Forum Replies Created
-
Posts
-
Tavery said:
I am going to take a strongly worded stance to reiterate Goutpal's comments.
Actually, zip2play's comments, but I agree wholeheartedly with everything that zip2play and Tavery has said here.
Allopurinol is the way to go, but always make sure you are getting uric acid tests to back it up. There have been many gout patients reporting allopurinol without any checks to see if it is correctly lowering uric acid levels. This trend of medication by guesswork must be avoided!
I second zip2play's call for alkalizing the urine – and more fruit and veg is definitely the best way to go. I have some lists of alkalizing food, though to be honest, it is well past the time for these to be redone with values per 100 calories rather than 100 grams.
15 years allopurinol without a uric acid test!!!
The world's gone mad.
It is a garbage product marketed by peole who haven't got the first clue about nutrition.
Anyone wasting their money on this type of stuff deserves the gout attack from hell.
GoutPal said:
Uloric (febuxostat) has it's own set of side-effects (I'll report these in a few minutes).
And slightly more than a few minutes later we have febuxostat side effects. These are from Adenuric authorization trials, but both Adenuric and Uloric are the same thing – febuxostat sold under different brands.
yes, I am drinking lots of pineapple juice right now. I get gout attacks alot during unstable weather and this summer has been pretty bad. Pineapple juice as well as an apple cider vinegar concoction (8 ounces of water mixed with two tblsp of apple cider vinegar) seem to really help although this morning nothing seems to work.
Argelia said:
Please help me!. I have taken Allopurinol 300mg for two years without any gout attacks.
Never mind the gout attacks – what about the uric acid levels?
I stopped the drug last Sunday and will see my doctor on Thursday. I have too many symptoms that are destroying the quality of my life and I am afraid of developing the Stevens-Johnson syndrome.
Why, after 2 years, do you attribute your symptoms to allopurinol, and why on earth would this develop into SJS?
I am suffering from insomnia, skin tone changes (darker and lighter spots, alopecia, skin rashes, liver spots, dizziness, short memory reduction, fatigue, and high blood pressure.
Similar symptoms are caused by too much Internet surfing
The drug for HBP interacts with Allopurinol.
HPB? High blood pressure? Which drug – there are many. Have you just changed to a new drug?
Has someone changed their UA levels through diet, exercising and drinking cherry juice?
Diet and exercise can certainly affect uric acid levels – both up and down. A reduction in uric acid through a properly managed diet and exercise program is certainly achievable – but it is only meaningful if the gout is caused by bad diet and poor exercise. For hereditary causes, drug interaction causes etc, it has limited benefit.
Does Iloric produce similar side effects?
Uloric (febuxostat) has it's own set of side-effects (I'll report these in a few minutes).
Allopurinol has a proven safety record, and febuxostat (marketed as Adenuric or Uloric) appears well tolerated in trials. Both will definitely lower uric acid, which can produce it's own short term problems, though none anywhere near as serious as the problems caused by excess uric acid. Both drugs also have interactions with other drugs. All drugs have interactions with food that affects the liver – especially fruits like grapefruit and pomegranate.
Marty said:
I am on a daily dose of Uloric 80mg. Allapuronal did nothing for me and I don't think the Uloric is doing any good either.
Do you understand that both these drugs take weeks, if not months, to have any effect?
They will do nothing for your pain immediately, in fact both Uloric (febuxostat) and allopurinol can cause gout flares before they get rid of all the old uric acid crystals. They will only work if the dose is high enough to reduce uric acid in the blood below 6mg/dL. Anyone prescribing these drugs must know that they must also prescribe pain relief to cover the occasional gout flare.
Probenecid is good for under-excreters, but allopurinol and febuxostat work for both over-producers and under-excreters. If they don't work either they are not being taken properly, or it aint gout.
2 extremely serious issues here, John:
- Allopurinol is not a painkiller. It helps regulate uric acid, but only if you check your uric acid NUMBERS. High / normal / low uric acid assessments are completely meaningless for the gout patient. You must know your uric acid number and keep it below 6mg/dL. If you only take enough allopurinol to let the number swing in the 6 to 8 range, you are forced into a cycle of perpetual gout attacks. Are you certain that the dose from your MD is enough to lower your uric acid below 6mg/dL?
