I want a divorce from allopurinol…

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This topic contains 4 replies, has 3 voices, and was last updated by  Keith Taylor 12 months ago.

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  • #5737

    Ron Harris
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    Hello, I’m a 55 year old male recently(3/17) diagnosed with gout/uac.
    I’m currently on allopurinol(200mg a day)and am looking for a way to get off of allopurinol, I do NOT to be married to a pill for the rest of my of my life:sad:

    When I was initially diagnosed, my UA was 8.2 and I was perscribed 100mg allopurinol, but after a month of meds my symptoms did not subside and my UA was at 6.5. I am currently on 200mg a day and my UA is at 5.7.

    My Background:
    – I have been a healthy vegetarian for 28 years, very low purine intake.
    – never been overweight, don’t consume a lot of sugar.
    – 6’2″ 220 lbs active, jog 15mi/bike 30-50mi a week, scuba, water/snow ski.
    – drink responsibly, hit vegas a few time a year and been known to party.
    – father had gout starting in his 40’s
    – grandmother had gout in her 60’s
    – had one misdiagnosed gout attack 9/16 then full blown attack 3/17.

    My rheumatologist indicated to me that my high UA was most likely the result of genetics. She ran multiple full panals of bloodwork looking at kidney function, UA, liver function, iron levels(found out I have boarderline low ferritin), CBC, all came back normal. She also told me that I most likely will be on allopurinol the rest of my life.

    So I have two questions:
    1). My foot is still sore and slightly swollen, what is the “average” time for full recovery??

    2). Based on life experience/consensus, once diagnosed, with no accute cause for the high UA, are you destined to take medication for the rest of your life??

    Thanks in advance,
    Ron

  • #5740

    nobody
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    Hello,

    My understanding is that full recovery from a gout attack typically occurs in less than 2 weeks.
    But I have had symptoms which lasted for months before I started taking colchicine in sufficiently large amounts. Others have experienced long-lasting symptoms as well.
    Your situation is not typical to begin with. Some of us have experienced ongoing symptoms after lowering our UA (be it through drugs or diet).
    If you haven’t yet tried colchicine, you might want to talk to your doctor about it. There are other drugs such as corticosteroids which might help put a stop to your ongoing symptoms.
    I don’t know when you’ve started taking 200mg but if your dose change was recent, I wouldn’t worry about your foot not healing just yet. If you’ve been on 200mg for a while, it’s possible you would benefit from taking a bit more.
    It’s also possible your last attack did some damage to your foot that explains (some of) your symptoms. In that case, drugs may not help much. Aside from the injuries that serious swelling can cause or contribute to, gout seems to contribute to the development of other conditions such as osteoarthritis. If your foot doesn’t improve, you might have to ask your rheuma to take a closer look at it.

    The information you’ve just given would lead me to guess that you’re going to have a long term relationship with allopurinol. If you have a problem with allopurinol in particular, there are other drugs and remedies you could take instead. But you’re most likely have to take something or other. You could try to optimize your diet and lifestyle but I don’t think that would be sufficient to keep you safe in the long run.
    There’s little harm in trying different things as long as your are monitoring your uric acid closely. There’s also evidence that people can quit allopurinol for a little while without ill effects. But I would wait until you’ve been symptom-free for a long time before attempting anything of the sort. The longer you’ve been taking allopurinol, the safer it would be to take a break. To be clear, I’m talking years.

  • #5741

    Ron Harris
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    Nobody, thanks for the quick response.
    I do have a script for colchicine but was under the impression it was for flare ups not ongoing pain? I will try it tomorrow. I do hope it helps i have been a sloth as of late and need to get feeling better about myself.

    I don’t have any ill effects from allopurinol that have surfaced as of yet(100mg for 1mo, 200mg for 3mo). I just hate hearing that the only way I can live “happily” is through pharmacology… I’ve prided myself on taking care; mentally, physically, and dietarly, this UA thing hit me unexpectedly and nocked me off my feet for 6 weeks. I guess I should have seen it coming with my family history. I had always thought it was more about “lifestyle” choices and truly thought you could avoid “gout” by living cleanly, eating right, and taking good care of yourself.

    You can never out run genetics…

    Ron

  • #5742

    nobody
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    I do take colchicine for flareups but I don’t think it’s the best way to use it because it acts slowly.
    So far as I know, it’s typically used as a way to prevent flareups (by taking a pill every day) but in my experience it can also disrupt them. It might bring a little relief but shouldn’t get rid of ongoing symptoms on the first day. But see if the swelling improves over the next few days.
    I don’t know whether colchicine would help but I think it’s worth trying. Knowing that it doesn’t help would be a clue as to what’s causing your ongoing symptoms.

    Some people can fix gout by tweaking their diets, losing weight and so forth.
    There’s a definite connection between gout and lifestyles. But if you strongly predisposed to get gout, you’ll get it no matter what. Lots of males get gout way younger than you did so taking care of yourself as you did may have given you many medication-free years.

    If you only got one blood test since you’ve been on 200mg, I’d get another. 5.7 mg/dl is kind of borderline and there are variations in test results. If your UA was lower than usual when you got 5.7, it could be too high much of the time.
    And some people recommend aiming lower than 5.7 in the first place. Opinions vary but I suspect my doctors would tell you to lower your UA further if your symptoms don’t go away after a while.
    Sometimes there is a medical reason not to take more than 200mg though.

  • #5750

    Keith Taylor
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    Ron,

    Allopurinol can be prescribed as an annual course for a few weeks instead of every day. But you’ll be lucky to find a doctor with enough gout experience to manage that properly.

    Extreme lifestyle changes might get your uric acid into the safe zone. But I don’t know enough about you to guess the likelihood of success. If you want to consider lifestyle changes the starting point is a lifestyle analysis that includes height, weight, exercise levels and a 3 day food intake diary.

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