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Diet drinks are great; it’s the fructose that is the culprit in non-diet drinks. I wondered over and over what the connection could be, and after much research I discovered that fructose is part of biochemical pathway that makes uric acid from purines. No fructose, no problem! ๐
Colchicine is not an innocuous medication. It interferes with microtubules involved in cell division. See standard warning below. As to it being ‘natural’…aresenic is natural as well. The ‘natural’ label just means occurring naturally in nature; it does not mean ‘safe’.
WARNING: Colchicine can damage the bone marrow causing severe anemia, low white blood counts, and low platelets. Reduced white blood cell counts may increase the risk of infections. All patients taking colchicine long-term require monitoring of their blood counts.
So I finally had my uric acid level tested on February 4/16 and much to my delight I have gone from a level of 416 umol to 249 umol in the course of taking 300 mg daily of allopurinol since November 11/15. As I told my doctor last week what really seems to be keeping me flexible and pain free in this treatment is taking 1.6 mg daily of colchicine. I have in the past few weeks tried to abstain from taking any colchicine and then get a mild flare up, take 2 tablets of colchicine daily again and within a couple of days back to healthy. So my doctor is trying to wean me down on colchicine,which I agree with, I am not a big fan of any long term medication but my question is this, what would be the long term effect of taking daily colchicine anyways? It is an ancient, naturally derived pharmaceutical that has been used since the times of ancient Greek civilization, apparently, so would it be damaging to take a low dosage for the rest of my living days? I understand that it reduces your white blood cell count and not a whole lot is known about it. I am very thankful that I don’t live in the U.S. as what the FDA has allowed to happen to this very effective treatment is criminal, to say the least.
Robert: I might add here that weight loss can also raise your uric acid levels and cause flares. Allopurinol is often given prophylactically when patients are in an accelerated weight loss program. So you are in a catch-22 place….She says you must lose weight before you go on medication, but the simple act of losing weight will make you more likely to flare, and then you can’t exercise…and round and round we go.
Keith: I was diagnosed with gout in June of last year, with a UA of 10.9, sed rate 79. DIP joint in my hand, but in retrospect, I probably had at least two flares earlier. One in the classic big toe maybe six years ago, one in a foot a year later following surgery on the other big toe,x and in a knee one year ago. Started allopurinol in June, last UA was 6.0 in December. My rheumy targets 6.0 and doesn’t feel the side effects of most medications warrant shooting for 4 type levels. As I get an annoying skin rash from allopurinol, I concur. Started at 50mg/day, then 100, then 150, then up to 200 by late August. UA at that time was 7.9.
I had a lot of flares over the past summer as I ramped up the allopurinol. Right ankle/foot three times, left ankle/foot once. Treated with 30mg Predisone for a week, then taper. Relief was considerable in every case after about 5 hours. Just had a flare last week in a middle toe, but it was relatively minimal. This was the first flare since August, so I was ‘flare-free’ for 5 months on allopurinol. I take 400mg of Celebrex daily for OA, and that was enough for my toe so I could walk; didn’t need Predisone.. I can’t take colchicine..GI symptoms are horrible.
Almost forgot..started probenecid 1/2 tab at the beginning of January, ramped up to one tab after two weeks. The toe flare occurred after I was taking the combined allopurinol 100 mg, probenecid one tab for two weeks. My worry is that the action of probenecid isn’t enough to stay ahead of my production of purines.I wouldn’t have changed medications except that I’ve lost half my hair since I started on allopurinol last July. It’s a known side effect, but still rare. Lucky me…
After a long conversation with the doc, she gave me another run of indomethacin which seems to be working now. I will start the allopurinol once this run is done and now I have colchicine should a flare occur once this has passed.
My gout pain is 90% better. My foot still feels like it was wounded, but no pain and the swelling is down considerably. I have an appointment with a rheumatologist, but March 9th was as early as they could see me. Evidently, rheumatology is a good business to be in now.
I’m going in for a renal panel and liver function test as soon as this flare is gone and things are back to an even keel. Also, because I was walking awkwardly on my foot, tendinitis cropped up at my Achilles insertion on my heel. Ice and rest are helping that as well but, geez, come on.
