Sorry about the gout diagnosis mate. Yes, I too initially thought long term medication isn’t something I want to commit too and went for the ‘herbal home remedy” method after my first attack. ACV, cherries, reduction in purines, etc. Frankly speaking no longer enjoying meals.
A year later I got my second attack and was home bound for a week and that was the deciding factor for me. I thought if a pill a day in the morning after breakfast could give me far more flexibility with my food habits (not to mention what all that nasty high uric acid in the blood was doing) then a pill a day was the way.
I started treatment at 100mgs, dropped UA levels from approximately 600ummol to 555 then after a month inncreased to 200 and dropped UA levels from 555 to 388(got a minor attack) then increased allopurinol a few days ago to 300mgs a day got a slightly painful attack yesterday) and am now due a blood test in a few weeks to see the new UA levels whilst on 300mgs.
With regards to start stop treatment, I too asked this to my rheumatologist and he said a trial was conducted where allopurinol was stopped after a year treatment plan and most people got an attack again within 6 months of stopping medication. When I asked why did it take so long to build up yet so quick to come back he simply said “as we get older our kidneys are no longer as efficient at removing uric acid so levels will rise fast and attacks will return..” Personally I’m not a believer of that statement and still to this day don’t understand why it comes back so quick but took years to develop.. but who knows…..
If you do decide to go the meds route (which I advise) be sure to keep some naproxen to hand and hit that tablet for a few days as soon as you feel the “gout attack about to bite” feeling because you will probably get a few attacks while allopurinol starts doing its stuff over a period of a few months.
Anyway good luck mate and keep us posted 🙂