Reply To: How to take control of my gout after 30 years.

Keith Taylor

Hey Gary, as you are new to GoutPal, you won’t know about the rages I get into when doctors talk about normal uric acid. But, you’ll get the idea if you search for something like normal uric acid rant.

Anyway, my point is that normal uric acid is medically meaningless. Because, it’s simply a statistical average. But, average people get gout. So 6% of men in that reference interval will have gout. And, Gary, you are one of them. and you don’t need a uric acid crystal test to prove it. Because, any uric acid level over 400μmol/L is dangerous. So, you have to get below 300 to be safe.

Now, allopurinol will make you safe. But if someone doesn’t understand uric acid test results, they won’t manage allopurinol properly. Trust me, I had to argue this out with 3 of the 4 doctors I consulted about managing my gout.

1. Allopurinol needs monthly monitoring through uric acid tests. Because, allopurinol dose must be increased until uric acid is safe. Once your uric acid levels drop below 300, you can extend period between uric acid tests. But, always test at least once per year. Also, uric acid tests should be accompanied by liver function and kidney function tests.

2. Until you have had uric acid below 300 for 6 months, you may experience gout symptoms. Because, partially dissolved uric acid crystals can trigger gout flares. So, we can adopt strategies to help you manage this. Then, it should not reduce your quality of life, as you finally get free from gout forever.

Obviously, that’s a very quick overview, Gary. But please ask for clarification wherever you need it. I’m confident that we can work together to make sure 2017 is the last year you are ever troubled by gout pain.