Author Archives: d q

Gout Pills Before, During, or After Food?

Febuxostat dose change. Or different time of day?

Hi @nobody and @Keith

Firstly, where you been nobody? You seem to have gone awol..? 🙂

Ok I finally have all the results in and wanted your opinions;

18th April – 388 ummol (60mgs)
23rd May – 413 ummol (80mgs) <— Strange result
18th June – 377 ummol (80mgs)
11th July – 360 ummol (80mgs)
15th August – 346 ummol (80mgs)
24th September – 350 ummol (80mgs)
3rd October – 362 ummol (80mgs)

So doing the most basic of maths (377+360+346+350+362 / 5) = 359 ummol.
Best result being 346 and the worst at 377.
It looks like the Febuxostat is maxing out at no lower then 346 ummol.
I doubt more blood tests will change figures significantly so I guess I’m at the cross roads. Do I move up to 120mgs? Or try 100mgs? or Stick with 80mgs?
(Liver markers all seems OK so far).

Can sticking with 80mgs cut it as more crystals dissolve in the hope that the overall UA levels drop further cementing 80mgs or is it too risky?

Thanks guys!

p.s. @nobody – come on show yourself! The forum can get lonely without you! 🙂


Gout Pills Before, During, or After Food?

Gout Pills Before, During, or After Food?

Does gout make your feet sore like running a marathon?

Pain in Ankle (gout worsening or improving?)

@nobody and @keith – hope you guys are well.

I noticed that my right ankle has swollen up and is a little painful. I can walk on it but its pretty uncomfortable (no way near the pain of gout in toe).

The question I had was; could this be a medium gout attack as a result of my uric acid levels dropping and the crystals are now dissolving in other joints or is this potentially a sign that levels are not low enough and crystals are now forming in my ankle?

Ultimately, do we get gout attacks in the ankle during the long gout recovery road or are ankle gout attacks only seen in the gout worsening road..? :/

Next blood test due in a few days!

Thanks


Uric Acid Blood Test Sample photo

Eating Food Before Uric Acid Blood Test

@nobody and @keith – hope you gents are doing well.

Just a quick one for you; my next blood test is due in a few days however on the day before the blood test a few of us are invited out for a steak lunch in which I will also indulge in. I was wondering if I should delay the blood test a few extra days in order to avoid skewed results from only a 24 hours gap between the steak meal and scheduled blood test.

What do you think?

cheers


Uric Acid Blood Test Sample photo

Uric Acid vs Urea diagram

Allpresan and Urea content – a Uric Acid concern?

Hey @nobody and @Keith! Autumn blues setting in yet?

I recently visited my podiatrist for the ingrown toenail issue and she noticed the intensive dryness on my feet so gave me a sample of this stuff to use. Detailed information of the product can be found here

I am a little concerned as it contains 10% urea and was wondering if this may seep through and possibly increase UA levels in some way or another? I know Urea is not the same as Urate or Uric Acid but this link seems to explain that Urea is converted to Uric Acid.

The cream is amazing, but should I just stick with Vaseline (or similar) :)?
Thanks!


Uric Acid vs Urea diagram

Topical Urea cannot increase Uric Acid.

How Gout Medications Work media

The quarterly Febuxostat and Colchicine update!

@Keith , @nobody! How are you guys! I haven’t been around the boards much due to work commitments and for some medical research purposes. Its been what, two months or so since I last updated you both? Does time go quicker when your having fun? Well I can safely say I haven’t been having too much of it. Anyway I have some interesting news for you;

So I finally moved up to 80mgs of Febuxostat and the last 4 results on this dose including that paradoxical result is:

18th April – 388 ummol (60mgs)
23rd May – 413 ummol (80mgs) <— Strange result
18th June – 377 ummol (80mgs)
11th July – 360 ummol (80mgs)

Now my rheumatologist which I saw a few weeks ago recommended I go to 120mgs as 377 ummol at the time was a little to high for he’s liking. I haven’t decided I want to do this just yet as there are upcoming new medications for my blood condition which could potentially reduce Uric Acid levels naturally as a result. In any case that will require time to test and time to market so that leaves me in this tricky position. I’m not too sure if I should press on up to 120mgs despite the urate having dropped to 360 ummol without a change in dose 3 weeks after the 377 ummol result. I remember we once said as crystals dissolve the level should generally go up first and then slowly come down as there is less and less in the tissues, joints and muscles which may explain the increase and then the steady decrease. Is this correct? If not, any other explanation?

Secondly, unfortunately I had a toenail infection sometime last week and went to see my GP for some advice in which she gave me some antibiotics and told me to soak he foot in salt water twice a day to help clear up the infection quicker. I did that and by the second day in the evening I could feel something wasn’t right with my foot. Pain was no longer only at the toenail site but was spreading slightly. I took no risks and started with the Colchicine, fast forward 2 hours and I knew this is turning into a gout attack. Took a second Colchicine 6 hours later and woke up to pretty much the start of a gout attack. 6 hours later saw me taking the third Colchicine finally hitting the maximum dose of 2mg for the day. I hit hard the second day with the first and second tablet 6 hours apart but by the end of that day I felt the attack was quickly resolving itself and stopped taking the stuff. The third day saw further recovery and by the fourth 90% of the entire attack has abated with only slight inflammation left.

Now I have never had an attack that has lasted only 4 days EVER, 10 days is the least let alone the magnitude of pain difference. On the other hand I have never used colchicine for an attack and only ever used Naproxen. The question that had me puzzled is could this be a result of the Colchicine or is one more inclined to believe this is due to the lower uric acid levels over the last few months causing the attack to be relatively fast and mild? I mean from what I understand 360-370 isn’t exactly low for someone trying to lower their UA levels but could this be playing a part? My other worry was maybe this is a gout hell experience (crystals forming and dissolving) being in that 360-370 zone..? Does the warm salt water over two days have a part in this?

