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sicboy,
I think the first order of business is to get a clinical recheck on that 10.8 SUA. Labs screw up.
If indeed it is repeated while you are on 300 mg/d allopurinol, you will almost certainly want to up your dosage.
I would think that if the 10.8 is accurate you would be having one attack after another so I am skeptical of the number.So, it’s milk protein, 200 mg.vitamin C, resveratrol, and grreen tea.
I hope it’s cheaper than buying the stuff individually from Puritan Pride and washing it down with milk.
Any studies showing effectiveness? It’s obviously safe.
So, having an open mind I decided on 6 pills and then 2 the following day. Light diarrhea started on day 2. The pain got a bit better as soon as the diarrhea began but then got worse again the next day. I guess I ?half cured? myself?and wasted 8 precious pills.
So spent another couple days in pain and yesterday I decided to bite the bullet and go for broke and take colchicine until diarrhea started. Apparently there is a residual effect for a couple days because at the fourth pill I started schytting like mad…total of 13 times in 6 hours with water just flushing through…and one more time this morning.
As soon as the diarrhea started the pain stopped within minutes…there MUST be a connection.So, if it ever happens again I am not going to fiddle around. And it seems that a 12 pill total might be my sweeet spot. (First time I tried this a decade ago I got to 22…super overkill out of ignorance, but it worked.
I developed a theory:
Kidneys work thusly: almost all material in the plasma is excreted in the millions of ascending loops but then most is recovered in the transversee and descending loops. Thus nearly all the uric acid is excreted but then almost all is reabsorbed.
Diarrhea is the expulsion of huge amounts of water into the colon and the colon has no recovery method.
I am strongly pushed towards believing it is a massive expulsion of urate into the colon that stops the attack.
Yes, I know the cover story that colchicine does not lower uric acid levels but I have read so much oft repeated nonsense about gout that I now consider my own evidence and logic system preferable to the ever repeated old wives tales…probably developed from NO evidence.So now no booze for 2 months, no pain, and I think I can hide the colchicine and indomethacin again.
I?m pretty much grasping at straws here, because I thought you?d got this gout thing nailed.
I am going to say that I too think I really DO have this nailed…but apparently nails can come loose with 5 liters of bad red wine in 3 days bracketed by 2 days of a 6 pack of beer.
My control to the low 5’s (last reading was 5.1) that gives me 10 years attack-free cannot be far off the mark so I will continue with 400 mg. allopurinol.You know, for 15 years I have had a full bottle of indomethacin in the bathroom medicine chest and onlay last week did I finallly throw it in the BIG BIN…my pharmacy to save the world in the event of Armageddon. Perhaps I will go in with a shovel and try to find it again.
No, I have never gotten any colchine through Hans. I will do a pill count and see what I have left and get back to you.
I took 3 colchicine today (and a quart of cherry juice yesterday) and have not decided if I am going for broke or temporizing. It’s at that tenuous point of hurting but not too much. If I knew it wasn’t going to get worse I would grin and bear it. I can walk with only a little catering to the right big toe.All alcohol goes bye-bye May Day until July 1.
edit: I have 167 colchicine…I should not worry about taking a full dose. I doubt that I will live long enough to need them all.
But I am strong evidence that once you have gout you ALWAYS have gout…so nobody should ever think they are cured no matter HOW much time goes by without an attack.
Phong,
He prescribed indomethacin 3x a day calling it gout.
If he did this without testing your uric acid, he is a quack who should have his license revoked.
You are classic for gout…weightlifter, overweight, obviously on a vey high protein.meat diet.
He was not a fool prescribing indomethacin, it’s a good pain reliever for gout, some doctors overlook it in favor of the latest drug brochure some gorgeous woman dropped off at his office, along with a pile of cash.
He/you should try colchicine but PLEASE check your uric acid. Control of your uric acid is the only long term treatment for gout.
So,
what is in PURIXA?? What are the active ingredients?
(Never take any “alternative” unless you know what it is.)
Isn’t it amazing that the oldest diagnosable disease now needs complicated multi-million dollar electronic machines to diagnose?
Perhaps some of our GP’s need training in something besides how to use a sphygmomanomenter to measure blood pressure.
Forget the machinery, If you have a very high uric acid and your pain is greatly relieved by dosing with colchicine, you have gout.
The ancient Greeks made the diagnosis without even being able to measure uric acid…or blood pressure.
I guess we have NOT “come a long way, baby.”
Hi, Keith.
kiteman,
There will always be a residual swelling left in any joint that has suffered an attack. I had only one gout attack in my right bunion joint and that was over a decade ago, but it STILL remains larger than the left bunion and I presume it will be this way til they close the lid.
