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Keith Taylor (GoutPal Admin)Participant
Look up.
No, look up a bit more (this page, not your ceiling)
Under 'Reference', seek out Uric Acid Levels, and all your liters, litres and moley conversions will be revealed.
Yes, it's 8.74mg/dL and a little bit.
More importantly, it's a long way above the .35 mmol/L that you need. Go to the chemist now.
Do not see this as a big scary decision on tablets for the rest of your life. Celebrate the fact that the problems you've suffered for about one third of your life will cease to be a burden for the coming decades.
Keith Taylor (GoutPal Admin)Participantsirlimpsalot said:
Are past mystery aches, high uric acid and PODAGRA a sure sign of gout? My joint fluid test came backe “inconclusive” which I think means they lost the results or didn't get them in time for my appointment. The doctor left the room after his statement of “inconcusive” and said “actually it looks like you have garden variety gout.” So I am still not 100% sure.
Also, if anyone could give advice on my earlier post “Gout since July” I would really appreciate it.
Thanks
There's nothing like a good doctor to boost one's faith in the medical profession, and this one is …
Who did your joint fluid test?
I think you have to proceed on the basis that this is gout, and get that uric acid number down.
Keith Taylor (GoutPal Admin)Participantsirlimpsalot said:
Post edited 11:32 pm – October 28, 2009 by sirlimpsalot
My first uric acid reading was 9.4 and the last time it was checked it had been lowered (with Allopurinol which I have taken religiously for over a month – 200mg) to 6.3. …
I am wondering if I am hovering at some place where deposits are being mad and dissolving explaining the constant pain.
At 6.3, I fear you are in exactly that hideous place. I'd seriously consider a phone call to the doc with a view to increasing to 300mg.
This will not do much immediately for the pain, but it should get your uric acid down to a level where this stage of your treatment (dissolving old uric acid crystals) is over quicker.
It is hard to form an exact opinion on the colchicine issue, but my bet is that you are in that place where uric acid crystals are partially dissolving, and possibly reforming, so the pain becomes almost continuous, and too much for the colchicine to counteract. I can only suggest another discussion with your doctor about alternative pain relief.
Please try and stay positive. If you can get your uric acid levels down to the point where most of the crystals dissolve, then you will get into the pain free phase.
Can I finish on a completely “off topic” note, and congratulate you on winning this weeks best user name competition (no prizes – just the warm glow of recognition).
Keith Taylor (GoutPal Admin)ParticipantIf your only affected joint is one elbow, it is not likely to be gout. Do you have a history of other gout problems? You really need a joint fluid test to get a proper diagnosis (usually from a rheumatologist)
I am not in a position to advise you about ibuprofen dosage, but could you perhaps discuss it with a pharmacist?
I can understand the psychological problem of 'lifetime of medication', but if you do have gout, I would much rather see you accept a daily dose than spend your golden years as a cripple.
Keith Taylor (GoutPal Admin)ParticipantHi everyone….
thanks for reply. i myself worked out (8.74) like nokka. but i was not sure about it so thought to ask you all.
i didn't quite understand zip, what do you mean by something is wrong? i double checked on the paper that doctor gave me and it is written in nice and clear hand writtings (for change…!) mmol/l. yes, i am in UK (Kent)
Trev, are you suggesting me to go back to my doctor and ask him for 100mg allopurinal instead of 300? or take 300mg for time being and go for blood test in about 6months time and ask him to decrease the dose? i still haven't bought the medication yet and wouldn't buy until i finalise everything.
it is scary isn't it trev (having to go on AP at this age….)
confused as anything…
hoping to hear from you all.
thank you.
Keith Taylor (GoutPal Admin)ParticipantYou need to understand that allopurinol tackles gout in the long term. It reduces uric acid, thus striking at the cause of gout. It is vital to take this, or some other uric acid lowering treatment, to avoid the crippling effects of gout. Allopurinol has no immediate obvious benefit, and may trigger a gout attack as it helps dissolve old crystals in your joint.
Colchicine is a pain-killer that is very effective for gout pain. It should only be necessary for a few months until the allopurinol has worked it's magic and all old crystals are dissolved.
There are 2 explanations, for your problems, I can think of:
- Your gout could be misdiagnosed. If the joint pain is from another disease (e.g. pseudogout), then allopurinol is unlikely to have any benefit.
- More likely, your allopurinol dosage is insufficient to dissolve all existing crystals.
Managing your uric acid numbers is vital.
Until you are stable, you should be tested at least every 3 months. If you have those numbers, please post them here, and we can give better advice. If you don't have them, please change your doctor (or send him here for re-education).
