Articular Gout Pain

[Mauri]

Hello: here my question. Is it possible that during the crystal clearance period (using allopurinol 600 and colchicine 0,5 as prophylactic) one could get diffuse articulate pains i.e. Shoulder, hip, fingers ? I feel sometimes like my whole body is involved in clearing 20 years of gout crystals and I am suffering all sorts of articular pains during this process. Am I crazy to think this? I’ve been taking this dose for 2 months now.
Best regards

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How long does it take to lower uric acid levels?

[Keith Taylor]

Yes, it is possible. And, expected.
No, you’re not crazy.
If you truly want to understand why, it’s all about uric acid levels. And, what happens during recovery from 20 years of avoiding uric acid control. So, post your uric acid test result numbers, if you want a complete explanation.

Also, it’s avoidable, if you:
1. Take your prophylactic colchicine at night.
2. Take time in the morning to think about your body. If you have any gout pain symptoms, take a second colchicine plus anti-inflammatory.
3. After 2 hours, if you still have symptoms, take a pain-blocker.
4. After another 2 hours, if you still have symptoms, take another anti-inflammatory dose.
5. Repeat 3 and 4 as necessary until you reach the maximum dose.

Notes:
A) 2 hours is a guide. 3 hours might work better for some people.
B) Anti-inflammatory should be at maximum dose, as prescribed by your doctor. Ibuprofen, naproxen, and indomethacin are the common options. But many others are available.
C) Acetaminophen (Paracetamol) is the popular pain-blocker choice. Again, your doctor should prescribe one that is compatible with other meds, and at a dose that is effective for gout.

The best part, Mauri, is this will soon stop. Once the burden of years of uric acid crystals has dissolved, you’ll be gout-free. Isn’t that something wonderful to look forward to?

[Mauri]

Thanks Keith: my UA level has dropped to 3.9 …. I expect crystal clearance will take months, therefore I don’t want to use too many anti-inflammatories. Don’t Think I should since this process will take a while. I of course will take indomethacine if I get a gout attack but for this diffuse articular pain I am willing to tough it out as long as I understand it is part of the process and shall pass!
Willing to wait and see; hopefully 6 months or so?
Regards

[Keith Taylor]

OK, Mauri. I got the impression that your joint pain was bothering you more than it actually is. It sounds like you are doing everything right.

I hope you have the “where did my gout go” experience. It happened to me a few months after starting allopurinol. I remember thinking one day: “I can’t remember the last time I had an attack”. So hopefully, you’ll experience that within the next few months. I hate putting actual estimates on how many months it takes. The main point is, as weeks pass, you notice that attacks become less frequent, and less intense.

[d q]

This has been an extremely interesting post as I’m still in the “finding the right dose” stage and currently on 200mg once a day which I doubt will be enough to bring my 570ummol down to safe levels. 100mg brought that down to 555ummol only. Let’s see what 200mgs does when I get tested next week or so.

Thanks for the interesting question Mauri and the informative answer Keith.

James

[Patrick]

Maury, congrats on your total Uric Acid reduction buddy. That’s awesome. 3.9 is great. Keep up what your doing, and welcome to your new lifestyle.

James, you might need to up your dose in a bit. I started at 100mg (which is normal) but in 3 months my UA went from 7.8 to 7.6 on 100mgs. Not working. My Rheumotolgist bumped it to 300mgs and within 4 months it went from 7.6 to 4.3 and has held around 4.0 for a year. I’d expect a bump up in your dose after your doctor can clear you on your next blood test, if your liver and kidney function test show your body can handle it.

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