May 5, 2018 at 4:15 pm #6987
DaveParticipantŦallars: Ŧ 0.45Rank: Carer
Been controlling my gout daily with 300 mg allopurinol, cherry complex and uric acid support supplements along with major diet changes. I’ve been monitoring my UA weekly with a monitor for the past four months and I’m averaging 3.9 mg/dl.
All has been going well until a few days ago when the ball of my right foot has all the signs and symptoms of a acute gout attack. With my UA levels controlled and low, I’m thinking this may be the crystals breaking down from the metatarsal joints.
Right now I’m treating with prednisone to relieve the inflammation, OTC pain control and increasing my H2O intake.
This may be totally unrelated to UA and something along the lines of metatarsalsia which I’ll have to get a consult from a podiatrist.
My inquire is to see if anyone else has experienced this same condition and what if any the findings were. Additionally I’m wanting to reduce the dosage of the allopurinol and at some point not take it anymore. This begs the question: how does one know when this is?
May 5, 2018 at 4:47 pm #6988
nobodyParticipantŦallars: Ŧ 470.84Rank: Scholar
You should definitely not quit allopurinol while you are experiencing this type of symptom, unless you’ve been able to rule out gout as a cause. It often takes more than 4 months to get rid of crystals and you want to get rid of all your crystals before attempting to live without allo.
Since you test around 3.9 though, you could try to lower your dose a bit. Or you could stick to 300mg if you have no compelling reason to lower your dose as larger doses than necessary may help keep attacks short. I can’t guess what an appropriate dose would be based on the information above and my guesses wouldn’t be worth much anyway. You’ll just have to experiment!
Ultimately it is your symptoms which will tell you what dose is appropriate and whether you can go without allo. But it can take years for your body to give you definitve feedback. In the meantime you can use UA blood tests as a rough guide: while you are still experiencing gout-like symptoms, 5.0 or less is best whereas once have been free from gout for 6 months of more, as much as 6.0 might be fine.
May 8, 2018 at 11:14 am #6998
Steve BatesonParticipantŦallars: Ŧ 4.29Rank: Detective
Ball of foot is certainly where it gets me the worst. Last spring it started as a lump on top of the foot and after some massage seemed to morph through and I had a large swelling underfoot for about three weeks. Can be either foot, often starts in one then travels to the other.
It was that that finally (after 9 years of random symptoms) got me a referral to a Rheumatologist who quickly determined gout was the cause.
Ultrasound showed Synovial thickening, MTP joint effusion and small erosion.
Its not confirmed, but I believe this has led to splaying of the gap between 2nd and 3rd toes that has been growing for some years.
At the moment I’m on 2oomg allopurinol daily (6 months now) and Colchicine as required. Also Vit C, H2o and cherry extract. Urate is coming down so hope to reduce the drugs in a bit.
Colchicine, Naproxen and co codamol are always close at hand.
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