Unsure of the advisability of current treatment

Stopping Gout Together Forums Help My Gout! The Gout Forum Unsure of the advisability of current treatment

This topic contains 11 replies, has 2 voices, and was last updated by  nobody 6 months ago.

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  • #7397

    larry wagner
    Participant
    Ŧallars: Ŧ 5.18


    I’m a 73 year old male. First had gout symptoms around 5 years ago. Pain and swelling in big toe. My doctor prescribed allopurinol. The first evening i took 1/2 a tablet. I must have been afraid of it, which is not normal for me. I woke up in the middle of the night to use the restroom. I was so dizzy i nearly fell. That was the last time i took allopurinol. Within days I had laser surgery on my left leg. The vericose veins were worse on that leg and my gout was in my left big toe. The swelling and pain in my toe started to go away immediately. In a short time my gout was gone. As time went on, I began to get twinges in the left toe again. It felt like the gout might come back. I found an article on the internet about using baking soda. Again, the gout went away. At times the twinges would return. I upped my intake of baking soda from 1/8 oz to as much as 1/2 oz temporarily. Two weeks ago a friend brought us drinking water from his water ionizer. He told me taking baking soda was dangerous. I stopped using the baking soda. I eased into the ionized water upping my percentage each day. I began to have acid reflux and other symptoms. I quit the ionized water and the acid reflux and flu like symptoms stopped.I’m ready to try other forms of uric acid control. I’m 6′ and weigh 205. I have lost 20 lbs in the last 18 months through a reduced sugar and carbohydrate diet. I believe the diet reduced the frequency of the twinges in my left big toe. I’m willing to take herbs or a medication if a med other than allopurinol is necessary. I have many allergies.

  • #7399

    nobody
    Participant
    Ŧallars: Ŧ 556.07

    Hello,
    As you know, the point of allopurinol is to reduce the amount of uric acid in your system. Since I don’t know your blood test results or anything else about how much uric acid there is in your system, I don’t know how badly you needed it.
    If you are getting side effects, there are alternatives to allopurinol. Some alternatives are much more effective than others. It comes down to which of the alternatives would be least dangerous in your case while being effective enough. And I know next to nothing about the health challenges you face.
    So maybe it would be best if you saw a doctor about this? Ideally it would be a doctor who knows you well. Rest assured there are solutions!

  • #7419

    larry wagner
    Participant
    Ŧallars: Ŧ 5.18

    Thank you for your reply. My uric acid level was in range 4 years ago when my doctor prescribed allopurinol. It was 3.7 if i recall correctly. At that time the pain and redness was very specific to the outer edge of the joint at the base of my big toe. The top of my foot was swollen as well. My doctor said it was gout. The surgery on my veins and continuing to wear support hose likely boosted the blood circulation in the foot. I will search on the website for diet ideas and herbal supplements. I do not have a great amount of faith in my doctor’s experience with gout. I live a substantial distance from experienced physicians in specialties. Thanks again!

  • #7422

    nobody
    Participant
    Ŧallars: Ŧ 556.07

    3.7 doesn’t sound right. If at all possible, I would recommend getting a copy of the results of your old tests.

  • #7454

    larry wagner
    Participant
    Ŧallars: Ŧ 5.18

    My UA at was at 5.1 on my last test in February 2017. I was using baking soda in water at that time. Since discontinuing both the baking soda and the ionized water 10 days ago I am feeling discomfort in my toes. I have started back on the baking soda. Hope you might have another suggestion for me. Thanks, Larry

  • #7458

    nobody
    Participant
    Ŧallars: Ŧ 556.07

    5.1 is less implausible but you need more data. If you haven’t gotten another test since, I suggest you schedule one. Try to retrieve your old test results while you’re at it. Depending on the results, you’ll need to take a second test after abstaining baking soda and stuff for several weeks.
    You’ll need a broader picture than just your uric acid by the way: at a minimum, you want to know your test results for kidney and liver function as well as your blood pressure.
    So it would be best if you could see a doctor to talk about this. Depending on your medical situation, there are different alternatives to allopurinol you could look into.

  • #7459

    larry wagner
    Participant
    Ŧallars: Ŧ 5.18

    Thanks for your reply. I will comply with your suggestions. It may take a while. I have been taking annual physicals for over 20 years. Twelve years ago I had been experiencing frequency and my PSA went slightly out of range. Part of my prostate was removed. That corrected the frequency and the PSA. Fifteen years ago I retired from full time work. My blood pressure went from 125 over 90 to 120 over 80 and has continued to drop over the years. It is now around 95 over 65. In the early years my cholesterol was borderline. My doctor gives me what I believe to be a complete CBC. The items I mentioned are the only ones to have ever been out of range. I exercise daily and my father and mother passed at 89 and 96 respectively. I thank you for your efforts.

