December 7, 2015 at 11:40 am #2514
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December 7, 2015 at 11:40 am #548
December 7, 2015 at 11:58 am #551
Hi Joseph. Thanks for sharing your opinions about gout, alcohol, and allopurinol.
I welcome discussion of all aspects of gout in these forums. I especially love it when people discuss my articles, as it gives me a chance to improve them.
You’ve given us a great example of why it’s important to take a personal approach to gout management. For people who feel that alcohol is adversely affecting their gout treatment, then it’s best to avoid it. Or, some people might be happy to simply reduce alcohol consumption – it’s a personal choice.
Whatever your views on alcohol consumption, it is very important to make sure that your allopurinol treatment plan is safe.
So, Joseph, what else do you do to make sure your allopurinol treatment is safe? Stopping alcohol is one thing, but are you also ensuring that you get the right blood tests at regular intervals? Are you certain that the allopurinol dose you are taking has lowered your uric acid to safe levels?
In my opinion, these safety issues are much more important than moderate alcohol intake.
Unfortunately, most of the allopurinol plans that I see are not safe. Joseph, for you or anyone else, I can review your allopurinol treatment plans, if you wish. Just post a new topic with your allopurinol plan details, and I will review it.
December 16, 2015 at 1:36 am #571
[feedback from Normal Uric Acid Levels]
i had gout before 1 year when i was in qatar.. and then i go back my country nepal while me in my country i dnt feel any pain on my joints and i thought i am fine now.. then i come saudi arab now i am in saudi arab and i feel pain again in my joints and the pain is very hard some time i cnt walk because of pain under the feet.
i went to hospital too doctor test my blood and he said my uric acid is normal. he said 3.5 to 7mg/bl is normal and my blood test show 6.6mg/bl. but i feel stil pain.
what do i do to get painless walk???
December 16, 2015 at 2:07 am #585
‘Normal’ is a statistical way of saying ‘average’ or ‘not unusual.’ If you take 1000 people, a 20-30 will have gout. That means that the 3.5 to 7 range includes people who have gout. Statistically, the normal range is not unusual, but personally, the upper end of that range is unacceptable.
Medically, it is meaningless, and the doctor you saw should know better. Unfortunately, 3 out of 4 doctors in my experience do not understand this. I get so angry about meaningless ‘normal uric acid.’ I even started a campaign NUANT – Normal Uric Acid: No Thanks! Unfortunately, I can’t get people interested in it.
To stop gout pain permanently, you must get uric acid below 5mg/dL
Tell your doctor that you want this immediately. It takes a few months for uric acid lowering treatment to get rid of old uric acid crystals. So, you probably need pain control for a few months.
If you need help with a personal uric acid lowering plan, or help with a personal gout pain control plan, please just ask: http://goutpal.net/forums/forum/help-my-gout/gout-management-plans/
December 23, 2015 at 6:26 am #651
[feedback from Stop Gout.]
I had gout in 2012 a couple of times and I was prescribed Colchicine and I was allergic to it and had severe diarriah.
I had it again in Feb. 2015 and ended up in emergency because of the severe pain. That time they did not realize it because I had twisted my knee and they thought it might be arthritis.
It came on again on June 8th and this time in my thumb and I realized it was gout and saw a doctor on the 10th. It then went to my knee. I had such unbearable pain that I ended up in Emergency again with heavy duty pain killers.
The next day I had to go back because of the pain, I have tried Colchicine again but but I found that I was still allergic to the med.
Do you think I can start taking Allopurinol even though I still have some pain?
December 28, 2015 at 10:16 am #685
My immediate thought is: “what dose of colchicine were you prescribed?”
There have been some very bad dosing practices. They should have died out by now. Also, colchicine by itself is rarely enough, especially once a gout attack has started.
It is perfectly wise to start allopurinol immediately, but you must do it right. Back in 2012, I published Start Allopurinol Quickly, But Carefully. Scientists had just proved that allopurinol could start during a gout flare. It makes no difference to immediate gout flares. But, the sooner you start allopurinol, the faster you get rid of gout. Unfortunately, there are also bad dosing practices with allopurinol. I mention them in that article.