Keith Taylor (GoutPal Admin)ParticipantThere is a study reported in the Archives of INternal Medicine/JAMA http://www.medicalnewstoday.co…..141562.php
It suggestes that Vitamin C does help significantly. 1500 mg a day reduced gout 45%. Sounds good to me. Haven't tried it yet, but will consider it.
Keith Taylor (GoutPal Admin)ParticipantSorry to hear it. Have had the same problem on and off. I take a couple teaspoons of baking soda a day which seems to help. This is discussed on the site in other forums. I have seen no studies providing evidence that it works, other than the intuitive point that the baking soda is alkaline and will help reduce acid.
But there seems to be strong evidence for Vitamin C helping
http://www.medicalnewstoday.co…..141562.php
and strangely coffee
Keith Taylor (GoutPal Admin)ParticipantThanks for the concern.
It is so complicated, a little of a fight between my nephrologist and my rheumatologist. Rheumy says off the uloric as a precaution. Since this kidney issue started the same time I started Uloric.
Neph says uric acid is a kidney killer, get back on the Uloric.
Who knows what to do. Both are very good Doctors.
I worry that maybe just maybe the Uloric is causing so many crstals to release that they are killing my kidneys. Do I take it to the grave?
Also I have had high uric acid numbers 12 plus all my life and not one person warned me off the risk to kidneys.
I am less then 30 gfr. I was normal in Aug.
Due to kidneys my blood pressure is now high after a life of normal.
ON A SIDE NOTE: does anyone have a rash on their chest from Uloric?
Thanks again to everyone who cares.
Ang
Keith Taylor (GoutPal Admin)ParticipantSo you think 4 days is the limit? Quess I'll have to drink faster. How often do you guys drink this stuff? Just when you have a attack? or do you use it on a daily basis to slow down a atack? I no this is not a cure or anything so I am reading on the alkiline diet foods. I've always been a meat eater so this is gonna be tough. Being raised in the day of everything is pre-cooked and pre-package. Instant potatoes frozen vegtables the only thing left to enjoy fresh was MEAT. Darn gout
Keith Taylor (GoutPal Admin)ParticipantI'm missing these debates, but I've just got to get that GoutPal.com site moved this weekend – then I'll be back to more frequent commenting (after another 3 weeks “bedding in”)
So a quick comment on this one. And apologies if it has already been said, cos I've got some catching up to do.
The important issue here is risk.
Everything I have read points to a strong statistical link between uric acid and cardio-vascular problems, but nobody has come up with an explanation of that link.
What that means to me in practical terms is that anyone with raised uric acid level should arrange for cardio-vascular tests. That way, if your higher risk turns into an actual problem, it gets nipped in the bud.
On the 'uric acid good for humans' front, the only sensible theory I have seen is that it is linked with the human penchant for walking upright. It is assumed by many that the presence of uric acid raises blood pressure, allowing blood to reach the brain better. For myself, I'd be quite happy to live life on all fours (occasioanl all-fives?) and do without the uric acid.
If I've missed something important on this, or any other topic, please can someone Private Message me with a link.
Keith Taylor (GoutPal Admin)ParticipantHi Guys,
I am going to try the BBB solution…I just started trying a combination of Cholchicine and ULORIC which has helped me greatly. I am concerned about taking medications it just that my hyperuricemia was getting worse and worse…I have had an allergic reaction to Allupurinol so I could not take it. Also I have Psoriasis and it was getting better but once i started taking ULORIC which was about 3 weeks ago..it appears my Psoriasis is getting worse. Not sure if its the ULORIC or my stress over taking a new drug that no one knows the real side effects. Anyway will keep you posted I will try the BBB solution and take it regularly to see if it helps. I really appreciate all of the advice here..its good to know “WE ARE NOT ALONE”….
Thanks Miles
Keith Taylor (GoutPal Admin)ParticipantI am on 100mg Allopurinol and it has been very effective for me. My levels dropped from 7.5 down to 5 and after three months of initial flare ups I have now been gout free for six months (which is a blessing indeed, as I had been getting continual attacks before the drug).
The consultant was surprised at the affect it had had in reducing my numbers, but said it does happen…Good luck Peter!
Keith Taylor (GoutPal Admin)Participanti have read with great intrest of the many quertions and answers regarding gout i was diagnosed with gout about five yers ago and was put on allopurinol strait away and for those years i have been almost gout free but just lately i have had some really acute attacks of gout having talked to some friends and read some of you`r answers on this site i am begining to think that the 100mg of allopurinol i take daily is not enough as with some of my friends they are taking at least 300 mg dailly i also take diclofenac for the pain as colchisine upsets my stomach as soon as i start to take them is it best to put up with the bad stomach and take colchisine instead of diclofenac as colchisine gets rid of the ulric acid diclofenac dose not i am at a loss of what to do but at this moment in time i have gout in my right ankle left knee and toes on my left foot and a twinge in the fingers on my left hand i have both diclofenac and colchisine tablets can they both be taken together or is it one or the other. (regards david bennett.)
