April 13, 2017 at 6:35 pm #3166
My doctor switched me from Febuxostat to Allopurinol since I started experiencing insomnia when I took febuxostat for 1 month. I started Allopurinol just yesterday and I had very stiff left shoulder and elbow joints on my left side when I woke up today. I just ignored it and took the dose today but as the day progressed my right shoulder and elbow joints also got quite stiff and it seems that my stiffness is affecting my spine also now. from what I read many people take allopurinol for long term without any serious side effects but I am having achy joints on the second day itself. Would it go away gradually or should I revert back to febuxostat and search for solutions for my insomnia. ALso which medicine has adverse side affects when taken in long term. I am just 29 now and I am already struggling with terrible left knee after 3 surgeries on that one and now this gout diagnosis is preventing me from attending my office regularly. Please suggest how do I deal with this.
April 14, 2017 at 5:17 am #3173
I really need to know your uric acid levels. Because without that information, I can only give you guesses. So, my best guess is that allopurinol is working as it should do. By which I mean, it is causing old uric acid crystals to dissolve. Therefore, if the stiffness is too much, you should take anti-inflammatory medicine, as advised by your doctor. In fact, you need a good pain control plan for a few months, until allopurinol has caused most of your old uric acid crystals to dissolve. If your doctor cannot suggest a good plan for gout pain control, then I can help you.
As for long-term side effects, I am not aware of any for allopurinol. But, there are concerns about long-term effects of febuxostat on the liver. For that reason, febuxostat patients should always insist on liver function tests at least every three months. You can use my search box near the top of each page to search for more information about febuxostat and liver.
April 16, 2017 at 9:58 am #3221
Thanks for your reply.
I am noticing a decrease in my joint stiffness now. It’s better than what it was a couple of days ago.
My uric Acid Levels are as follows
Feb 20-> 7.0 md/dl
After using febuxostat 40mg for 6 weeks
Apr 1-> 4.0 mg/dl
Discontinued the febuxostat and after 11 days
Apr 12-> 7.0 mg/dl
I am wondering if the uric acid lowering medicines just mask the symptoms of high uric acid level but they never get rid of the crystals that are deposited in the joints. So from my understanding the moment we discontinue the medicine the uric acid level rises again. And it keeps adding to the crystals that are already there. It looks like these crystals can only get bigger and more painful but they would perhaps never fully vanish from body. Also I notice these tinges in many other joints in my fingers and toes unlike many who only seem to have it at a single joint.
Indian diet is different from what western diet is and for us rice and pulses are our staple foods. I am an eggitarian but live with my family. It’s baffling really. I asked my doctor couple of times what to eat and what not for my gout diet but he just said I should stay away from meat and asparagus,mushrooms. I am already avoiding foods with high purine as per info on the internet. But in the South Indian context, that info is not all that helpful. There are many other oils, spices, pulses that we use in our diet. I am compiling a list of all food items that we use in our kitchen and hopefully you can help with some of the foods.
My doctor switched me to Allopurinol now but from my research on the internet both febuxostat and Allopurinol can cause serious side effects but I guess we do not have many options now. The natural or home remedies do not seem to do any good.
April 16, 2017 at 9:38 pm #3225
Sandeep, I’m sorry to say this. But, your doctor is a fool. Or, at least, he knows very little about gout. Asparagus is good for gout. Mushrooms are neutral. And small amounts of meat once or twice a month make very little difference.
I vaguely recall saying to you, in another topic, that you need not worry about purines. Just ensure you have a healthy diet. I know that Indian diet is different from Western diet. Which is why I directed you to an Indian nutrition website. I’ve never heard of an eggetarian diet before. But, I understand it is a vegan diet with eggs. If that means you avoid milk and cheese, it could cause gout problems. But, allopurinol will take care of that. So, stop worrying.
When uric acid lowering medicines (febuxostat, allopurinol, or anything else) is prescribed, a sensible doctor will also prescribe pain relief for up to six months. There are thousands of combinations of pain relief suitable for gout pain. I hope you can find a doctor, or pharmacist who can help you with a pain relief package. If not, I’ll try my best to advise you. I explain why you need pain relief in Allopurinol Medication: Why It Hurts To Get Rid Of Gout. But, although I focus on allopurinol, the same thing happens with febuxostat. Because gout recovery can hurt. But, if you keep your uric acid below 5mg/dL, any gout symptoms will get less frequent, and less intense.
