August 17, 2019 at 11:34 pm #9052Kymberly PonegalekParticipant
I am a very active 52 year-old woman of normal weight who had a gout attack on Monday night, July 29, 2019. I have taken nothing prescribed (Colchicine 0.6 mg cap and Indomethacin 25 mg caps) as I have been too afraid of the drugs. My biggest question is, am I harming myself by not using these medications? Is it too late to take them now, 20 days later, if that is what’s best?
The attack hit in my big toe. Not knowing what it was and assuming I had “slept on it wrong,” I got up and ran 5 miles on it the next morning, and rode my bike aggressively the day after that. Thursday I knew something was wrong and went to the Dr, but he didn’t think it was gout because it wasn’t swollen at the time. The pain and swelling did not get bad until the next day, Friday. On Saturday I went back to another Dr., who took one look at my swollen red foot and said it was gout, and I was prescribed the meds. No acid tests were performed even though I asked. I never took the drugs, because I assumed they were for pain and I just breathed through it all. Bad pain and swelling lasted through the weekend while I used crutches, after which both subsided. So far, the pain and stiffness come back a bit if I get too active (or at least I think that’s what causes it) and then I take it easy for a day. So far, that seems to help.
My history is this: my grandpa had gout (didn’t know til now). For the past 14 months or so, I have been eating 5 ounces of liver, 9 ounces (2 cans) of sardines, 4 ounces of salmon, 36 ounces of chicken/beef, 10 ounces of mushrooms (1 1/2 ounces per day) every week in an attempt to get my iron levels up (in April 2018, I was diagnosed with anemia after a couple of years of poorly executed vegetarianism). I have also been taking 25 mg of iron bisglycinate per day for 14 months for the anemia. In addition, I practiced 8/16 intermittent fasting each day (8 hours eating/16 hours fasting). I ate lots of vegetables, but also lots of fruit (usually 5 pieces a day). Sweet potatoes and a teaspoon of raw honey every day as well. More of fructose there. I missed a couple of periods right before this attack, so I’m sure menopause is setting in and hormones are changing.
I have since cut out the liver, the sardines, the mushrooms, and most of the meat. I’m down to 4 three-ounce servings of meat (1 salmon, 1 beef, 2 chicken) per week, one every other day. Still eat eggs and dairy and lots of plant foods but less fruit, mostly berries. I now drink lemon water 2 times a day, concentrated tart cherry 1 tbsp a day, apple cider vinegar 1 tbsp a day. Drinking lots of water. Trying to keep active with stationary bike and slow walks. Back to three meals a day, more spread out. Dr said I still have to take the iron for anemia. Can’t do much about menopause.
I would rather continue on, without drugs for now, unless that is a poor choice. Will the crystals go away by themselves over time without the Colchicine or Indomethacin? I am not opposed to drugs as a last resort, but should I wait to see if I get another attack? I’d like to wait. Kaiser Dr. wasn’t interested in doing any further testing at this time. If I do have another attack, are these the best drugs to take in my situation?
August 18, 2019 at 3:07 pm #9053nobodyParticipant
Explain to your doctor that serum uric acid measurements are critical both to the diagnosis and the management of gout. They are cheap may prevent lots of doctor visits, complications from drug side effects and so forth in the long run. And because there is noise in the test results, especially when gout symptoms are suspected, this test should be repeated several times every few weeks or months. If he doesn’t want to listen, get another doctor/insurance and/or complain to the higher ups. If that sounds like too much trouble, just get the blood tests done at your own expense (they shouldn’t be expensive but you might want to shop around for an affordable lab).
It’s not clear at this stage you even have gout. If you do, my wild guess would be that the pain in your toe wasn’t gout at first but ended up triggering gout.
Being careful with your diet until you know how much uric acid there is in your blood may be prudent considering you have gout in the family. If your current iron supplement isn’t helping much with your iron, try heme iron instead (you might possibly be able to quit meat entierly if you take this).
Colchicine and indomethacin do not help much with crystals. They are mainly used to deal with acute symptoms and to prevent inflammation from causing lasting damage. It doesn’t sound like you are at risk of lasting damage but you might want to try these drugs if the mobility of your joint remains impaired or if the pain doesn’t go away completely after a while.
Definitely hang on to the pills and don’t travel without them because you’ll need them badly if you get a textbook gout attack. In case you feel unexplained (no injury or something) joint pain getting worse and worse over the course of a few hours and notice swelling and/or redness, my advice is not to delay taking these drugs.
August 18, 2019 at 7:40 pm #9054Kymberly PonegalekParticipant
THANK YOU so much for your reply! I really appreciate your help. I will press my doctor to give me a uric acid test. Having this happen has made me feel so overwhelmed, lost, and alone. Finding this forum and reading through all of the posts has been a mental and emotional lifesaver. Thanks again for reaching out.
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