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Hey Mark, that’s a brilliant chart. Any readers who haven’t seen it should go to Blood UA Results.
Sorry, I should’ve responded earlier Mark, just to say thank you. I spent too long thinking about what I might add to it. But, it’s your chart, so thanks is enough.
I must add: I hope you will send updates as you continue to add more data.
Getting back to exercise. Though it seems bad that uric acid rises after hard exercise, it’s not the biggest concern. Short term increases in uric acid production usually cause short term increases in uric acid excretion. So, for most people, the net effect is minimal. In fact, I reported a study showing that, statistically, exercise lowers uric acid.
But, that’s only a pointer. On a personal level, it is important to measure uric acid excretion. Note, the excretion test is only truly valid before you start uric acid lowering treatment (including herbal medicine). Ideally, for exercise enthusiasts, you would arrange 2 tests. One day with normal activity, and one day including strenuous exercise.
The point of the tests is to get the best gout treatment for yourself. Your treatment can be improved if you are an underexcreter of uric acid. So, for the Gout Patient, you might take probenecid on exercise days. And, for the Gout Dieter, you might change some of your usual water intake to skim milk. Finally, for the Gout Herbalist, there are many natural uricosurics to choose from.
This topic is fantastic for emphasizing why gout treatment has to be personal. Exercise done in the right way, is generally beneficial to gout sufferers. But, exercise has to be managed by someone who understands gout. It’s so easy to get it wrong, if the Gout Person is not considered carefully as an individual.
Hi Pat,
Issues with uric acid meters are mostly due to the way they are used. But,quality may be a problem with some test kits.
I recommend the uasure meter. Mostly because they have excellent technical support. Or they did when I used mine. In fact, I’m happy to let you have my meter for nothing, if you pay the postage. Or, I’m more than happy to meet you. I’m in Yorkshire. Where are you?I’m not convinced that having your own meter is the best way to go. My first question is: what part does the meter play in your treatment plan?
My second question is: what is your step-by-step testing routine? ‘Prick and hope’ will not work on any brand of uric acid monitor.I mentioned that the important first step for Gout Victims is to acknowledge that untreated excess uric acid is dangerous. Coincidentally, I just found ‘Tophaceous Gout of the Knee: Revisiting MRI Patterns in 30 Patients’
That shows damaged joints, and I’ll review it as time allows. Encouragingly, there are new procedures for repairing damaged cartilage. So, I might also review ‘FDA approves first autologous cellularized scaffold for the repair of cartilage defects of the knee’Of course, it’s better to control uric acid before it damages your joints. So, any Gout Victims who want personal help to avoid damage, should start their own personal uric acid control therapy now. Start a new topic to start your recovery.
Thanks Regina, for your uric acid blood test results. They answer your headline question – yes, you do have gout. More than that, your blood pressure medication (amiloride hydrochlorothiazide 5/50) is probably the cause. Or, at least a major factor. It’s a pity your doctor is showing such ignorance of gout. But, maybe we can train her.
I’m hoping you’re experiencing no side effects with allopurinol. Professional recommendations are to start with 50 or 100mg per day. Then, increase inline with blood test results. I’m pleased to see you are getting another blood test after two weeks. That’s the perfect interval for allopurinol dose adjustment.
Hopefully, your uric acid will be safely below 5mg/dL soon. And, in the meantime, it’s good that you seem to have effective gout pain control. Once uric acid is safely below 5mg/dL, gout attacks will stop after a few weeks or months. Every gout patient has a different gout recovery time. But, the good news is that you are on the road to recovery.
Gout diet isn’t really an issue. But, if you are concerned, I can give you more feedback. It’s all about balancing your total diet in a healthy, gout-friendly way. Individual foods are only important once we’ve analyzed total diet.
What I’ve written here might raise other questions for you, Regina. Please don’t hesitate to ask for clarification of anything I write. And, please continue to post updates about your uric acid test results, and gout symptoms. I think you are well on the road to recovery. It will make me very happy when you can confirm that you are fully recovered from gout.
Incidentally, you don’t say what your replacement blood pressure medication is. Less of an issue if allopurinol is effective. I’m just nosy!
Wouldn’t it be interesting if we had statistics on why gout sufferers become Gout Victims? I guess, I’ll get some next year, as I develop that support plan more.
In this case, it looks like the doctor has not followed latest professional guidelines. Though, I’ve seen similar cases where the patient has not listened properly. Or, chosen to ignore their doctor’s advice.
So, there are many reasons for failing to control uric acid. But, I feel the most important first step, for gout victims, is to understand the dangers. Especially in this case, where it looks like ACV abuse might add to longterm health problems.
