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Got it, thank you very much ‘nobody’ and Keith!
Have gone up to 150mg, will let doctor know when I show him blood test results.
I have finally had kidney and liver function test done after 7 months on 100mg Allupurinol daily. My doctor is very laid back about it all so any interpretations much appreciated.
Creatinine 0.73 mg/dL (Has been similarly low in last 10 years of blood tests before taking Allupurinol)
Uric Acid 5.94 mg/dL
AST 25 U/L
ALT 23 U/L
C reactive protein 0.42 mg/dL. (Between 0.1 and 0.2 mg/dL in last 10 years of blood tests so has gone up since taking Allupurinol but still within limit.)
e-GFR 105 mL/min
Thanks in advance
The doctors draw a blank on the neck glands.
After the low carb diet when right big toe started throbbing, uric acid was found to be slightly raised – 0.46 mmol/L. At the same time I noticed my right hip had lost some flexibility which was weird. Then over the next weeks an ankle would ache, then a knee, then an elbow, once my jaw, then elbow other side then knee other side. I had a phase of getting bursitis of the knee if I ran or played football. Wrists would sometimes ache lightly. Now, 6 years on, all these places ache mildly and symmetrically except for my jaw which doesn’t. There has never been any redness or obvious inflammation although I feel tender knuckles if I knock on a door or painful knees if I kneel down for too long. Then, 7 months ago I tried Allupurinol at 100mg per day. Got my first proper gout attack a few weeks ago in the midst of decently low uric acid of 4.7 mg/dl and pains seem to have subsided all over. I found it all very confusing and wrote on this great forum.
My kidney stone was 5mm Calcium Oxalate Monohydrate.
I will get a kidney and liver function blood test.
Thanks very much for the guidance Keith.
Wine is very cheap here… but I take your point.
Great to hear from people like yourself who have been there, done it and de-mystified it.
The doctors and specialists acted baffled about the migratory joint pains.
They have a knack of hearing the first thing you say – throbbing right toe – and ignore the rest. Having insisted with them it seems they consider the migratory pains not typical of gout but I can see on this forum that it is a possible symptom.
The swollen neck glands for 2 years don’t seem to be though.
I can get Uric acid tested monthly at my local chemist and in the last 4 months it has actually been consistently below 5 mg/dL – low enough to think I was over it but then… the big attack came a couple of weeks ago and I will stay on it as you and others recommend for at least a year. I found it hard to come to terms with the fact that a normal looking toe would suddenly become so red and swollen as something that was there all along breaks down but your last point clarifies this too.
Very grateful for your reply.
I suppose the confusing thing for me was whether to take Allupurinol at all because my migratory joint pains were not typical of gout and my uric acid levels were moderate – apart from that stabbing pain in the right toe. Specialists put it down to arthritis wear-and-tear which to me is crazy as the pain would move round my body – even in my jaw one morning – and I’m not a great talker…
Having started on allupurinol, that recent ‘proper’ gout attack seems to be telling me something.
I forgot to mention that I had very low Vit D and moved to a warmer country a year ago to get away from those British grey skies – this is why I have little medical back-up here. In fact, I have not had kidney or liver function checked since starting Allupurinol (although no rash or obvious problems with it) because every blood test is expensive here and I have not found work yet.
So, yes, it is hotter here and I don’t drink enough water and must work harder on that.
All the best
Thanks Jean. I also managed to control purine levels with a vegetarian diet but found it hard to stick to it in Italy where vegetarians are seen as almost crazy…
The problem with the standard medical definition of OA to me is that, if what I have is just OA, it happened so suddenly and was migratory like an entity attacking different parts of my body.
Please let me know how your scan goes.
Thanks for the advice, I will get a liver and kidney test done by my doctor in that case. The problem is I am temporarily living abroad and am not fully registered here.
All tests are very pricey.
The chemist uses what looks like a centrifuge-type machine.
