Reply To: Gout, Bunions, Allopurinol and more Questions

Stopping Gout Together Forums Help My Gout! The Gout Forum Gout, Bunions, Allopurinol and more Questions Reply To: Gout, Bunions, Allopurinol and more Questions


I agree with you that now is not the most prudent time to take more allopurinol than you ever did. I’d save that transition for when you’re feeling better.
But I agree with your doctor that now might not be the best time for surgery either.

I can’t replace your doctor obviously but for what it’s worth my opinion is that you shouldn’t take 300mg. Or rather: first you should increase your dose to no more than 200mg, wait a few weeks and get a blood test to see what the first dose increase did to you. In fact, you should arguably get a blood test not just after but also before changing your dose.
My assumption based on the data you shared here is that 300mg would be pointlessly risky in your case. Aside from the effects of the drug, having very low uric acid might also affect your metabolism. Certainly tripling your dose brutally would be pointlessly risky!

In my non-expert opinion, the dose increase most likely to help you avoid waking up in pain isn’t allopurinol but colchicine. But of course I have no crystal ball, everyone is different and so forth…

In my opinion, every patient with serious arthritis symptoms should see a rheumatologist. It may not be necessary but I’ve seen enough clueless non-specialists to have an inkling about the damage they can do.
But the situation in which I think a rheumatologist would be most useful is if you doubted you have gout or I you suspected you have another condition on top of gout.
You’ve been trying uric acid lowering therapy for long enough that I think it makes sense to wait a while longer to see if your symptoms finally go away before seeing a specialist.