Also, thanks for reposting here from the Helpdesk. It’s saved me a job. That might not sound significant, but every little helps when you’ve got presents to wrap.
I’ll give short answers for now. Then, people can ask for more information if they need clarification.
1. Yes, you can do that. At least one eminent rheumatologist has suggested that intermittent uric-acid lowering treatment will become common in future. From memory, he was suggesting annual treatment for a few weeks.
There are dangers with this approach that need to be carefully managed. The biggest hidden danger of excess uric acid is joint damage. Al joint tissues are susceptible. I wrote about tendon damage in gout. But, cartilage and bone will suffer the same fate.
Therefore, the intermittent allopurinol strategy could avoid gout attacks. But, it could raise the risk of bone damage. We also now understand heart valve issues better where they are attacked by tophi. I’m not certain how soon that becomes an issue, when uric acid rises above the safe level. Current research is limited. However, now that pathologists are starting to understand the fatal nature of gut, this issue might get more attention.
To me, daily allopurinol seems a small price to pay for heart and joint safety.
2. That seems to add weight to my response to 1. If you share the links of what you’ve found so far about “about Thalassemia and Gout / Uric Acid?” I might be able to do more research.
3. Perfectly true. Wise rheumatologist. But, gout sufferers need personal management. So, purine intake control can work in rare cases. If the person’s gout is managed properly.
4. No, this is about the conversion of purines into Uric acid production by our enzyme, xanthine oxidase. Allopurinol inhibits that enzyme. Unconverted purines are pissed away.
5. No, sorry.
I hope that helps, James. Please feel free to ask for clarification. And, post more questions as you think of them.