Reply To: Gout Patient Discussions

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#562
Keith Taylor
Participant


The first thing to understand about a gout attack is that it is an immune system response to invading uric acid crystals. Your immune system does not like foreign matter in it’s domain, and it’s job is to kill it. That works nicely with bacteria, but inanimate uric acid crystals cannot be killed.

Instead, your white blood cells engulf the crystals, and eventually they become hidden. When exposed uric acid crystals reduce in number, your immune system settles back down, and inflammation disappears.

Everyone’s immune system is different. One or two weeks is typical, and usually no more than three weeks. This time can be shortened by anti-inflammatory meds. I’d recommend to keep mobile, but not to stress your ankle. Keep it wrapped to avoid exposure to cold. It sounds to me like it’s almost over, but there is more to this story.

This sounds like your first attack, or at least the first flare that you’ve recognized as a gout attack. The crystals that caused the attack have been slowly building up for several years. They will continue to build up until your uric acid levels stay below 6mg/dL. You are unlikely to qualify for uric acid lowering treatment on your first attack. However, it is very useful to start recording your uric acid levels now. The more data you have, the easier it is to manage gout treatment in future. I can help with that whenever you are ready, but for now, I’ll return to your current gout pain.

As I said, you should be back to normal in a few more days. However, once gout starts, it will return faster and stronger until uric acid is controlled properly. Therefore, there is an outside chance that pain could continue beyond the three weeks I mentioned. This happens when a new attack starts before the old one is completely resolved. It feels like one long attack, but in reality it’s a series of more than one. If that happens, all you can do is return to your doctor for more pain relief. In that situation, you would definitely qualify for uric acid reduction treatment.

Finally, you should be aware that most gout is genetic, so there is little you can do about it. On the other hand, it might be caused, or worsened by controllable factors such as poor diet, exposure to environmental toxins, or meds for other health conditions. If you would like me to help you review your situation for controllable gout factors, please just start a new topic.

If you do not understand any of the points I have made, please ask for clarification. Sometimes I miss an obvious point that I’ve taken for granted.