Reply To: Febuxostat dose change. Or different time of day?

Stopping Gout Together Forums Help My Gout! The Gout Forum Febuxostat dose change. Or different time of day? Reply To: Febuxostat dose change. Or different time of day?

#8990
nobody
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I don’t think dietary changes have much to do with how much liquid or solid UA there is in your tissues. While uric acid is definitely found in significant amounts in solution outside of the blood, I have found doctors to be unaware of the modern evidence regarding crystals. Not that it matters: whether small crystals would show up with expensive imagery or not is irrelevant to your treatment at this stage.
You never know when all the crystals are gone. You can only guess. And I would recommend not lowering your dose immediately after they’re all gone anyway (see the other long thread I posted in recently). In any case, it’s too early to concern yourself with this. You’re clearly not out of the woods yet.

I found the ALT/AST ratio more useful than AST alone though I suppose the absolute value might be important to deal with different issues. Either way, I don’t understand why they don’t test AST. I suppose ALT is the number most likely to become “abnormal” but AST is necessary for a more cogent interpretation of test results (my ALT has typically been “abnormal” even when I didn’t take any drug).
I got one or two high ALP results but that number has been pretty noisy in my case.

You could always take a small bit off a 120mg pill every day instead of alternating. It would be imprecise but you’d still get smaller daily variations. It’s not so much the UA variations which worry me but the side-effects. Maybe this is an unwarranted concern but if our bodies are better able to process a steady dose, that would be one fewer potential cause for these rare but nasty side-effects which might possibly be associated with febuxostat (the evidence is quite weak so far).
That said, my guess is that you’d handle 120mg per day just fine. You could always lower your dose later. But that’s only a guess and high febuxostat does aren’t that well-tested…

I believe I have previously suggested you simply post your email here if you want me to write. Posts can be edited so your email wouldn’t have to stay up forever. Yes, you could set up a temporary email address and add it to your email client (if you use one) or forward it to your main email account (if your webmail provider offers that feature) but I’m not sure it’s worth the bother. I certainly wouldn’t recommend one of these services which requires you to check your email on their website (that’s only good when you know you’re going to get an email right away).
There are of course other ways to exchange information or chat but I don’t suppose you use IRC or GPG for instance.