?weed risks doing your brain in, sooner or later, IMO.
Hi Nate- firstly , great to hear of your progress back to full activity. That ski slope sounds the business- though I've never tried it.
On the Paleo diet ?[good link] . I've been interested in this for a long time and, as a blood group 'O', a good candidate, apart from being a non meat eater. One reason I default to keeping fish in my otherwise veggie diet.
FWIW- I had best success with digestive problems by cutting out just modern [hybridized]?wheat , as much as possible [and using Spelt]. A recent strong anti-biotic has triggered a problem in the 'gut dept' -and I read the link data wiith interest re: the well known?promoting of friendly bacteria and use of soluble fibre, rather than the?'tough' type.
I can't remember all the pros and cons of Paleo right now, but in my mind is that it is a good diet -and one we have moved too far away from in recent times [ie: the last few hundred years, at least].
I have some printed data from earlier work -I will find and check through. No doubt tons of stuff more on line, now available.
My strong belief is that alcohol and sugars are counter gout health and taking meds to compensate for these?has a long term? 'hidden' cost.
Woody, square one is your own thread in this heading [Your Gout]- even if Den never returns here- he still has taken and stopped AP, so- unlike yourself.
Diet is particularly 'personal' to each?of us, so try that for a?focus going forward , you'll get a better response :)?
That's whats to do -and apply some practice from that.
Don't forget the need to test SUA occasionally- plus the side effects of medicines can take time to appear.
Co-conditions are also relevant for both the illness and treatment.
Drs. have much to answer for, but it would be a mistake to reject all for the sake of a few bad experiences- better to find a good one and get cheap meds from a good source and take an intellegent interest in all aspects of ones condition.
Mostly, I find that my Docs will listen if you've done your homework well, and also try to maintain a healthy lifestyle on top.
I admit to feeling that the drug treatment culture is normal? 'start and end' for too many medics these days, but this doesn't in itself substantiate 'generic quackery' in the least.
All drugs are potentailly harmful and it's the old balance of benefits versus? side effects that is the battle ground, so often.
Strict aviodance of alcohol- 2 shots- who you kidding π
If you want a pain free life- get on some meds for gout if you just can't resist seafood, training sessions that stress your system and think? a few tweaks on diet will cure a [possible]?metabolic error that can lead to serious health issues [Gouit].
Sorry Den, you have to use the head of steam you have?and what you learn here to get a grip?NOW and save some pain many of us don't want to experience too often in?one lifetime.
I disagree that once on?UL meds?you can coast on diet and lifestyle- but you'll still be in a better place.
I agree that your medical care?advice so far has been 'Noddy like'?&?unless there are unstated reasons for stopping AP, ?find a more practiced advisor on gout. This can only help.
As you haven't posted for a while, maybe you've already done this?
Hi there.. I've spoken to 30 yr old women [also teetotal] with gout- it does happen.
Good to test SUA ?[figure?], without it – all in the dark, esp. without a bunion [big toe] flare at some stage, like you have avoided>
I've had attacks in lesser toes- after an initiating one in the larger joint occurred previously.
I have scarred kidney and still have good GFR [last check]. Needs keeping track of though.
Try not to worry over much- your Doc seems on the case and you can get good follow up support here ,if gout [or even psuedo gout].
Both are?incredibly painful, yes- but can be managed OK – if properly addressed.
One word- Disgusting.
Apart from the bald?price and corruption issue -and the witholding of effective cheap treatment is the fact that people are sure?going to be angry,?but?TOO?many more depressed, by their own lack of volition in their health care.
Maybe there is some kind of corporate/ Govt 'power grab' going on- and people becoming frightened for their future freeedoms and well being.
Glad to see that the Fluoride in water scam is finally becoming exposed in the US – after?about 50 years.
Hopefully these two issues can run together now?-and people wake up?
In the states people aren't quite as passive as over in the 'UK'[ My quotes]??, even though well dosed, by comparison.
You're not as overweight as me, if that's any consolation Cant! Even with 7kgs off you're still over the ideal though.
70 kgs is better for your height. That may help tip the balance, especially if you get the right management with gout too. Better for your heart as well :)? but don't take off weight faster than a few pounds [or 2+kg] a week.
I take 100-200 mg SulfP daily, a low dose- I'm wondering if a break would be good actually, but afaik- it can be continued some time. It lowers SUA well enough but doesn't help like the Urate lowering meds with deposits , I suspect.
On your tests, SUA testing is good- but I was really referriing to a UA excretion test saving your output over 24 hours in the fridge and getting your? UA output rate assessed. I may try this myself soon- as still looking into best meds for myself too.
Cantaner- would not a 24hr UA excretion test help?
This would indicate more which treatment may be best for you -even if there are attendant risks with any med.?always likely to be present.
Also, what is your age,?weight &?height?
Why not keep going on the SulfinP ? Kidneys can be monitored along with your liver- and with plenty of fluid, stones are not a certainty to occur. Urate stones are apparently easily passed at the small stage, too.
Forget herbs at this stage- in my exp. you need to be a lot lower in SUA to make any difference. Plus- they are very much a hit and miss event- though my view is they can be useful in the right context.
Not yours, though, I'd wager, only in early day approaches [where not full blown attacks]!
What is your kidney GFR result ?then- it may be an issue with uriscoric use. [See first?? above]
Hello Cantaner- I hesitate to say welcome, as most people don't want to be here really π
Due to language difficulty [possible] make sure you discuss all advice with your Dr. Here we are all sufferers with different ideas and many similar- but as you have a medical issue ,apart from gout, this must always be considered in that context.
No surprise [@9.5 SUA]?you have toe? discomfort -and you already know what that may mean.
My feeling is that shock alkaline diet moves won't help much now, and may get a bad name with you- if they trigger an attack, by altering your system balance at a tricky time.
You really have a job to do to replace the AP after so long. A rebound is unavoidable. You don't say if you are continuing with a lowered dose of AP, but probably not. If you stopped 2 years ago you have been lucky to escape so long.
Can you ask your Dr about a Uriscoric drug?? I take Sulfinpyrazone, which has been around a long time. If your kidneys are OK,? [a good GFR] this will?stop SUA?staying so high. Diet is still important as purines are still bad news.
If you do use this method do remember to take lots of fluids [water best] to help clear uric acid out.
It all depends on where you are on the attack/ pain curve and the risks you're prepared to undertake with drug?remedies for both long and short term issues in gout.
It's a perfectly natural reaction that people try to find a holistic solution and who's to say how many manage to succeed and never come near? a GP site??
I think?if you watch your diet and lifestyle and don't over indulge in alcohol ,there is a lot less pressure on your body and less need for medical intervention. If this becomes?absolutely necessary eventually, as it may well do with gout being hidden from awareness, then being informed to the max is No1 on the list , as Docs are often no more keen on competition than Big Pharma are from your own interventions!?
IE: Think & act?for yourself- you take the hit on YOUR body!? [ Otherwise, Gout pain is a good teacher? ]