- If gout has failed to respond to proper daily use of allopurinol, there is a strong chance that it is not gout. You should be referred to a rheumatologist to test for pseudo-gout and other conditions that are commonly confused with gout.
I have never been able to stay on this drug, Allpurinol
Just never works, I can't move at all wiith it, so even if it hurts worse at first after even 2 weeks and you can't go to work thats not helping you at all.
How would you pay for the medication let alone keep a physically active trade job?LOL
You have to try to eliminate the problem not band aid it with drugs IF possible.
I have had uric acid blood tests for years and it never shows high counts according to my MD.
They have checked not running an attack and with running an attack.
My MD last commented wow is your system ever touchy to small amount of anything.
I had gout recently for over a month, a couple months ago till I completely cut off a bunch of stuff like peanut butter,fibre rich bread, eggs, bacon, mushrooms, any red meat period.
My colchicine or indomethancin wouldn't even touch it.
Thou on the first yellow pills they have cut me down to 2 per day now.
That won't dislodge a bad attack.
Indomethacin killed the pain
But it isn't good for you either really.
Now still good going on two weeks no gout ..so far I will see if gout tries to go around my change in eating and tag something else. The body can be like that.
Its very difficult to say specifically what works or doesn't work…as everybodies body can and does react differently to various foods their associated additives or lack of.
Just like some people can absorb different vitiamins more or less than another person.
If anyone applies for this, or if you have been involved in any gout medication trial, please share your experiences.
5.4 to 6 will dissolve any old crystals, as long as you don't get too cold.
As your feet are affected, it's fairly easy to keep the (not too tight) socks on.
To me, the whole point of taking allopurinol is to live a normal life.
The body keeps producing uric acid at whatever is the normal rate for your genetic make-up. The kidneys keep getting rid of it at whatever is their normal functioning rate.
These rates can be varied slightly by what you eat and drink. Assuming your normal diet is a healthy one – i.e. nutritionally balanced to your energy requirements and with adequate vitamins and minerals – then you should aim to adjust your dose to a normal diet.
The days of regarding a meal consisting entirely of animal protein as normal are probably over, but this is unhealthy for many reasons besides gout. Sushi is probably a good example of this – a sushi meal might be very high in fish, but a more normal sushi meal would be balanced with rice and vegetables.
You mention a uric acid level below 6 for 6 months, but what you really need is a uric acid level of 6, or just below, for the rest of your life. I'm not sure if you are trying to this through allopurinol or lifestyle changes.
I'm sorry, this is just a list of generalizations really, as I'm not clear what your goals are.
On allopurinol, you should not need to restrict your diet to the point where you crave for anything. However, if the craving is for something outside the realms of “normal healthy diet”, then that is a different discussion.
Lowering uric acid depends on setting a target.
Before I discuss that, the background is that there are 3 phases to urate lowering therapy:
- Titration – gradually increase medication to achieve target uric acid level.
- Urate dissolving – this lasts until you have gone six months at target level without a gout attack.
- Maintenance – relax dose to maintain at 5.5 – 6 mg/dL forever. In some cases, with dramatic diet and lifestyle improvements, this might be zero dosage.
The target really depends on how long you have had gout, whether or not you have tophi, and how effective the uric acid lowering medicine is.
If you have tophi, or have had gout for a few years, it is good to opt for a low target. Hershfield reckons 2 is safe. 3 or 4 might be more easily achieved. The point is that the lower you get it, the quicker you dissolve old crystals. You'll hate me for saying it, but triggering an attack is not the issue – it's all about getting rid of crystals as soon as you can, to reduce the risk of bone and tendon damage.
If you have only had gout for a few months, it may not be necessary to go for such a low target – around 5 is probably OK.
cjeezy said:
I would suppose UA below 5 would quickly dissolve crystals and allow anyone to eat or drink just about anything.
That's the beauty of lowering uric acid – it is not a true cure, but an effective treatment. It allows you to live life and forget gout.
Never explain – just say it's a sporting injury
.It would be a good idea to see the doc about something to help lower the uric acid whilst you improve your diet. Weight loss is a notorious producer of uric acid. Taking allopurinol or similar uric acid reducing treatment can help balance this, as well as kickstart the process of dissolving old urate crystals. Once you've lost sufficient weight, you may be able to cut out (or at least cut back) the medication. This will help prevent any further tissue damage.
