Reply To: Thalassemia, gout, uric acid, and allopurinol

Stopping Gout Together Forums Help My Gout! The Gout Forum Thalassemia, gout, uric acid, and allopurinol Reply To: Thalassemia, gout, uric acid, and allopurinol

#2461
d q
Participant


Hi Keith,

Hope your well mate – Sorry for the delayed response. It’s been a while since I’ve had time to sit down and focus on a detailed response and I also wanted to wait until those Mod-January tests. OK, here goes with the answers / updates:

1. I asked my rheumatologist about ‘start/stop’ Allopurinol treatment plan and he explained that a trial was conducted and most people that did stop treatment eventually got an attack between 4-24 months later. I asked him to elaborate further as to why it took so many years to build up and yet after stopping treatment all it takes is just 4/24 months before an attack occurred. He’s answer was as simple as ‘our kidney’s become less efficient with age’ what we could excrete in our teens/twenties is not the same as the kidney can excrete in our thirties and over. He basically said we get older, we get less efficient. I’m not too sure if its as simple as that but that’s apparently why it takes just 4 to 24 months for an attack to strike back.

2. Links to reasonably useful information I have are:
1) http://williams.medicine.wisc.edu/thal_intermedia.pdf
2) https://books.google.co.uk/books?id=5UcgAwAAQBAJ&pg=PA376&lpg=PA376&dq=thalassemia+intermedia+and+gout&source=bl&ots=6pDb6ruqLq&sig=-FRCFE0F0nvJBvzaV1-VAvlQGso&hl=en&sa=X&ved=0ahUKEwjH0cafx9bRAhXJC8AKHZUaBtk4ChDoAQghMAE#v=onepage&q=thalassemia%20intermedia%20and%20gout&f=false

3. I re-asked the question about diet and gout and to cut a long story short, take Allopurinol and you should be able to enjoy most foods in moderation without having to count life by the minute and avoiding all sorts.

4. Perfect – got you.

5. No worries mate thanks.

With regards to numbers, so after one month on 100mg daily my levels have dropped to 555 umol/L and as a result he has increased my daily dose to 200mg daily in attempt to get me below 360 umol/L. We will retest blood levels in March.

He asked me again if I would like to take Colchicine as a precaution as we increase the dose to find the right dosage for me but I refused and said if an attack should occur during the dose increase I will just deal with it using Naproxen and he said that’s OK too.

Do people starting Allopurinol always get an attack as they increase the dose or is this not always the case if its done slowly and carefully?

Thanks Keith! 🙂