Thanks, Dave, for the clarification.
In my view, you are well on track to becoming gout free. 🙂
Your plan is certainly above average. Whether you want to make more effort to get rid of gout quicker, is up to you. Here’s my thoughts on your progress:
This sounds right to me. You’ve increased allopurinol dose inline with blood test results. 267 is a perfectly acceptable target. It allows the uric acid burden that has built up over several years to dissolve. Most people would regard this as ideal. But, if you have visible tophi, or if you want to get rid of your uric acid burden quicker, talk to your doctor about further increases in allopurinol. Once the burden is significantly reduced, you should be able to slowly reduce allopurinol dose to maintain uric acid below 300 μmol/L.
Because our bodies change with age, I strongly recommend all gout sufferers get a uric acid test at least once a year. That way, you can make sure it never creeps above 300, which might allow uric acid crystals to start building again.
Your diet sounds good, as long as you are happy with it. Personally, since controlling uric acid, I’ve focused on trying to eat healthily. That’s usually the best thing for uric acid, as well as general health. If you are happy with your diet, all seems good to me. If not, we can chat some more.
Hydration for Gout
Hydration is always important for gout sufferers. This does not change on allopurinol. Some people might argue hydration is more important when on allopurinol. I won’t bore you with the details.
If urine is darker than a pale straw color, drink more fluids. Water in all drinks and foods is part of your fluid intake. It does not need to be plain water all the time.
Pain control during early allopurinol treatment
As I mentioned, you have a uric acid burden from crystals that have formed over many years. It takes at least six months to get rid of that burden. Usually longer. During that time, naproxen as required is usually a very good strategy. But, don’t be surprised when old crystals dissolving cause a little discomfort. Take the naproxen at the first twinge, and try to stay mobile. I recommend a dance of celebration – gout pain when uric acid has fallen below 300μmol/L is a sure sign that you are recovering from gout! 😀