Keith Taylor (GoutPal Admin)ParticipantDon't worry about the patent loss. Someone will soon be bombarding the FDA with new test results (and who knows what else) to get restrictions back on the generics.
Sorry, did I sound sarcastic and cynical?
I meant to sound angry.
The FDA and URL Pharma are nasty, mealy mouthed, lying, cheating, money-grabbing bastards.
That feels better
Keith Taylor (GoutPal Admin)ParticipantHi GrimmJV,
I've moved your post here as it was in the middle of a topic about something completely different. It's not that I'm a stickler for etiquette, but when you do that, it either spoils the flow of the topic, or (as in this case) you get ignored.
There is no doubt that heavy exercise will increase uric acid, but this is a very short term thing. Levels retain to normal after a few hours. In fact, with regular exercise, although this peak occurs, you tend to fall back to a lower level – regular exercise is good for gout.
We all try to look for reasons when gout occurs, but there are just too many variables to consider. Losing weight may help, but this is best done by taking urate lowering therapy at the same time. Rapid weight loss is one of the sure-fire ways of raisng uric acid. Discuss a six month course of allopurinol with your doctor to keep your uric acid down as you get back into shape.
At the same time, arrange for a 24 hour urine test to see if you are under-excreting uric acid.
Keith Taylor (GoutPal Admin)ParticipantGary, that is one of the worst pages about gout I have ever seen.
Pages and pages of random substances with no explanation and no references.
There are many ways to lower uric acid, and none of them are listed there (or if they are they are so well hidden amongst the dross that they are meaningless).
It all starts with a uric acid test, as there is very little you can do until you know your starting point. It's a good idea to get one as soon as you can, and we'll discuss the results here and advise you of the best way forward.
Keith Taylor (GoutPal Admin)ParticipantDan, the allopurinol is about as near to a cure as you will get, but you have to work with it.
It will take a few months to get rid of existing uric acid crystals. During that time, lowering uric acid can cause some gout flares, but these are a good sign that your body is getting rid of the old uric acid crystals. These flares will get less intense, and less frequent.
This will only happen if you take the allopurinol every day, and get tested regularly to make sure your uric acid stays below 6mg/dL. Get it as low as you can (say 3 to 4) for the first few months and the old crystals will dissolve that much faster. You may have to push your doctor on the testing – some really do not have a clue, but it is absolutely vital.
Come back every month to discuss your numbers and how you are progressing – it helps to keep you focused, and you'll soon feel better.
Keith Taylor (GoutPal Admin)ParticipantHi Dragos,
I concur with everything zip2play has said.
The allopurinol experience was almost certainly a sign that your joints were getting better as old crystal deposits dissolved. This happens, but soon gets less. It is far better than waiting for the urate deposits to damage your joints.
The time is definitely right for you to get your uric acid levels under control ( and that means under 6). Then you can enjoy your 40s and beyond without having to worry.
Keith Taylor (GoutPal Admin)ParticipantHi: There is nothing wrong with my tap water. I had well water for years and my township ran city water and I was forced to tap in and it was a big difference. thats why I went to distilled. My Dr is giving me 300mg of allopouranal (thinks that how it is spelled) to lower my acid level. but I hate pills they always help one thing and destroy something else. Tired of gout someone somewhere has a cure(i hope) because the medical community doesnt care, not enough money in it. Dan
Keith Taylor (GoutPal Admin)ParticipantWhile we wait for zip2play to pass judgement on your doctor, let us all read, learn and inwardly digest the truth about ionized water.
My own judgement is that she should focus on what matters – your uric acid levels. What are they, and what is she planning to do to manage the level so you do not get gout attacks?
Keith Taylor (GoutPal Admin)ParticipantMore power to your elbow, Faraz.
Don't forget, it's not just FMF sufferers who rely on generic colchicine, though their situation seems to be worst. Gout is widespread and growing (another issue for you – why add iron to food when most of us have too much, and iit causes gout?).
Because colchicine is so well established in medicine, doctors use it for many conditions.
In 1998 Ben-Chetrit & Levy reported:
The efficacy of colchicine has been proved in FMF, gout, Behcet's disease, and cirrhosis
A quick look in PubMed also reveals colchicine treatment associated with amyloidosis, autosomal dominant polycysstic kidney disease, pericarditis, slow transit constipation, amongst many others.
Oh, and a little known disease called cancer.
