Reply To: Should I start allopurinol now, or wait until all pain is gone?

Stopping Gout Together Forums Help My Gout! The Gout Forum Should I start allopurinol now, or wait until all pain is gone? Reply To: Should I start allopurinol now, or wait until all pain is gone?

#3598
Keith Taylor
Participant


Thanks for this great question, Alan. It’s very interesting to me for a few reasons.

Most importantly, your question highlights the problem of getting new gout research known to frontline medical professionals. Because, we now know that, for most gout patients, there is no need to wait for gout flares to resolve before starting allopurinol. So, that’s the quick answer to your question – start now.

Then, you ask, what will happen if you don’t start allopurinol now. So, again, the quick answer is, you will needlessly delay your admirable goal of wanting “to get to the root of the problem”

Now, I’ll indulge myself with a bit more explanation. Please feel free to ignore this if you wish. Because, most of it relates to the importance of your question to how I manage GoutPal.

Firstly, I searched for “should i start allopurinol now or wait until all pain is gone”. But, as you can see, there are no results that are relevant to your question. Because, it’s a fine example of the paradox of asking good gout questions. That is: you don’t know the best way to ask the question until you know the answer.

Incidentally, I get round that paradox in 2 ways:
– Either, you do exactly what you did, and post your question here. That’s the best way for most gout patients.
– Or, you start a structured help project. Which, requires time each week, but results in a more personal answer.

Next, I changed my search to “when should i start allopurinol”. So, I was delighted to see my complete explanation at the top of those results: Start Allopurinol Quickly, But Carefully. But, in reality, it’s not the complete explanation about when to start allopurinol. Because, I need to improve that page to reflect:
1. More recent science confirms the findings of the report I reviewed.
2. The message needs to be clear: this only works where the gout patient is confident of gout pain control during uric acid lowering. So, I believe this to be true in your case, Alan, as you refer to indomethacin with confidence. However, I’m slightly concerned that you don’t make any reference to uric acid blood test results.
3. I need to widen the scope of this key information to ensure it gets picked up by searches similar to “should i start allopurinol now or wait until all pain is gone”.

I hope that answers your question adequately, Alan. If not, please ask for clarification. Also, please feel free to ask more questions about managing your gout recovery. Because, I want to be sure that 2017 is the year you finally kill the root of your gout problem.