There is permanent damage done to any affected joint, whether noticeable or not, and we can only hope that the PAIN caused by that damage is fleeting and slight.
Like Keith says, control your serum uric acid so that REPEATED damaging attacks do not occur making the situation worse and worse.
You cannnot undo the past, only affect the future.ltjuggernaut said
Greetings,
Wow Gout-pal forum really changed. Anyways straight to my question.
The bottom of my feet and padding of my hands are red and sore on a daily basis.
Is this normal to feel sore while on a 400 allopurinol therapy? I dont have the current lab results so PLEASE dont ask about my UA level.Do a liver function test. An almost universal symptom of liver damage is red palms so it behooves you to rule it out.
tomsgout said
Thank you!
Finally Indoxen/ indometacin did the trick. I am relieved for now.
It’s quite surprising how specialists like rheumatologist and orthopedists do not really know what works best and what does not… Rather they are very bookish….There’s so much to learn about gout and I can do that from this site than from my doctor(s)Indocin/indomethacin is a good drug for gout pain but alas, it makes me quite dizzy.
Yes, you will learn more here than your doctor has ever DREAMED of learning. I think they spend about a day on the subject in medical school.It’s a tough call from the OUTSIDE, but an X-ray clearly shows a bone spur in sharp contrast, like other bones and a tophus as “fuzziness.”
Location plays a part as well, for example a lump sticking out the back of a heel is usually a spur. A non-pointy lump at the bunion joint is usually a tophus. A POINTY lump is usually a BUNION.Fingers are especially tough becasue tophi and the nodes of osteoarthrits look pretty similar.
X-rays are misread every day and I’m sure some hands were even misdiagnosed as FEET.
And history can help. For example, If you’ve had 3 gout attacks and you see a new lump, odds are VERY good it’s gout.
That dosage of cochicine is pretty much useless for an acute attack, as you have discovered. Small doses have a role only in PREVENTING attacks
But now that it has been re-patented at 50 times the original cost, the manufacturer and doctors MAKE BELIEF only a tiny dose is necessary.ZYLORIC is the expensive patented brand name for cheap generic allopurinol. It is usually started AFTER an acute attack has passed, although a month is overkill.
Most of the NSAIDS like Voltaren are pretty much useless in stopping an acute attack that has gone on for over a week.Colchicine when given in the proper dosage gives almost IMMEDIATE relief within hours, so no, you are not wrong in expecting quick relief but you won’t get it with one or two colchicine per day.
jrodd88 said
I am a 41yr. old male, 6’4″, 245lbs. I was diagnosed with gout over ten years ago. I always get flare ups in my ankles and in the small bones (instep) of my foot. Lately the traditional allpurinol and colchicine dont seem to work. I have constant pain in my instep (enough to limit activities) and tylenol and alieve don’t do much good. I am also on coumadin for the rest of my life due to a clotting disorder and a dvt in 1993. Is it normal to have constant pain while on a daily dose of colchicine?
thanks,
JeffManaging your gout in no way mitigates the possibility of suffering other conditions. Constant pain in the instep is USUALLY plantar fasciitis which may or may not be related to gout.
I had PF once and it lasted 6 months and disappeared as mysteriously as it developed. In retrospect I don’t know if it was gout or not and it was somewhat before my formal diagnosis of gout…at the time I had no idea what colchicine even WAS.
The fact that your instep pain does not respond to colchicine points more than a bit towards NON-gout. Colchine is quite gout specific.
After 17 years of avoiding medication you have probably piled up a considerable amount of urare in the joints and tendons of your feet. It is the reduction of these deposits that is likely the casue of your continuing discomfort.
There are cansequences of avoiding gout treatment for nearly two decades.
Hang in there, you will probably see slow improvement.
Do you have visible tophi on your feet (or fingers?)
A gout attack in an ankle is a VERY common early acute attack site. In fact my second attack was right there, even before the big toe.
Of coursee I believe that NOBODY will get any relief from 100 mg. allopurinol. I do hope your husband is not still on that dosage. The thought of someone on 100 mg. allopurinol for a year sends shivers up my spine.
A doctor’s guesstimate of “Achilles tendonitis” is just that. And acually an acute gout attack in the Achilles tendon is very much TENDONITIS, an inflamed tendon.
Get his blood tested and see if he is getting the desired low uric acid, below 5.0 mg./dL. On 100 mg. allopurinol, I very much doubt it.
(Consider a new doctor. Mr. Achilles Tendonitis sounds dubious.)