One thing I forgot to mention is that soon after developing mild gout, I developed some kind of auto-immune response. I have had swollen glands in my neck for 2 years now but causes are unknown. (I even developed a hard bony lump above my right ear but it strangely disappeared within a week!)
The doctor seems a bit unorthodox. Apart from prescribing me Allupurinol ‘as and when,’ he has prescribed me Salazopyrin (which I have not tried by the way) to see if it relieves my symptoms. In which case it would indicate to him that I do have RA.
In reply to earlier question, Naproxen is quite effective if I take it before going on a longish walk or going swimming to reduce potential pain.
Would pseudo gout respond to Allupurinol?
I suppose uric acid levels would go down if anyone took Allupurinol whether they had gout or not.
(I note that 33% of people with RA do not have it show up on blood tests.)
The rheumatologist suggests drawing fluid from the knee joints if they inflame visually or are red in appearance which they are not.
For these reasons the medical profession are inclined to label it OA which to me seemed absurd as it all started suddenly 8 days after starting a low carb diet and the pain was so migratory at first that ‘wear and tear’ was conceptually ridiculous.
I can confirm that the last 3 monthly uric acid levels are all around 3.5mg. (My local chemist provides the service at 6 Euros per test.)
I wondered if 100mg was enough to actually remove crystals from joints as I had understood it to be only a beginner’s dose to see whether one can tolerate it. I will carry on with 100mg then, thank you!
To be honest, I have a doctor who told me to try Allupurinol only if I had eaten richly that day. As I had never heard of using it ‘as and when’ I decided to take 100mg daily.
I have not had any liver or kidney tests since starting Allupurinol about 4 months ago but have no allergic reactions.
Thanks for the answers.
My uric acid was 8mg.dL in 09/17, it has gone down to mid 3s in the last few months after taking 100mg Allupurinol daily and severity of pain has lessened. I find that my toe starts lightly throbbing if I stop taking Allupiurinol. The rheumatologist found me to be negative to RA in blood tests and said to return to him if I get visible inflammation. I don’t have visible inflammation nor redness and yet knocking on a door makes my knuckles ache and kneeling is tender and can cause bursitis. All quite strange. I would like to try going up to 200mg Allupurinol to see if it helps lessen the pain further but uric acid levels are good now so I am not sure whether to try it or not.
Mystery Moving Gout with Strange Symptoms
I saw this fantastic website and wondered if I could ask a question please.
I am a 54 year old man.
Nearly 6 years ago I went on a low carb. diet and within 8 days developed gout.
My big toe became painful and the doctor found slightly raised uric acid.
(A low carb diet meant I had eaten more protein.)
I had never had any joint pains in my life before this time.
A scan showed a 5mm kidney stone – Calcium Oxalate Monohydrate which is not gout related – now passed.
My questions to you are because my symptoms are not mentioned, as far as I am aware, under normal gout descriptions.
I had migratory joint pains which would travel round my body. One morning my jaw would feel like it had been punched, another day my left elbow. I have not heard of this moving type of pain with gout. Is that normal please?
Also, I believe gout to be intense attacks for 3-5 few days at a time, whereas I have continuous low level pain day after day. Is that normal?
I briefly have joint stiffness every morning.
The doctor gave me Naproxen, and sent me to a rheumatologist who found no signs of rheumatism.
Now, almost 6 years later, the pains are still low level but not migratory and in 12 joints – quite disconcerting.
What I am asking is does this fit in with gout or is it something else in your opinion?
I get a lower level of joint pain, never excruciating but debilitating.
My feet often feel freezing cold when sitting still.
A long walk leads to bursitis and burning pain in the ankles.
All these symptoms came from nothing is my point.
Also, I don’t drink alcohol or eat organ meats.
I haven’t seen these generalised symptoms being linked to gout but my toe aches again if I eat meat protein e.g 2-3 times a day.
I would really appreciate your thoughts.