Hi cjeezy,
I did get the light headedness side effect, and I also noted out of balance at times while I was walking. Like you suit smoking, which drives you to think and confuse what could be the cause, I also had started taking Tenormine – BP reducing medicine for the first time in my life. The high doses of Mortin caused high BP, to counter which I was advised to take Tenormine 25 mg twice a day.
The doctor said Tenormine is more likely a cause. The dose was reduced to 25 mg( That I understand is the minimum dose) in the night only. I am an anxious character and get nerveous too fast by presuming too many things. The interesting thing to note is that with 2 times BP medication, my BP was showing in 140-145 and 90-95. With one dose at night, it now shows 125-130 and 80-85( and I do have white collar BP syndrome). The doctor has already told me to withdraw Tenormine over next 2-3 weeks time.
The things are better as of now though there are still occasions when drowsiness, lethargy show up but to lesser extent now.
To summarize, there may be other factors than the Allopurinol only to cause some of these side effects, including nerveousness.
UTubelite
When I was getting the side effects, I talked to my doctor and showed him twice in 3 weeks time. He gave me an anti-anxiety medicine and that helped me. I am still taking it. He said a lot of time, the breathlessness and light headedness( which I got one day when I got up from the chair and I have to hold on to the wall to stand straight…as I had also started taking BP medication just weeks back, it was not clear what caused it) is due to anxiety of mind thinking into possible side effects. I would also see my eyes in the mirror to see if they were getting yellow.
So, seeing my anxious nature and to put the things in better prospective, after 4 weeks of Allopurinol and Colchicine, the doctor ordered labs for Liver and Kidney enzymes . Every thing came out OK. Before the Allopurinol, he tested me for Liver, Kideny and a lot of other tests including iron, other minerals, vitamin levels etc…..all of them were OK.
I think, most medications do cause transitionary side effects, which we have to live through unless some of them are disruptive enough. Doctor can best address them and advise.
UTubelite
GoutPal said:
Good to see, from UTubelite, that the fatigue side-effect seems to reduce in time.
I cannot find any serious research in this area – presumably because the state of mild fatigue is not debilitating enough to justify investigation.
One possible explanation is that, as uric acid crystals are dissolving, your immune system is hard at work fighting a widespread outbreak of old urate deposits. Though this may not be concentrated in a small enough area to trigger a gout flare, but might be enough to cause fatigue – or am I the only one to have occasionally felt totally knackered during a mild gout attack?
The sensible approach is to have a word with your doctor. He may be able to run tests to look for obvious causes – anemia? (clearly, I'm clutching at straws here)
Good to see, from UTubelite, that the fatigue side-effect seems to reduce in time.
I cannot find any serious research in this area – presumably because the state of mild fatigue is not debilitating enough to justify investigation.
One possible explanation is that, as uric acid crystals are dissolving, your immune system is hard at work fighting a widespread outbreak of old urate deposits. Though this may not be concentrated in a small enough area to trigger a gout flare, but might be enough to cause fatigue – or am I the only one to have occasionally felt totally knackered during a mild gout attack?
The sensible approach is to have a word with your doctor. He may be able to run tests to look for obvious causes – anemia? (clearly, I'm clutching at straws here)
Yes, I felt side effects when my doctor put me on 300 mg on day 1. I was fatigued with very less energy. I reduced it to 150 mg from day 2 and continued for appox 4 weeks. Then I increased it to 200 mg for last 2 weeks. I have been taking it for appox 6 weeks now. Last reading of Uric acid was 6.3 in the afternoon test after 1 week of 200 mg. I am getting it tested again tomorrow to see if the value is above 6.0 and if the dose should be increased to 300 mg.
On some days, I feel very lethargic and drowsiness, which continues for few hours at times. I am unable to link it to anything, it just happens occasionally. In the begining, there were many days when I have symptoms of flu, malaise etc. but then the nody probably got adjusted to it.
I did feel mild breathlessness couple of times and more exertion while climbing stairs as compared to before. I also felt stomach aches on couple of days. But I think the body is getting adjusted to it and now I feel less lethargic.
99% certain it is gout.
Like me, my sister's husband has gout, and my nephew got it in his 20's. Sounds like you are genetically programmed for gout, and your diet just brought it on sooner.