P.s. this is the right foot which hasn’t seen an attack since 2015.

Thanks guys..!


How Gout Medications Work media

Which Gout Medication Do I Need?

To eat or to reduce?

Quick one for the foodies;

I know there is the ongoing purine from vegetable and purine from animals debate but certain foods really do improve your health. The foods I wanted to very briefly ask about were;

1. Tomatoes – huge controversy surrounding these, safe to eat in quantity?
2. Sweet Potatoes – super foods for you, are they safe?
3. Carrots – Beta Carotene that gets converted to Vit A, safe to eat daily?
4. Olive Oil – I love this stuff, teaspoon or two daily OK?
5. Honey – the big one, Are we OK consuming this on our daily toast? I mean the expensive Manuka type?

I really want to increase my consumption of these but I hear all sorts of rumours about those. Does anyone have any firm evidence on their record on the gout scene? The intention isn’t to get a purine list, just more so about if they can be incorporated into the gout diet in larger quantities.

(I’m also aware if we are on meds anything is OK, but the question isn’t about if we are on meds, its about the types of food listed).

Thanks.

UK Febuxostat (Adenuric) 80mg packaging

How to take febuxostat for best uric acid results?

So after that paradox result [increase of Febux resulting in increase of UA] things have completed changed. The new test results are in:

366ummol after 20 days of 60mgs Febux.
Haematology numbers seem fine but too early to tell as that takes more time to stabilise. Rheumatologist is relieved and has asked me to go to 80mgs to try and drop it a little more. Not sure if going to 80mgs will make these lower back and abdominal pains worse but we’ll see. It might be useful to try and go to 80mgs for a period just to see these low grade foot pains go. We talked about this in detail and he assured me that if this pains are due to uric acid accumulation then they should slowly settle down now that the levels are coming down. He did mention however that if damage has already been done it may never return to normal and the best thing would be to rub a thin layer of low dose Voltarol gel on the painful area on the bad days to keep mobile. Avoiding the additional nasties of pills I guess. If I remember Voltarol gel actually is diclofenac, not sure of the drug levels however. He gave me a few more blood forms and asked me to get tested again in around 4 weeks.

I’d like your opinion on a few things;

1. Any advice generally on the above?

2. Assuming hemo holds at no more then 60mgs of Febux, will 366ummol be enough to dissolve (even if slowly) and keep gout at bay going forward? For that matter even if hemo and liver are fine at the higher 80mgs dose is there really a need for lower UA levels to warrant adding more of that drug in me.

3. Can cardio based exercises bring about gout attacks (increased blood flow)..? I’m not talking about running that may mobilise crystals in joints causing attacks. Just speeding up heart rate in other ways to reap the health benefits?

Looks like things ‘may’ be heading in the right direction after all.

Cheers

Blueberries and Gout photo

Blueberry antioxidants and febuxostat

@nobody – hope your well. Being on Febuxostat longer then me your experience may help. My blood results have come back and the hemoglobin has recovered slightly so things seem ‘reasonably stable’. The one result that baffled me and the rheumatologist for that matter is the uric acid level climbed up to 512ummol which is almost as much as it was when I was taking 20mgs. So going by the numbers we have:

20mgs – 514ummol
30mgs – 491ummol
40mgs – 487ummol (blood test mid Jan)
40mgs – 512ummol (blood test end Jan)

continue reading Blueberry antioxidants and febuxostat

Relapse Rates after Stopping Uric Acid Treatment chart

Temporary Uric acid Medication Stop

@keith – hope your well mate. We don’t really hear much from you these days! Where have you been! Holidaying again? 🙂

Keith, I had a few questions I wanted to ask you (and anyone else that may have tried this actually). I remember you mentioning you took an Allopurinol break after an intense regime for a period of time. You also mentioned that providing you find a good rheumatologist who is ready to work with you on this method it can actually work. Now as some of us cant take Allopurinol or Febuxostat for long periods of time due to side effects or other related boundaries would it be possible you could explain how this start/stop treatment works..?

Is there a certain procedure for e.g. Uric Acid under (xxx ummol) for a given period of time and then you can take a few months drug break? Or is there a specific method or formula according to gout severity or length of time you have had it, etc?

I’d like to discuss this option with my rheumatologist as Allopurinol caused me a few problems and I want to talk pre-emptive action if Febuxostat doesn’t work too.

Thanks mate 🙂

Uloric brands around the world

Febuxostat and Side Effects.

@nobody

Getting straight to the point on this one, as you know I’ve been on Febuxostat since mid November where I started 20mgs and I’ve experienced the following;

1. Change of water habits, I am now drinking at least 2 litres per day
2. An occasional feeling of a flare up otherwise my foot pain is reducing!
3. Dropped from +/-600ummol to 515ummol
4. Otherwise all OK.

Upon starting 30mgs however;

1. Water consumption still at 2 litres sometimes more, is this normal?

2. A week later I’ve been experiencing general back pain – possibly related?
I use Deep Heat to help with the pain which helped a lot. Sometimes it feels like a digestive thing, other times it just feels like a muscle thing.
What did you do for your pain? Did it go alone?

3. I’ve been taking Febuxostat with a small amount of water in the morning and having breakfast about 30 mins later. The PIL say’s you can take it with or without food but as you know Allopurinol should be taken with food and a lot of water. How do you take it? Could taking it alone with little water be causing the occasional stomach pains / digestive tract feelings?

4. Any change of toilet habits / frequency?

5. Lastly, did you perform and specific liver scans other then a blood test? An MRI or Ultrasound to monitor size for example? If so, how far into starting?

Thank you – I honestly appreciate your help here.