Now comes what could be the hard part ? convincing my GP to prescribe me AlloP?
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Isn''t it sad that things have to be thus. Go in with a slight quirky uptick in your blood pressure and youll be given enough drugs to fill a wheelbarrow. Yeah, some of them cause heart attacks, but “what the Hell.”
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Just INSIST on the allopurinol. If it doesn't work, get another doctor immediately.
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(I checked my Insurance company liist of affiliated doctors and I used as a sort criteria “within 2 miles.” I got a list of over 2,000 GP's. Had I thrown in all specialists the list might have toppped 4,000. So no doctor dares say NO too often lest he has to sell one of the two beach houses and give up the third girlfriend.)
?ianking531 (at) gmail (dot) com
replace (at) with “@” and (dot) with “.”?
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What a curious way to list an e-mail address?
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C'mon, we're all friends here. Just tell us the “magic bullet” without all the rigmarole and then we can go away happy.
The lower the dose of alloupurinol, the greater the chance of gout flares, or even a frank gout attack.
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Now that you have ascertained over two weeks that you are NOT allergic to allopurinol (like almost everyone who has ever taken the drug) I wonder what your doctor intends to find out by giving you 200 mg, yet another sub-standard dose of the medication, risking yet more flares.
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Oh well, I guess he can take solace by saying “Hey, it's not MY foot!”
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I must say Ashley that your narration of the pseudo gout diagnosis would have given me a good laugh but for the fact that I knew every word was true: “?photographs taken during arthroscopic surgery which
showed deposits which appeared to be CPPDD deposits.”Wouldn't it have been nice if the surgeon was actually WATCHING during the surgery so he could have taken a sample of the mystical pyrophosphate. My technique is to?observe a surgeon before an operation ?and if I suspect a seeing eye dog by his side or dark glasses at night?to look for another doctor.
Okay I WILL laugh: diagnosis by picture. It really is worthy of Laurel and Hardy. :D:D:D
Because people who have high Uric Acid have a bad lifestyle that causes the High Uric Acid in the first place?
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That seems not to be true. Improper uric acid disposal is a genetic evolutionalry “defect.” Perhaps not even a defect. I once saw a farily believable correllation between gout and high intelligence. I know that those with high musculature, certainly not a defect, have a high correllation with gout presumably because of release of nucleic acids?(RNA and DNA)?which break down to xanthines and then to?uric acid. (Yep?Surprise, another benefit? of allopurinol on NION dietary xanthines.
Uric acid convey some sort of advantage to humans but WHAT that advantage is is elusive and unfortunately it conveys detrimental qualities, like gout and heart disease. My best guess, and a guess it is, is that uric acid, especially when crystallized is considered foreign by the immune system and it begins an assault. On a macro level we see it as a massive purple toe warmed by the fires of Hell. But consider the same process on a micro level at the surface of a coronary artery. That same inflammatory process and the same kind of scarring might account for the initiation of a fatty plaque.
?I am convinced that man lost the ability to break down urates, almost UNIQUE in the animal world, for an evolutionary advantage. That's the way evolution works. This advantage? is just not easy to understand. But often an evolutionary advantage is a two sided coin. We can walk on two legs and use our arms to battle an enemy?but that advantage also convers the curse of the “bad back” which is the plague of MANY!.
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It is sad though that one of the DISadvantages has to be coronary artery disease?a real BIGGIE. Too bad evolution is not much use here?because we men who are most likely to get the disease have already done our spawning by the time gout rears its ugly head. There is not much evolutionary advantage gained by keeping 50 and 60 year old men alive.
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Another “partially baked” train of thought is that species evolution is SLOW but human “civilization” moves quickly. Gout is a disease of meat eaters and for most of man's history he has been a plant eater?except for the kings and priests who could afford meat and got animal “sacrifices for the “Gods.”?These privileged few got GOUT.??In animal speciies, I posit that the carnivores quickly developed the enzymes? to break down urate. Man hasn't been eating meat long enough to develop this evolutionary trait and the “meat at every meal” is a very new concept for the common man, and only in the wealthier societies, perhaps less than a century old.
Remember the promise of the DREAM, “a chicken in every pot”?on SUNDAY!
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Maybe in a few more millennia we willl produce uricase.
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So while I agree that an improper high fat, high calorie diet and slothful (and SLOSHFUL)?ways may generate heart disease, I doubt it has much to do with gout or uric acid buildup.
which later came down to sub 7 .
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subhashish,
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That level is just not good enough. Alas, it is exactly what one might expect starting at so high a level of SUA. I recommend you up to 400mg./day allopurinol for a month?and see if you can get it lower. Between 6 and 7 is a terrible place for gouties to be.
