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


I hope you’ll forgive me if I don’t answer every question and answer questions you didn’t ask instead.
I’m going to try to use my experience to give you the information which would be most helpful to you without writing a whole book. I have gout in my family and have gone through more than a dozen doctors (or experienced specialists without a medical degree) who have made a ridiculous number of mistakes with me so telling you about my experiences would be a long story…

I recommend you try febuxostat if that’s what the doctor suggests. Gout tends to get worse (possibly resulting in permanent damage) if you let it develop and this drug works better than almost anything else. You can try a very small dose at first which should minimize any risks and see for yourself what side effects you get (if any).
There are natural remedies but if you want them to be effective, you’re going to have to use them like a drug. And if you use them like that, there are going to be side effects as well. One issue is that you won’t be able to dose them anywhere as precisely as you can dose pharmaceutical products. Another is the cost and inconvenience.
I would also like to remind you that you would probably be able to allow your uric acid to rise into unsafe territory temporarily AFTER you’ve cured yourself properly. That is the best time to experiment with unproven ways to keep uric acid low.

Arcoxia is a regular anti-inflammatory. It’s one of the many drugs which has a slightly different target than tradtionnal anti-inflammatories (which is supposed to reduce certain side effects). One noteworthy difference is that Arcoxia remains effective longer than regular Indocid pills (it’s more like the delayed-release pills).

There are several problems with your plan.
One is that losing weight that fast isn’t recommended, especially if you’re not taking a drug to control your uric acid. It’s liable to make your gout worse. The same goes for exercise: moderation is recommended.
Another is that you need to learn how to replace animal flesh properly before trying to limit calories and exercise at the same time. Most people have no idea how to avoid nutritional deficiencies and you need to consider the health impacts of what you replace meat with which isn’t the same for everybody. Even professionals sometimes give out bad nutritional information. If you want to do this responsibly, it’s going to be a slow learning process.
Another problem is that, on top of the side effects and interactions (please don’t start using all these products at the same time!), some of the unscientific stuff recommended for gout may actually make it worse. People get confused about all kinds of health issues but gout is especially confusing because you don’t feel the crystals when they are left alone to grow. But if they are disrupted, your body will react. So people might end up finding tricks which limit their symptoms but promote crystal growth. If you want to know what actually works, you’ll have to try one thing at a time and test your blood several times after each change… this would take years, and would be quite costly to boot.

The 0.36 (more like 0.355 actually) story is more complicated. Crystals should not form even with somewhat higher values (barring extraordinary circumstance). The thing is, you want a safety margin to protect against random variations… but how large should this margin be?
The “magic” number only has scientific backing because of what you might call historical inertia. It was a traditional treatment target, and so was used in many studies. Time and again, people who achieved this target were shown to have gotten rid of their crystals. But that doesn’t mean a higher target wouldn’t have worked or that a lower target wouldn’t have worked better.
Some doctors do not give much credence to the traditional target and medical guidelines support using a lower target in severe cases. The traditional target may not be ideal or work in every case but it’s been shown to work in most cases which is good enough for most people.

Yes, too little uric acid can be bad. This is not going to be a worry unless you take whole Uloric pills or something equally effective. Even then, the mainstream opinion is that it takes a long time for a lack of uric acid to do any damage so it’s probably fine if you take too much febuxostat for a few months.