Keith Taylor (GoutPal Admin)ParticipantReally thank you Mr GoutPal about all assistance u gave to me, you and Mr zip2play, thanks for the useful site. im writing down their mobile's numbers and will call them as soon as i can.
Mr zip2play after all i didn't get you will, what about going and buy colchicin! anyway I'll ask about it and try.
Regards
Keith Taylor (GoutPal Admin)ParticipantHello all,
I am a journalist in the UK, looking into the restrictions on generic colchicine and the problems caused for sufferers of FMF. I work for one of the UK's top pharmaceutical publications, SCRIP (you can view this online at scripnews.com).
I am looking at the human aspect of the story and trying to get more comprehesnive comment from the FDA, with whom I am currently in touch on the issue.
If anyone is interested in contributing any information, such as whether the gateway to Canada is now officially shut, or how much colchicine is left on the shelves in the US etc., I would be extremely grateful.
Best wishes and good luck,
Faraz Kermani
Keith Taylor (GoutPal Admin)ParticipantFor gout, a rheumatologist is the specialist. That link will help you find one, or check with your nearest hospital. Your IP address suggests you are in Jordan, and the rheumatologist finder lists 2 – 1 in Amman and 1 in Irbid.
A rheumatologist will also carry out joint fluid tests. The test does not need special equipment, other than a polarizing microscope.
I am still not convinced that you have gout. You really need to get your blood sugar levels checked, and any doctor should be able to do that.
Keith Taylor (GoutPal Admin)ParticipantGoutPal said:
He will draw fluid from the joint, and check it for uric acid crystals.This is way beyond my knowledge and needs the attention of a properly qualified medical expert.
First of all, thank you very much for your concern.
About checking for crystals in the joint (i don't have this type of test in my country).
Iam really thinking about visiting a qualified medical expert, (WHAT TYPE OF DOCTOR'S SPECIALIZATION DO I HAVE TO SEEK ADVICE FROM)…..??
Keith Taylor (GoutPal Admin)Participantkatie300 said:
Are gluten free foods okay for a person with advanced stage of gout? My mom was severely allergic to allopurinol and colchichine (she nearly died) and now is on the Uloric. The only way we have to help her is through diet (she is 83 and has heart and kidney problems). I carefully watch her diet avoiding those “bad gout” foods. I was hoping to find some alternate cereals and breads just to offer some variety from rice and white flour.
It is good that your mom is on Uloric (febuxostat), as this means that she does not need to worry about different types of food – just make sure she has as much variety as possible.
Regular uric acid tests are a must to ensure she is on the right dosage. Some doctors are excellent at this, but some really need to be pushed. Please post your mom's uric acid levels each month, or her doctors excuse for not testing – we can discuss these and make sure she is on the right track.
I hope that mom knows she might still get gout flares until the febuxostat dissolves existing uric acid crystals. She may need pain relief, and must discuss with her doctor what options she has that will not interfere with her other conditions.
Keith Taylor (GoutPal Admin)ParticipantHi Ammar,
Thank you for the extra information.
Zyloric is allopurinol, which needs to be taken daily in the case of gout.
Quite rightly, you question if you have gout. I think you need to get this confirmed by a rheumatologist. He will draw fluid from the joint, and check it for uric acid crystals.
There is another possible explanation.
Though there is no direct link between G6PD defficiency and high uric acid, there is an indirect link. G6PD defficiency can cause low glucose levels (hypoglycemia) and this can cause high uric acid levels. The answer to this is not to take medicine to lower uric acid, but to take something to maintain glucose levels. This is vital in G6PD deficient patients, as low glucose is also responsible for severe anemia (hemolysis).
This is way beyond my knowledge and needs the attention of a properly qualified medical expert.
You need to take advice on your glucose levels, and see if, by raising glucose level to the top end of the normal range, you can reduce uric acid.
If that does not work, then you may well need to continue with allopurinol to get your uric acid down to around 350.
Keith Taylor (GoutPal Admin)ParticipantImpossible to know without uric acid numbers.
100mg might be just enough to disturb old crystals but not enough to dissolve them quickly.
Best to start a new topic with some history and uric acid test results for a better answer
Keith Taylor (GoutPal Admin)Participantruff12two said:
Hi Zip2play,
The Neuropathy appears to have been handed down from my father. The Neurologist who diagnosed the symptoms, could not determine the root cause.
I do like a beer once in awhile, so that may contribute.
Otherwise, everything else seems normal. Not diabetic…
Thanks for your contributions to this forum. I have spread the word about Gout Pal to all my new found friends in the medical field here in the Tampa Bay area!
Thank you kind sir.
I note you've been on allopurinol for a long time, but uric acid tests are few. Without good history, assessment is difficult, but long-term gout can cause bone erosion, so this might be linked to the avascular necrosis.
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