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It’s good to welcome @lenzomaru to the gout forum.
Lennon, I’m just catching up after Easter, and I’m very please to see that you’ve started your personal gout profile at https://gout-pal.com/users/lenzomaru/profile/
The gout facts in your profile help all the gout forum contributors to make their responses relevant to you. I can see that you’ve never been tested for uric acid. I hope you get tested soon, because without it, you never know if your gout is under control or not.
For example, you’ve told us you are on a vegetarian diet. That can help some gout sufferers. If you eat less meat, you should get lower uric acid. However, it always makes me wonder what you are doing about the meat that makes up your own body. I emphasize this, because it’s so easy to get confused and eat the wrong things if you do not know your uric acid levels.
I always say that the best approach is to go vegetarian if that is what you want to do. For vegetarianism to help gout, you have to match it with your treatment plan. One problem with vegetarianism is lack of certain key nutrients. If this leads to other health problems, then those problems might make your gout worse.
If you are vegetarian or not, the key to a good gout diet is a healthy balanced diet that supplies all the nutrients you need, and just enough energy. A good vegetarian diet is usually very good for gout, but the details always matter.
Lennon, I hope you’ll share more about your vegetarian diet and your gout. Many gout sufferers are interested in controlling gout through diet. For some it’s possible, for others it’s not. I’m always looking for people to help with gout diet. If diet changes can help, they are often the healthiest way to find Gout Freedom.
My uric acid levl is 2.4 ml/dl..how is this possible..i have been on the vege diet for week and i have been off allpurinol for about 3 wks now. Wen i came off meat the following day my gout significantly inproved. What lvl of uric acid do u have to be at to get gouty symtoms..was i misdiagnosed?
Hi Lennon,
This is really interesting, but I’m surprised by that test result. What does your doctor say about it?
If it’s really 2.4 mg/dL then there are some explanations I can suggest, and we can soon work this out.
Can you give me a bit more history about when your symptoms started, when you went on allopurinol, and how much a day were you taking before you stopped.
The more information I have, the better. I’m looking forward to some more information so I can answer your questions properly. There are different explanations depending on your history, so I don’t want to confuse this by speculating until I get more facts.
I have not discussed it with my doctor yet.
I had gouty symptoms for about 2 weeks before i visited the doctor, stiffness was my worst symptom, the pain and swelling were tolerable.
I was prescribed Allopurinol (1 pill twice daily) along with an anti inflammatory for 5 days on the 19th March 2015.
After taking it all i still had gouty symptoms, (I was still consuming meat during this period, my doctor told me to stay away from pineapples and hot sauce not meat,alcohol.. etc). I decided to do some research myself and reduced my intake of meat,fish, alcohol tho im not really a drinker (2 beers in 3 months).
After about a week of swelling and pain, I went back on the allopurinol and anti inflammatory once a day for 5 days. By the end of this course i had significant improvement. I also noticed that when i cut out meat i almost felt no pain the following day. Therefore i decided to go full vege.
After being on the vege diet for a week i tested my uric acid blood level five days ago and it was 2.4mg/dl
I’m getting closer to an explanation and a plan, but still need more info.
After being on the vege diet for a week i tested my uric acid blood level five days ago and it was 2.4mg/dl
A self test or a lab test? i.e. tested with a home test meter and a finger prick, or a lab test with blood drawn from the arm, or something else?
Also, 100mg allopurinol or 300mg allopurinol?
Less important is the name and dosage of the anti-inflammatory?
Sorry for being so nosy, but if I assume the wrong facts, I won’t give good advice.
A lab test with blood from the arm, go the result back in 24hrs, it cost me $8 US
300mg allopurinol I took on both occasions
name of the anti inflammatory – dexamethasone 0.5mg , the first time i went on treatment it was 3 times a day then when i resumed taking the allopurinol a week later it was once at night. It worked quite well
………………….dont worry you’re not being nosy
Lennon, I think I’ve got the picture now, but I’m a little bit vague on the exact date you stopped allopurinol, and the exact date of the blood draw for your uric acid test. Anyway, I’m going to proceed with my theory, and you can shoot me down in flames if I’m wrong.
300mg allopurinol twice a day is a great dose, in my opinion. 800-900 is the usual maximum. 600mg per day will have a significant effect for most gout suffers. It will get usually uric acid nice and low, which is what you need to get rid of old uric acid crystals quickly.
Allopurinol lasts a long time in your system. The usual advice is to wait 2 weeks after stopping or starting to get an accurate blood test. I’m going with the theory that you still had allopurinol in your system when the blood was taken. If this is right, then your uric acid level was low enough to allow crystals to dissolve.
As they are dissolving, old crystals can sometimes cause gout attacks. This can happen even if uric acid is low. However, the attacks tend to be shorter and less painful than gout attacks when uric acid is high. Also, because the volume of old crystals is reducing, such attacks become less frequent. There is no fixed time for this process. It depends how long you had gout, and how high levels were before allopurinol.
Earlier, you asked:
What lvl of uric acid do u have to be at to get gouty symtoms..was i misdiagnosed?
If you have had untreated gout for many years, when you start allopurinol, you can still get gouty symptoms for a few weeks, even though uric acid is low. Therefore, I don’t think you were misdiagnosed, but I would need to know your blood test results at the time of your gout diagnosis to be more sure.
Anyway, I’m proceeding as if it is gout, and you are experiencing the common problem of gout attacks during the early days of uric acid lowering treatment. That’s why most doctors recommend pain control. Personally, I don’t think your steroids are the best option for this type of pain relief. You are looking at more like 5 weeks rather than 5 days. For gout patients who don’t get uric acid as low as you did, they might be looking at 5 months.
What really matters is that you understand that these symptoms happen because old crystals are dissolving. That is a good thing. The pain will not last forever.
Latest science has shown that uric acid crystals don’t cause pain by themselves. They need other chemicals to stimulate the inflammation. It’s new research, so I don’t have all the answers yet. The best estimate is that Free Fatty Acids (FFAs) are to blame. As these are common in meat, this fits in well with your experience of less symptoms on a vegetarian diet.
This leaves me wondering what you want to do next. I don’t want to suggest options at this stage, because I’m not absolutely sure if my theories fit with your exact timeline. I’ll wait and see what you think about my ideas, and then we can discuss what you want to do next.
If it’s gout, I can help. If it’s not, you need to see a rheumatologist.
Looking back at what you said, i actually tested my uric acid a week after stopping Allopurinol, so it may be the cause of the low result.
What i am planning to do is continue my vege diet wait a couple months and then retest my Uric Acid level i will also retest if my gout flares up again.
Then i would know if it is indeed gout and not some other type of arthritis…which leads me to my other question..from your knowledge..if i have another gout attack does this mean that my UA level will be high if i test?
Thank you a lot for the information and website, i actually know a lot more about gout now, after i’m done with my plan maybe i can get my dad to follow a gout management plan more seriously.
It’s good to know we’re getting somewhere, Lennon
If you test during a gout attack, uric acid levels are often artificially low. This is because some uric acid in the blood has turned to crystals, so the dissolved uric acid falls slightly. I’m not sure exactly how much, but probably around half to one point. So if you tested at 6 during a gout attack, the result a week or so later might be around 7. Anyway, it’s always best to think of a range, as uric acid fluctuates naturally during the day. That’s why gout professionals say the safe upper maximum is 5 because it might actually go to 6 at some point in the day (or 4 if you’re lucky the other way).
It’d be great to get your dad on here. If he’s not an Internet user, you could always set up an account for him, and type his messages. Lennon Roberts – worlds first Gout Secretary! I look forward to that 🙂
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