With gout, it is never good enough to “have tried colchicine.” It is never right to simply “start taking allopurinol.”
Dose is vital.
Get dose right, and gout is easy to manage, and quickly controlled. Get dose wrong, and it might be useless, or even make gout worse.
Joy, I urge you to post more information about your doses of colchicine and allopurinol. Also, colchicine alone is not sufficient once an attack has started. What other pain relief has been prescribed?
November 8, 2016 at 4:04 am #2239
hey there – so, while I’ve never had my gout diagnosis confirmed, I’m somehow confident that I’ve had flares over the last 10-12 years. I’ve always been able to correlate the “events” with heavy drinking and binge eating of many high purine foods. this time (10 days ago) was no different in that I traveled a couple times over a 10 day period and ate terribly and drank a lot of alcohol.
I was traveling as my foot exploded in pain (and swelling) over a 2 day period that involved lobster and massive cocktails and I didn’t know what to do. I iced it for the next 5 days (apparently a bad idea?) and also began the herbal route with celery extract, black cherry juice, magnesium, and fish oil. immediately upon returning home, I went to the doctor and had my blood tested and had him look at my foot.
as somewhat suggested on this site, my doctor wasn’t sufficiently knowledgeable to confirm my self-diagnosis and was confused when my blood came back with a 5.9 uric acid level. fortunately, he still wrote a colchisine prescription which had a fairly significant positive impact within 2-3 days. it’s now been 5 days and the swelling and pain have subsided somewhat but I still can’t get a shoe on.
I’ve started taking allopurinol on a daily basis and I’m going back to have my blood tested again this week. I’m watching my diet, I haven’t had a drink in a week, and I’m still taking the herbs mentioned above. I really need to get this all the way gone and keep it gone: so here’s my question: now what?
November 9, 2016 at 2:51 am #2240
Hi Bertram, and welcome.
Keep taking your allopurinol every day.
Take colchicine as needed for a few weeks.
Return for more uric acid blood tests every 2 to 4 weeks.
Post your uric acid test results here.
Recover from gout.
Live a happy life.
Whenever you feel unsure, or need more information, post here.
Bertram, it’s going to take a few months to recover from a disease that’s been building for 10-12 years. But, you can expect a complete recovery. I’m here to help, whenever you need it.
November 13, 2016 at 7:43 pm #2241
hey Keith – first, thank you for this site – I think it’s about the best thing I’ve seen relative to a comprehensive understanding of gout and support for those who suffer from it. next, I really didn’t specify a couple of additional questions.
I couldn’t get to a doctor until 6 days into my attack, but began an aggressive course of celery extract, black cherry juice, magnesium, and fish oil on the evening of the 4th day. question: could that explain my relatively low uric acid level of 5.9 (after day 6)?
if yes, my next question is if it’s advisable to continue the herbal approach “in addition to” or “instead of” allopurinol. I’m planning on getting my level checked in the next couple weeks but I’m also wondering how much difference it made going 4 days without alcohol before the test.
the good news is that the colchicine was a miracle. I took that stuff for about 10 days (just finished the course) and I’m about 95% mobile. bad news is that I’m struggling with diet. there are purines in everything so not sure what to eat. anyway, thanks again and I’m seriously dialed into your site.
November 13, 2016 at 9:55 pm #2243
Thank you for your kind words. And, for your extra information.
The usual explanation for uric acid falling during a gout attack is to do with what happens during the attack. Uric acid crystals forming in the joint reduce the dissolved uric acid measured in the blood. But, other explanations re possible.
The main thing is to establish routines for uric acid tests so that you have a history. Then, we can look at how your uric acid changes over time, and in response to various treatments. Herbal medicines can reduce or remove allopurinol dependence. But, you need monthly uric acid measurement to know if this is happening safely. Allopurinol might be avoidable, but testing isn’t. Uric acid tests should always be accompanied with kidney function and liver function tests.