I’m gonna get this thing by the neck one way or the other. It’s hard to describe to those who don’t know, the impact this has on every aspect of your life.
How much prednisone were you taking? My doc always has me take 30 mg/day for 7 days, then taper. I usually have significant relief (as in I can walk) in about 6 hours.
Just took my last dose of prednisone in this run. Didn’t touch it. I let the doc know and she called in a scrip for colchicine. Never had it but I read some good reports. If this doesn’t cut it then off to a specialist. I took your advice and started the allopurinol right away but the doctor still swears that’s a bad idea. I read the link you posted about it being fine to do, but that doesn’t seem to be the popular notion around here. I’m a little discouraged given the amount of pain I’m still in.
I have had similar problems with my GP. My gout first started in the classic place, the big toe. Uric acid was normal, so he prescribed surgery for bone spurs. Next attack, middle finger. He said it was cellulitis. Gave me antibiotics and sent me to a hand surgeon to look at the ‘mucous cysts’ in that finger. The surgeon took one look, said, ‘that’s gout’ and sent me for lab tests where my uric acid was found to be 10.9. I think gout is too complex an illness for the average run of the mill GP. If I were you, I would make an appointment with a rheumatologist ASAP. You need to be under the care of a physician who understands gout.
Because of hair loss from allopurinol, my rheumy decreased my allopurinol dosage and made up the difference with probenecid. As a result I’m now having my first flare in six months. Is anyone else on this combination therapy? Is it less effective than a higher dose of allopurinol?
I have been an infrequent gout sufferer since 2011. The past two years attacks have become more frequent. I have been dealing with near constant flares since the end of November. These have been treated with either indocine or prednisone with good results until the meds are gone. Yesterday the doc gave me another prednisone burst with a graduated allopurinol program to follow the treatment of the current flare. (Uric acid levels are currently 7.5) allopurinol treatment starts at 100mg a day for a week followed by 200mg a week then topping out at 300mg a week. Is the graduated program to try to lessen the likelihood of causing another dramatic flare? I didn’t ask her because I hadn’t researched the drug much but I haven’t seen anyone describe such a method in my couple hours of surfing.
Hi Keith,
Thank you so much for your reply and sorry for my essay! ๐
I went back to the doctors today and she again said that he result was what she considered normal – I pushed for the print out of the results which she in the end gave me..Ok so the rate was .24mmol/L (0.12-0.38)
Not sure what the numbers in brackets were about but they were next to the result?
So using your conversion that is 4.03.
The only thing is this was taken back in October and was just after/during a flare was settling down. So I know this can effect things..
The doctor today told me to only take indomethacin if I feel the pain..?
Thanks Keith ๐ Awaiting your reply from Australia!
Hi,
I was told by a doctor 4 months ago that is likely the pain and sudden flares in my toe were likely gout and was put on indomethacin to help the flare. I am 25 not over weight and do not drink a large amount so he sent me on my way.. The Indomethacin did help but only to control the flare and then the pain was back once the tablets stopped.
After xrays and unltrasounds which did not show a break etc and a blood test with normal results ( this blood test was taken a week after the flare started however stiffness etc was still present).
After another bad attack when I was away on holiday in November ( drinking a little more than normal) I went to a foot specialist/surgeon and she agreed also it sounded exactly like gout and that I was to be put on allopurinol – I have since started this at 300mg a day.
I have now been on Allopurinol just coming up 6 weeks and have also been taking indomethacin when I have felt pain/flare.Diet wise I have not had a drop of alcohol for 2 weeks and even before that it was nothing in high amounts. I have given up red meat,shellfish and I am on a veggie diet 80% of the week. Cheery active I have been taking and lots of water!
By reading this forum I understand that the pain is old deposits dissolving? But I was wondering whether anyone could give me any guidance on how long these flares will continue for and also should I be taking indomenthacin constantly to prevent the pain or when I feel pain to stop it? I feel a little concerned about taking the indomethacin for long periods of time.
I did try to make a gout profile but the activation email hasn’t seem to of come through :S
If anyone could give me any guidance! I am getting married in 7 weeks and do not want to be in pain![originally posted by lapsed member, francesca searle]