  • #7461

    nobody
    Participant
    Ŧallars: Ŧ 556.07

    I’m glad to read you’re in such good health. Men in my family do not get that old. But you did say “I have many allergies.” So I think you should make sure there’s a good reason for you to try potentially harmful drugs or herbs. That’s what the blood tests should establish.
    Something else I didn’t think about earlier: if baking soda and ionized water work for you, it may be because you are correcting a problem with your diet or metabolism. Most people get enough minerals simply by eating fruits and vegetables. So in addition to the blood test, maybe get your urine’s acidity checked (and possibly your blood’s as well). Perhaps a doctor would know something else worth checking in a patient who seems to benefit from baking soda.

  • #8792

    larry wagner
    Participant
    Ŧallars: Ŧ 5.18

    On Christmas Day I came down with respiratory flu. I’m still not completely recovered from it. Two weeks ago on a Friday I suffered a sudden attack of gout. Same location as first time. Joint of left big toe. Pain on top, bottom and side of joint. Swelling in foot. My Dr was able to see me the following Monday. I stopped taking the baking soda as you suggested prior to seeing the doctor and having the blood draw. My doctor was very helpful. He asked the lab to run the tests you suggested. He gave me the prior year results of my uric acid levels. Two weeks ago, with the attack in full swing, it was 6.6. In 2018 it was 5.1. in 2017 6.0. In 2016 5.6. In 2015 5.8. My uric acid level has never been over 7.0 (out of range) according to my doctor. That is the reason he has been okay with me using baking soda and not insisted on allopurinol. He prescribed a six day regimen of steroids. He suggested two options. I told him the anti inflammatory drugs constipated me. I did not resume the baking soda until three days into the steroids. The swelling was going down rather slowly. I have faith in the baking soda. Whenever I have had twinges in the past, an increase in the baking soda for a few days has things back to normal. To answer your questions. Uric acidity – which I believe is UA pH is 5.5.My doctor said a blood acidity result would require an arterial blood gas draw. I know from my son, who used to be a lab tech and my doctor that I would not want to undergo that due to the pain. Albumin is 4.2 and Creatinine is 1.1. eGFR AA = 79. eGFR Non-AA = 65. Protein total = 7.4. ALT = 25. AST = 26. Alk Phos = 145 (H). Bilirubin = 0.6. My blood pressure was something like 110 over 80. It has been low like this since I retired around 10 years ago. My glucose level is 110. It was 115 last year and always under 100 in prior years. UA protein = 30. At this point, 2 weeks later, I still have some discomfort in the toe, am taking my minimum amount of baking soda and am able to walk at a reduced pace for 35 minutes without stirring it up too much. Thank you, Larry

  • #8793

    nobody
    Participant
    Ŧallars: Ŧ 556.07

    So it looks like your uric acid (not acidity!) is only occasionally too high for a gout sufferer. That means allopurinol is probably not necessary (or at least not necessary yet).
    Recently, your weight loss diet with reduced carbs probably contributed to the problem but perhaps you used to have a different diet or lifestyle which gave you gout 5-10 years ago. Now that you have lost weight, it may be possible to use less dangerous remedies than allopurinol to keep your uric acid down. The most common foods people take to reduce uric acid are probably milk (or yogurt) and cherries. Avoiding meat or fish (or at least reducing the amount you eat) is also key to keeping your uric acid in check if you don’t take allopurinol.

    One urine’s acidity (not uric acid!) is more complicated than a single number out of context but a pH of 5.5 does suggest as I suspected that your diet might be deficient in minerals (specifically: calcium, magnesium, potassium). I would recommend eating more mineral-rich food such as most whole fruits and vegetables every day rather taking supplements or baking soda. It’s not uncommon for elderly folks to need to watch their urine’s acidity so you should be able to get advice from doctors and dieticians about this or your could look at food databases for yourself. A less acidic urine would help your kidneys and in particular help them to get rid of the uric acid in your system.

    Note that all the dietary tweaks I mentionned would only help over the long run by preventing gout and the damage it causes. They are not quick fixes for when you’re in pain.
    If you need to use baking soda when you’re in pain, fine. But perhaps you could also consider other anti-inflammatories than the ones which have caused you trouble. For instance (and depending on where you hurt) you could perhaps try a local (topical) anti-inflammatory rather than a pill. There’s also colchicine.

  • #8794

    larry wagner
    Participant
    Ŧallars: Ŧ 5.18

    Thank you so much for your well thought out suggestions! I will implement them and do my best to keep my uric acid under control. Do you accept donations?

  • #8795

    nobody
    Participant
    Ŧallars: Ŧ 556.07

    I don’t accept donations and I’m not sure whether Keith does. But many fine organizations such as Oxfam do if you’re feeling generous…

    Something else I neglected to mention but which may not be obvious to everyone: if you’re not taking allopurinol or an equally powerful drug, beware of alcohol. As with all these dietary tweaks, different people are sensitive to different things but alcohol is about as bad as it gets. A very small amount shouldn’t be a problem but binge drinking definitely would be.

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