That gives you a safe environment for testing your herbal products. Remember, if they are any good at lowering uric acid, they are potent enough to have side-effects. Herbal does not mean safe. That is why I strongly recommend the kidney and liver tests.
If you are also struggling with diet, you might consider a combination of herbal medicines and diet improvements. You are absolutely right that it is impossible to avoid purines. First, there is no need to avoid vegetable purines. Second, animal purines should never be significant in a healthy diet. So, twice-weekly fish and twice-monthly meat should not significantly raise uric acid levels.
The easy way to manage gout is to take the correct dose of allopurinol that makes uric acid safe. Usually, safe means below 5mg/dL. Once you move away from the easy option, you have to investigate, measure, and plan in more detail.
I’m happy to support anyone who wants to lower uric acid with herbal medicines and/or lifestyle changes. It’s rare to find a gout sufferer who is prepared to put the time in to manage diet and herbal supplements in enough detail to make a difference.
If I were doing it, I’d start with a gout diary. Then, I’d commit a set amount of time to measure and manage my gout.
I realize that doesn’t really answer your specific question “could that explain my relatively low uric acid level of 5.9 (after day 6)”
I’m afraid it’s impossible to answer that without more uric acid test results. That’s why I’ve fallen back on the most common explanation. But, it’s better to have good data, rather than guessing.
November 1, 2017 at 6:11 pm #5884
KELLY WILDERParticipantŦallars: Ŧ 0.32Rank: Carer
Managing Gout through Diet and Daily Testing
I don’t have gout but my boyfriend does. His diet lifestyle is so much better than mine (always eats organic and tries to limit preservatives) but he suffers gout attacks fairly frequently. We are going to try to manage his attacks through a change in diet. He already takes allopurinol daily (which is expensive..yikes) but he loves beer. I ordered a Home Uric Acid Test Kit (and that was an experience in itself!) and we are both going to follow a Gout Diet and monitor our uric acid levels. I thought it would be beneficial to have a control (me) to see what causes a spike in UA levels in his system versus mine.
The literature out there on gout friendly food is all over the place. A lot of the advice that you get is counter-intuitive. Do you a particular diet that you recommend? I bought the book – Eat This – Not that for Gout.
Also, who determines the purine levels in foods? Is there standardized testing?
November 1, 2017 at 7:08 pm #5885
nobodyParticipantŦallars: Ŧ 421.08Rank: Scholar
As you noticed, there’s lots of nonsense out there about gout and food. And the trustworthy information one manages to find is too often quite vague. There are some things reasonable people disagree about but there are a few things we do know about gout and food. If you really want to, I’d be willing to discuss that with you, tell you where you can find reliable information and so forth.
But if I may… in my opinion, it would probably be a waste of time. Indeed, the most important thing you said was that your boyfriend takes allopurinol daily. That changes everything. Getting allopurinol right is more important than getting food right!
Most people can easily control their uric acid by taking allopurinol regardless of what they eat… on one condition: they need to take enough!
If you think your boyfriend still has too much uric acid, maybe he should be taking more allopurinol. In some cases, it’s more complicated but in many cases the only thing that needs changing in order to fix gout is the daily dose of allopurinol. The typical dose isn’t appropriate for everyone.
A warning though: allopurinol is a serious drug. Your boyfriend should be monitored for side effects and the dose shouldn’t be changed without discussing it with a doctor.
Something else about allopurinol: it’s an old drug and you can stock it for years. It should therefore be quite cheap.
If you’re paying a lot for it, it may be because you’re paying for a brand. If for some reason there is no cheap brand of allopurinol for sale in your locale, perhaps you could plan a short holiday some place where you can buy a personal supply of the stuff cheaply.
Finally, if you want to experiment with your diet and measure your uric acid, that’s great! I’d be interested to know the results of your experiment.
But your experiment wouldn’t help your boyfriend much because taking allopurinol changes the effect food has on your uric acid. Everyone is different anyway but your experiment would be more likely to help someone who wants to lower their uric acid without drugs.
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