1. Stop worrying about diet. But, if you have specific concerns, please ask me for clarification.
2. Stick with one of your uric acid lowering therapies, and get blood tests every month for 6 months. Post your test results in your personal gout diary. Then, we can make sure you are keeping your uric acid safe.
3. Make sure you have access to good gout pain relief for 6 months. You won’t need it every day. But, it’s good to know it’s there when you need it.
I recently decided to celebrate my 60th birthday in India during February/March 2018. It will be great to combine that with celebrating your Gout Freedom! 🙂
April 20, 2017 at 11:09 am #3343
Thanks for the link but India is a diverse country and the food habits are diverse as well. I searched extensively but couldn’t find any advice for South Indian diet. And I am not a vegan. I love cheese a lot and used to drink at least 1 glass of milk everyday with Protein supplment. Ultimately when I doubled for 4 months. At the same time I was taking certain biscuits as healthy snack alternatives and turns out they are protein rich as well. And I didn’t know that Peas are high on protein as well. So I believe it is this faulty protein-rich diet that led to my gout.
And I am seeing a rheumatologist this week for checking my uric acid levels two weeks after my allopurinol start and I would check with him if he has any dietary recommentations. In India we don’t get low-fat milk or low-fat curd. I get the Toned milk(first one in this link):
And Yogurt is prepared in our house through this milk. Since I have been told to stay away from sugar and Protein supplements, I am not sure how I should be drinking my milk now. Because without any sugar the milk tastes bland and for while I thought about a powder called Horlicks but my doctor said that it is mostly sugar and thst wouldn’t help my cause.
Previously I used to eat an omlette every now and then but now I am making a conscious effort to have at least 4 eggs per week. 4 soaked almonds everyday. Peanuts+Chickpeas paste in the morning. These are my protein sources.
I am going to stick with Allopurinol because I am not having insomnia as I did when I had febuxostat. Allopurinol causes mild joint stiffness every now and then but overall the symptoms have abated. It’s not as bad as it was for the first 2 days. I got to monitor my uric acid levels this week to see if Allopurinol has worked. I will ask my doctor about options in case I have a sudden attack midnight.
Thanks for your advice Keith.
April 24, 2017 at 5:55 pm #3371
Firstly, Sandeep, I’m planning to spend my 60th birthday next year, in Goa. So, if you know any places that you recommend visiting, please tell me in the General Discussion forum.
For your diet, protein is good for gout. That gets misunderstood, because most high protein foods are animal flesh. But vegetarian protein sources, and dairy products are good for lowering uric acid. However, you need to avoid too much protein. Because, it puts an acid load on the kidneys, which can reduce uric acid production.
Excess sugar isn’t good for gout. But, dairy fat shouldn’t be a problem. So, no need for low-fat milk or cheese. However, you still need to control calorie intake. Because too much fat can make you overweight, which is very bad for gout.
Generally, allopurinol should mean that you can eat anything you like. As long as you remember weight control and a good mix of healthy whole foods. But, it takes several months to work fully. So, it is usual to experience some gout symptoms at first. But, you are doing the right thing in getting uric acid checked. So, let’s hope you will soon be fully recovered.
April 25, 2017 at 10:54 am #3397
d qParticipantŦallars: Ŧ 340.34Rank: Scholar
“Generally, allopurinol should mean that you can eat anything you like. As long as you remember weight control and a good mix of healthy whole foods. But, it takes several months to work fully. So, it is usual to experience some gout symptoms at first. But, you are doing the right thing in getting uric acid checked. So, let’s hope you will soon be fully recovered.”
This is exactly what my rheumatologist pretty much said. As long as it isn’t organ based foods then it only really contributes to 15% uric acid production.
(Although I am changing rheumatologist as he seems to be pretty careless in everything except that one statement when he first prescribed me allopurinol)
The 15% can be enough for some people to control by food only. Me on the other hand loves food too much to fuss around with that 15% for a tablet or two a day. I’ll never be able to get it low enough anyway as I have secondary gout. Rapid cell breakdown and release of their uric acid is what is causing my gout.
April 25, 2017 at 11:38 am #3400
nobodyParticipantŦallars: Ŧ 470.84Rank: Scholar
Assuming it’s even evidence-based, this 15% is only an average and only looks at half of the isse because food also affect how your body excretes UA.
My UA readings dropped by more than 15% after tweaking my diet and drinking habits (without trying very hard and without losing much weight). I had already eliminated organ meats and such before that >15% drop.
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