Unfortunately, Patrick, we both read about that failure to consider longterm dangers, far too often. And, the saddest part is, it’s much harder to deal with the consequences when you are older.
“I was going to contact my doctor regarding swelling and pain on my big toe base”
Regina, have you seen your doctor about this yet? Did you get the uric acid test that Patrick recommended? If so, please post the results. We need the exact number, together with the scale (usually mg/dL in the States, and mmol/L in most other countries).
Generally speaking, Richard, exercise is good for gout. But excess uric acid causes joint weakness (and other dangers).
Therefore, exercise has to be carefully managed for gout sufferers. There are general principles, such as avoiding over-exertion. And, avoid over-stressing weakened joints.
On a practical level, exercise should be managed as part of a personal uric acid control plan. Are you currently taking any uric acid control medicine (including herbal)? If not, now is the perfect time to get a uric acid excretion rate test. Talk to your doctor about it. It’s an easy test involving collecting urine output for 24 hours. It gives you more information for controlling uric acid without allopurinol.
I agree with Patrick on Furosemide/Lasix. It’s a well known gout-causing med. If you search for it in my gout search engine (top-right of every page), you get loads of info. You will also see several old discussions, including some that explain certain gout patients who have had success with a Furosemide and Losartan combination. But, that’s something that you should discuss with your doctor. My gout search engine is fueled by Google. It accepts ‘Frusimide’ as a misspelling of furosemide.
On the whole, milk should be good for gout. That’s because it lowers uric acid, as part of a gout-friendly diet. But, no single food or drink can be good for gout in isolation. Success depends on milk, or any other helpful food item, being part of a healthy balanced diet. Also, this is part of uric acid management. Which is not the same as gout pain management.
Rita, you’ve probably raised more questions than answers. But, there are perfectly logical explanations for all aspects of gout. You should keep asking for clarification about the responses you’ve been given. That way, you’ll get to understand your situation better, and learn to control your gout.
Or, you could get your doctor to change your ‘Frumiside’ for something that doesn’t cause gout.
“Also any idea what % of people get attacks when starting allopurinol and how long until they start after starting allopurinol?”
That’s not possible to answer, and even if it were, it doesn’t really help in gout management. It’s a bit like a learner driver asking what percentage of new drivers have a crash, and how soon after they pass their test.
In gout, to avoid the “crash”, be prepared with a 100% effective personal gout pain therapy. Then, you’ll never have a “gout crash” during early allopurinol treatment. And, once allopurinol gets your uric acid down to a safe level, you’ll never have another gout attack.
Boomer, don’t “assume that Iโll end up on 300Mg to bring SUA to the desired level”
A) It might be 300mg daily, or it might be a different dose.
B) Effective uric acid control does not depend on desires. It depends on a target that is safe. That’s below 5mg/dL for most people. But, personal circumstances can dictate a higher or lower target.
Also, if you’re thinking of stopping allopurinol because you think it’s causing too many gout attacks, watch Allopurinol for Gout video.
Hi Chetan,
You posted via my old gout forum. The GoutPal Helpdesk team posted your message here. They’ll be in touch with you about how you can post here yourself.
You definitely have gout. Your first gout attack can be extremely worrying. I’m here to share your worries. A gout attack needs much more than “indomethacin (3 times) for two days”.
Gout Pain Control
Indomethacin is a good component of a gout pain therapy combination. But it only works by itself for mild gout flares.Normally, I suggest colchicine as the first part of the combination. But, you are probably too late for this. Discuss it with your doctor, if you have to see him again about your gout.
Indomethacin for severe gout pain should be maximum strength. You can take indomethacin, ibuprofen, or any NSAID (Non-Steroidal Anti-Inflammatory Drug). But, never mix them. Usually gout attacks resolve in 3 to 5 days. 7 days is not unusual. Prescription strength anti-inflammatories should help you get mobile quicker. In my experience, gout pain resolves quicker if you stay active, with gentle exercise.
With severe gout attacks, you can get residual pain, even with maximum strength NSAIDs. If you have residual pain 2 hours after an NSAID dose, you should consider support from a compatible drug that blocks pain. Usually, this is acetaminophen/paracetamol. But, you must ask your doctor what is suitable for you. Be sure to tell them about all medicines you take (including herbal medicines). You want a compatible pain killer at maximum strength, which is safe in combination with other meds.
If you are not sure about your best way to control gout pain, please ask for clarification.
