[Steve Bateson]

Totally endorse all that has been said about getting your own tests and recommendations from your own doctor, but just for your reference I have been taking Allopurinol together with a ‘sporting’ dose of Aspirin for a few years now. My rheumatologist, general practitioner and trial pharmacist were not concerned about mixing the two and my latest round of blood tests have been ok.

October 2015 started 600mg aspirin daily as part of CaPP3 trial
October 2017 started 100mg Allopurinol urate 470 umol/l
Jan 2018 increased to 200mg Allopurinol at 397 umol/l
July 2019 increased to 300mg Allopurinol at 370 umol/l

Tested twice since then and recorded 299/298 umol/l with no issues on liver/kidney function. Next test due next month, Covid permitting.

To reiterate, your situation/medical history may indicate otherwise.

On a slightly different note, I’m sure I’ve seen reference to the possibility that low dose Aspirin can increase Uric acid. There’s another conundrum for you.

Steve

[Steve Bateson]

Hi Dave,
Ball of foot is certainly where it gets me the worst. Last spring it started as a lump on top of the foot and after some massage seemed to morph through and I had a large swelling underfoot for about three weeks. Can be either foot, often starts in one then travels to the other.

It was that that finally (after 9 years of random symptoms) got me a referral to a Rheumatologist who quickly determined gout was the cause.

Ultrasound showed Synovial thickening, MTP joint effusion and small erosion.
Its not confirmed, but I believe this has led to splaying of the gap between 2nd and 3rd toes that has been growing for some years.

At the moment I’m on 2oomg allopurinol daily (6 months now) and Colchicine as required. Also Vit C, H2o and cherry extract. Urate is coming down so hope to reduce the drugs in a bit.

Colchicine, Naproxen and co codamol are always close at hand.

Steve

[Steve Bateson]

Thanks Nobody,

I’m going to look up salt and mood as it never occurred to me there could be a correlation, however I think you hit the nail when you mentioned tiredness. I believe that is behind the grumpiness.

I have also just been reading Keith’s article from the current sidebar about gout triggers, and am thinking that the effort of mustering further white cells to tackle dissolving crystals may be draining my resources, so to to speak. That being the case, as I fully subscribe to the ‘lower faster’ mantra, I could be in for a painful 9 months or so based on the one month per year of build-up rule of thumb.

The 312 reading was just over a month ago and as I’ve stuck with the regime I expect the downward trend will of continued, but guess it will have to level out sometime. Is it normal to be able to reduce the allopurinol dose to a management level in time?

Steve

[Steve Bateson]

Mood swings before a gout attack?

Hello all,

Really pleased to have found Goutpal and learned a lot from what is here, both the site and the forum.

First the history

After 9 years of occaisional and repeated pain that numerous medics could not identify, this time last year I had the mother of all attacks and after much to and fro got a referral to a rheumatologist. One large array of blood tests later and I was given the diagnosis, pretty much along the lines of ‘it’s obviously gout’. Sadly not that obvious to the previous 6 or so medics that were happy to dispense Naproxen and not dig any deeper. Probably my fault for getting it in the achilles, the knees, the ankle in the ball of the foot etc, and not presenting with a throbbing big toe.

At diagnosis my urate level was 492. Not horrendously high but high enough.
10 months late after a steadyish drop the last reading was 312. We’re aiming for sub 300, so subject to variation its almost there.

This has been achieved by (in my rank of effectiveness):-
Allopurinol 200mg
Increased hydration
10kg weight loss
More exercise, mostly indoor rower
Vit C supplement 1000mg
Cherry concentrate capsules.

I’ve also been using Colchicine. 500ug daily at first, reducing to ‘on demand’ now.

Obviously I’m not in the clear by a long way, and had to hit the Colchicine again last night but it seems to have worked its magic.

Now the question.
I have noticed, retrospectively I must say, that recent attacks have been preceded by a couple of days of unexplained bad moods. Nothing specific, just a general grumpiness and malaise. If I was your puppy you’d be fetching your own stick, that kind of thing. As a result, I find myself wondering about cause and effect.
Is there something causing the change in mood that is also triggering an attack or is an impending attack from trigger(s) unknown causing the change in mood?

Does anyone else experience this sensation? I am also wondering if I could use it as an early indicator to take up the Colchicine again.

Regards

Steve

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