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You may NEVER get to the desirable level of below 5.0, but the least you should settle for is consistent levels below 6.0 ALL THE TIME.
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If you are a beer drinker, consider switching to another beverage.
subhashish, (does that mean less hashish than most people use?
)You must get more precise with your care. Define “HIGH” uric acid.
You must use that amount of allopurinol that gets your uric acid below 6.0 or better 5.0 mg./dL. (Depending on your part of the world the molar definitions of these amounts might be different but easily convertible.)
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When you are controlling your uric acid to a low enough level with the right amount of allopurinol?your attacks will decrease and eventuallly (or quite quickly) STOP.
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A sensible weight is desirable but rapid weight loss is actually LIKELY to cause gout attacks becasue of the breakdown of cellular material. Weight loss won't likely help much but allopurinol will.
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How much allopurinol are you talking. Have you gotten a uric acid level since you started?
Keith Gout Advisor said:
zip2play said:
In all seriousness Limpy,
I don't think there is a legal basis for patenting allopurinol.
Yeah, but 3 years ago, did you expect to see colchicine protected as it is now?
I have not figured out how they will make profits, but no company spends this amount of money without good expectation of a return.
No, but again they used some sort of distorted logic about “orphaned drugs” that might pull the wool over some judges.
In the last 5 years, Pfizer, arguably the most powerful pharmaceutical powerhouse on the planet, tried EVERYTHING to keep the effective?patent on Lipitor, the biggest selling drug the world has ever seen. They got extensions in court for several years on bogus claims.?They even paid a generic maker BILLIONS to NOT sell the alternative.Now they are using a scheme involving a “Lipitor coupon” with false claims to continue selling the patented med instead of RANBAXY's newly awarded atorvastatin permission. (This generic exclusivity lasts for 6 months with Ranbaxy then anyone can enter the market.)
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My point is that if even PFIZER with more lawyers than Carter has little liver pills cannot repatent Lipitor, it simply cannot be done.
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So yeah, colchicine/Colcrys was an unimagined abomination but patenting allopurinol would be an order of magnitude more egregious.
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There are also numbers to consider: far fewer people were regular users of colchicine but a LOT of people are on daily allopurinol.
Taking colchicine wiith it to start CANNOT be a bad idea. So yes, take one or two colchicine per day with it.
How about:
New ARDEA drug: 300 mg. allopurinol + 81 mg. aspirin…prolongs life better than allopurinol: $11 a pill.
They could call it: LIFFENOL or ETERNOL
I'm? a muscular 6/2″ and about 220# and I just started at 400 mg. after more than a decade at 300mg.
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Probably a good rule of thumb is that allopurinol needs is not far from proportional to daily food intake.
The big difference between the rape of cochicine and the potential rape of allopurinol is that they invented the duplicitous term, orphan drug, for drugs like colchicine that existed LONG before anyone knew that North America existed (except those living there.) Thus colchicine never was patented. SO they invented a crooked way to patent it.
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Allopurinol was, of course ZYLOPRIM, patented by Burroughs-Wellcome in 1966. Following U.S. patent law, that patent expired 17 (or 20) years later, or even later (not sure of the legalitie)?with court extensions. But it would take a sea change in patent law to repatent an expired patent because someone did some tests on it.
As far as I know, no drug that has gone off patent has ever gotten back ON.
But, given the colchicine debacle I am sure that peole in the U.S. FDA are being well bribed to do what they are told by the big VERY RICH drug companies, nothing would surprise me. Pulling the wool over the wooly-headed Congress and incompetent executive branch, who know how to do nothing but wage war, is small potatoes.
When Ardea finally get their exclusive license to market Allopurinol, I'd like to bet $500 that the packaging is brown and cherry red.
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Brown and CHerry red is very appropriate because those are the mose common colors seen during a vicious?anal rape.
If this “re-patent” of a drug that lost it;s patent decades ago?goes through, I will make it my life's work to bring down the FDA and see some of the crooked bastards behind bars, even if it means going into politics and losing my immortal soul (yeah right.)
Stealing money from the ill is about as low as mankind sinks.
Thanks, I just returned from the dr. He upped me to 300mg. and said I'm his only patient on the high mg. allopurinol.
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If you want to REALLY throw him for a loop, next time ask him for 900 mg., the highest recommended dose.
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The dose you need is the dose that will give you consisten readings of <5.0 and/or the dose that will prevent ALL future gout attacks.
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(Your doctor should crack open a book at LEAST once a decade.)
