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i’m a 33 year old male 275 lb with fatty liver .About 3 years ago i had the swollen toe. I took ibuprofen and it went away. About 1 month ago i went on a strict diet (gym, no fried foods, junk foods, sodas etc.) . i was doing very well until i decided to treat my self for good behavior. i had an excessive amount of mexican food plus dessert. 1-2 days later i felt my body in a weird state. My bones were hurting. Tingling in almost all joints and my feet hurt a little. My big toes looked a little fatter/swollen but no reddning. I felt stinging in almost my joints. i woke up one day noticed a small tophi looking thing on my left big toe. looked like a small white patch on next to the nail. i found it weird because i never felt pain in that toe just a stinging once or twice for about 1-2 mins. i went to my doctor 3 days later. Got blood test my uric acid was 4.6 m ..He said that he dose’nt see any indications of gout and that i do’nt have that. i explained all the pains and he insisted that it wasnt gout. Two days later i noticed a small white marble shaped ball on the tip of my elbow..this got me worried. No pain what so ever. I also noticed some of my toes with a white color next to the joints.which felt alittle numb. I am worried.i was still on my strict diet throughout the whole thing. I lost a few pounds but still feel stinging in my joints. I want to know what is happening to me. I bought a uric acid meter and every reading was from 3.4-5.9 mg throughtout the whole incident. I read almost everything on this site and my question is does tophi grow so fast and silent like that? Is the stinging with no redding or pain gout like? Did losing weight so fast give me tophaceous gout? help i dont want to any more tophi to form.
4.6 is a little low, but it does not rule gout out, as levels drop during and immediately after a gout attack.
The most sensible thing you can do is consult a rheumatologist and get those lumps tested. If they contain uric acid crystals, that will be an immediate confirmation that you do have gout, and you can easily get treatment for it.
Also, I should have answered your subsidiary question. Yes, tophaceous gout can occur silently. Uric acid crystals usually grow very slowly, and not everyone gets the gout pain, especially in early years.
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