Reply To: My Gout Attacks won’t Stop despite Allopurinol

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#4906
nobody
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Good news about your test reults. A 3-6.5 range would have been strange!
Possibly the confusion was caused by mixing units. If your range has indeed been 3.8-4.5 mg/dl (as opposed to 380-450 umol/l for instance), you have been on your way to recovery for a while. But maybe your recovery would be quicker with stronger medication…

I don’t know if Uloric is right for you. I take it myself so I’m not saying it’s a bad drug but it is dangerous. So is allopurinol but we know your body handles allopurinol and it might possibly do better with a larger allopurinol dose than with Uloric.
One of the things which makes Uloric dangerous is that doctors often don’t know why or how it should be used. I guess it makes sense in your situation to follow your rheumatologist’s advice and switch to Uloric. But there’s no sense in being reckless about the switch.
Firstly, when starting Uloric it is very important to get blood tests to monitor your liver function in particular. Second, you don’t need to start with 80mg which is a very strong dose. It would be safer to start with a lower dose for a couple of weeks, get a blood test and increase the dose if the test raises no red flag. People have started with doses as low as 10mg but I guess that would be impractical in your case. Lots of people start with 40mg (there are 40mg Uloric pills) but if you wanted to play it safe, you could try to cut the pill in half in order to take 20mg for your first few days on the drug. Just don’t start with 80mg.
It’s also best not to start another drug at the same time as Uloric so it would make sense try colchicine first and see if it gives you a break from your serial attacks as well as what side effects you get (if any).

I don’t know if a diet consisting of “veggies fruits yogurt milk” is safe and sustainable in your situation but at least you can get the proteins you need from yoghurt and milk if you consume large amounts and are able to digest them. Most people would benefit from adding other types of plants such as cereals to that diet however. That way, less dairy would be required.
Your are probably going to be suffering from these joint problems for a while still so you need well-considered and sustainable solutions.