Vegetarian Gout
Vegetarians, statistically, have the lowest risk of gout. But, you can still get gout. Because, your body turns the plants that you eat into meat (your flesh). That’s where most uric acid comes from. If your body cannot deal with uric acid, you get gout.If you have an unhealthy vegetarian diet, you might be able to improve it. But, it’s most likely that you will need uric acid lowering medicine. How do you feel about that?
“itโs awful that an insurance company has to pay out that ridiculous cost.”
It’s much worse than that, Patrick. You are paying it in your premiums. That’s why insurance companies never kicked up a fuss about it. Conspiracy? You betcha!
Thank you Carol, for the extra information. I’m still a bit confused about your exact timeline. But, I’m going to assume that your uric acid blood test result is after you started taking allopurinol. That result shows that your uric acid in your blood is safe. But, you will still be at risk of gout flares for a few weeks. That risk will reduce as allopurinol does it’s job.
It’s great that allopurinol is working for you. Just be patient. Also, keep getting tested for uric acid at least once a year.
As I say, you should recover completely from gout in a few weeks. If you need help with gout pain during this time, please ask.
Patrick, there’s been so much debate on this over the years, I don’t know where to start. I’ll try to recap. This is from memory, so forgive me for any slight errors.
The FDA gave what is now Takeda a license for monopoly supply of colchicine, branded as Colcrys. Up to then, colchicine had never had full approval (it was called an ‘orphan drug’). This was a few years ago, and caused considerable outrage at the time.
Some people took the Canada route that Stephen describes. I also reported a legal workround through the “compounding pharmacy” route. There is also a discount scheme for low-income gout sufferers.
But, the Colcrys monopoly was only granted for 3(?) years. Generic colchicine should be available. I’ve seen reports that it is being licensed. And, I’ve asked for people to find out for me, what the situation on the ground is:
I’m hoping to get time in January to chat to friendly pharmacists in the Southern States. Also, I’m in DC for Inauguration Day (coincidence!). I’ll try find out what The Donald thinks ๐ ๐
There is a serious risk of infection. Get the tophi site dressed professionally immediately.
Then, get uric acid safe. As quickly as possible.
Let me know what your father’s doctor plans for uric acid control. Then, I can offer assistance. Hopefully, we can get him safe soon.
“is there a Doctor in the house that can answer these questions for me?”
From the footer of every page on GoutPal:
Information on GoutPal is provided by a gout patient to help you understand gout and related issues. Gout information is provided by a layman, with no medical training or qualifications. It should not be used for diagnosing or treating any health problem or disease. The information is given to help you understand your doctor’s advice and know what questions to ask. It is not a substitute for professional care. If you have an actual or suspected health problem, you should consult your doctor.
My role is to help people manage uric acid and gout safely. Primarily, I do this by helping people learn the right questions to ask their doctors. Then, I offer to help them understand their doctor’s responses. I also offer other levels of gout support. But, there is no substitute for a strong relationship with your doctor.
Ground Beef and Gout
Hi Kim,
It’s good that your son’s uric acid has fallen to 6. But, getting to 5 would be safer.
Reducing dead animal flesh will help with that. But, that’s not my main concern. Your son is well within the maximum dose of allopurinol. So, increasing to 500 or 600ย mg per day is an option. In this regard, gout is easy to manage. But other serious diseases are not so easy to prevent.
Every health authority that I have ever read warns against too much meat. Heart disease, stroke, and cancer rates are consistently reported as being higher when we eat too much meat.
It’s hard to change the habits of a lifetime. But, slow, gradual changes are often very successful. For example, I started adding increased amounts of vegetables to casseroles, ground meat dishes, etc. I also gradually introduced tasty vegetarian meals. Personally, I love macaroni cheese, and spicy Indian vegetable dishes. Everyone has their own plant-based favorites that should be encouraged.
I also realized that improvement is easier when you review your shopping before checkout. This is easiest with online shopping. Each week, change a meat item for a plant item. If that change is too rapid, try once a month.
It takes time. But, slow progress brings lasting results.
Carol, I’d love to help you more. But, I just do not have the relevant information.
You say: “blood uric acid always gives 4.3” and “urine uric acid test and gave very high: 1,200”. But, you haven’t told me what scale these results are measured in.
If I were a gambling man, I bet that your blood uric acid is actually 0.43mmol/L. If that is the case, allopurinol can reduce it to safe levels. But, You should really start with 100mg per day. Then, you can adjust dose to get uric acid to a safe level. But, this is all guesswork without accurate test results.
If you have photographs of your test results, that is very useful. You can send pictures, or other files, via the GoutPal Helpdesk. Just click the orange Gout Help button, then attach files to your message. If you cannot send photographs, please type in the lab report uric acid information carefully.
