Reply To: Just Started Allopurinol, Unclear on Follow-Ups

Stopping Gout Together Forums Help My Gout! The Gout Forum Just Started Allopurinol, Unclear on Follow-Ups Reply To: Just Started Allopurinol, Unclear on Follow-Ups

#8846
Fire Titan
Participant


Hi.

I am also a fellow gout sufferer …aargh
1. 48 years old
2. First attack in toe joint
3. Could not walk for 5 days intitially(Atttack lasted 1 month)
4. Took Indocid (Anti inflammatories 3 times a day for 2 weeks)
5. This did not work so well so took predisnone for 1 week – immediate relief
6. Then Dr put me on 100mg Allopurinol and 1 Colchicine tablet daily
7. Been taking this medication for 10 days now and swelling seems to be going down and pain ok now.
8. Skins is peeling on joint area and reddish/purplish
9. Pad of index finger sore ? , leg bone above ankle sore , elbows sore ?
Is this because the Allopurinol is getting rid of crystals elsewhere in my body that were not active soon , not sure
10. Only drink water (3litres), coffee (1 a day) , tea sometimes & sparkling
water
11. Eating no meat, but some fish and chicken
12. I have high iron, not haemachromotosis, but Dr said two years ago to give blood but ignored her, could high iron contribute to gout , I have heard yes
13. Waiting for Blood place to call me to give blood
14. My friend got gout attack but only took Allopurinol for a month and then stopped and he has not has an attack for years.
12. Good web resources

https://www.hss.edu/conditions_gout-risk-factors-diagnosis-treatment.asp
https://www.medicines.org.uk/emc/files/pil.6006.pdf
https://www.racgp.org.au/afp/2016/may/the-management-of-gout-much-has-changed/
https://ard.bmj.com/content/annrheumdis/33/4/304.full.pdf
http://www.healthtalk.org/peoples-experiences/bones-joints/gout/diet-and-self-management-gout

https://journals.sagepub.com/doi/full/10.1177/2040622312462056
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1954685/

13. So it’s been nearly 1 month now, swelling has gone down but not cokmpletely
14. Aim to only take Allopurinol and Colchicine for 1 month, but according to the above resources , it takes 3 months for the number of crystals to halve
and then from 3 months to 3 years to get rid of them completely
So may need to take the meds for at least 3 months.

14. So many factors to consider
a) Diet
b) High iron
c) Fitness
d) Body weight(fat)
e) Genetics
f) Specific gout triggers

15. Effects of Allopurinal and Colchicine I have had
a) Hot flushes
b) Skin went oily for a few days after taking , acne
c) More joints became achy (Finger,elbow,leg)
d) Funny taste in mouth
e) Upset stomach first few days not to bad
f) Not feeling 100%
g) Cough I had has not recovered (Wheezing like athma)

So in conclusion it seems diet only reduces Uric Acid levels by 1mg
Medication is the answer
Just like others dont want to rely on medication all my life
My friend has been taking Allopurinol for 30 years now , and he says he stopped it once, major attacks

I cant afford to stop walking for a month !!!
So just like you I would like to know long term side effects on kidney etc.

Apparently studies show that after long term Allopurinol use , UA levels go back to what they were 1 to 2 weeks after stopping.

The reason why people may not be getting attacks is that the uric acid “store” has been depleted and needs to build up again before the crystals start forming again (Curse you damn crystals !!)
But those who do get attacks after stopping , maybe crystals still exist and get re-activated ?

One of the articles analogies was quite good , UA crystals are like unlit matches in your joint , unlit no worries , then once it is triggered , wildfire and then the body sends white blood cells to fix it which causes inflammation and extreme pain
So colchicine to dampen the matches and Allopurinol prevents new matches from getting created.
But at the same time as the overall UA level is being reduced in the body , the body will try increase and then suck those crystals or dissolve them out of the joints, that’s how I understand it.
So we need the meds to do that.

The thing is what happens if you have naturally high UA like I have naturally high Iron levels !!
How can you reduce without the meds besides diet and exercise.
Maybe diet and exercise are not enough.

Anyway hope this helps everybody and happy to chat.
I really empathise with all on the forum.
This was the most painful thing I have ever experienced in my life and completely debilitating , I had to work from home for nearly a monnth, but some people can’t do this and could lose their livelihood !!

From the 4 friends I have spoke to which are on Allopurinol for a long time now , none of them have had an attack while on the meds , so very good , the issue is that not happy with taking daily meds forever !!

Good tips
a) Buy a water bootle and put it on your desk to regularly sip water
I bought a insulated Kleen Kanteen one excellent on with a push in nozzle
Dr said dehydration can cause gout
b) Always take meds with food to prevent upset stomach
c) Swimming is a good exercise for aerobic exercise if you cant walk
But my foot was still a bit sore kicking the water !! so sensitive.
d) Buy/wear sandals that dont touch your toe joint , I found that closed shoes make your gout area expand like a balloon

Thanks for all your posts guys & gals the info is really valuable !!
Cheers
Firetitan