Get your uric acid measured and, if necessary reduce it below 6mg/dL
The authors of “Effect of Marijuana Smoking on Blood Chemistry and Serum Biogenic Amines Concentrations in Humans” report:
The concentrations of serum creatine, phosphate, urea nitrogen, triglyceride, choline, uric acid, serum aspartate transaminase, serum glutamate transaminase and alkaline phosphatase activities of the marijuana addicts were significantly higher
Did anyone try Personal Labs? They charge $ 20 for uric acid test without any prescription and provide online results.
I am not sure about the accuracy of the test we do at home as the results can dramatically vary, brining more confusion than helping.
This is as good a place as any to vent.
It is unfortunate, but your joints will be packed with uric acid crystals, and as these dissolve, they can bring about the type of gout flare you are experiencing. See Allopurinol Medication: The Gout Cure That Can Hurt.
The only good news is that the attacks will get less intense and less frequent, as long as you keep your urc acid level below 6. The only way to speed up this process is to increase the allopurinol to make the uric acid crystals dissolve faster.
Hang in there – it will get better.
Excellent points, zip2play, and ones which strike at the heart of what I see as a chance to improve the management of gout.
At the moment, most gout sufferers are offered 2 choices – go on a restrictive diet and lose weight, or face a daily pill for the rest of your life.
The psychology makes the gout patient:
- Think his gout is avoidable by diet (which it often isn't).
- Think medication is poor second choice to lifestyle changes, and it's all his fault (when in many cases it is simply genetics).
I am not suggesting that better diet and more excercise is a bad thing, just that they might not work, and even if they do, it is much better to offer a third choice – support the lifestyle improvement with uric acid reducing treatment for as long as necessary.
As you say, it might be possible to reduce medication to zero. If not, the patient has a much lower exposure to the dangers of uric acid. Lifestyle improvements supported by uric acid reducing drugs is a win-win strategy that should be the first choice for managing gout. We now have to convince the world.
By the way, if anyone has seen this strategy proposed or supported by any health authority, please post details here.
I actually got gout in college while playing college football, (high protein diet) the morons thought it was a bad case of turf toe and I played a half a season on it in abject pain. it travelled to my knee and I ruined the joint by playing on it. I still play but it sucks that nobody caught it in time.
Btw I learned something you all may find valuable. if I drink Orange and Pinapple juice each morning and evening It really helps. I tried not drinking anything other than lots of water and honestly I had the longest attack I have ever had, after almost 2 weeks I drank some OJ and felt way better.
I may go on the allopurinol just because the attacks are ridiculous now.
When I started with 300 mg, on the day 1, I felt very lathargic, with flu type feeling. It was a weekend so I reduced my dose to 150 mg next day. That worked better but somedays, I still got some itching(minor) and some dizziness ( which could be due to BP medication that was started due to Mortin induced BP). Anyway, over a period of time, I got adjusted to it and for last one month I am taking it now with dose increased to 200 mg for last one week. I know for sure that some days, I get anxious and that makes me feel many vague symptoms that go away after some time.
I guess, these symptoms may go away but doctor is the best judge.
I cannot find anything to specifically link Avelox (moxifloxacin) with gout or elevated uric acid levels, but a bout of pneumonia is certainly enough.
Pneumonia can induce hypoxia (lack of oxygen in the blood) and acidosis (lowered pH), both of which are strongly associated with gout. If you couple this with rapid weight loss and dehydration, it is almost guaranteed to result in gout.
On the contrary, allopurinol can significantly improve kidney disease.
Hi Muzz. Hope you don't mind me moving your post hear, but the “Lingering Gout Symptoms” thread is getting rather long, and your post adds issues worthy of their own discussion.
I'll waffle on a bit until zip2play comes in with some succinct one-liners.
On the colchicine, what sort of dose did you take?) It seems to work well – to the point that if it doesn't, there is a suspicion that something other than gout is at work.
Have you had a gout diagnosis confirmed by analysis of the joint fluid? Goutlike symptoms can be caused by other crystals, e.g. calcium crystals in pseudo gout, and by other invaders as in septic arthritis.
If it's definitely gout, then uric acid control is the only answer. Allopurinol should allow a few beers, though there is strong evidence that a switch to wine is better for gout.
Yes, Gouty = Shiny