Allopurinol for Gout
Discussion
I am still trying to get to the bottom of my 'trigger' and as to whether there actually is one or not.
I am probably a stone overweight at just under 14st but very active at 43. My diet isn't bad, almost no alcohol possibly 1 unit per month and a night out on the drink 3-4 times a year when I will binge. Almost no red meat, lamb now and again and beef only once a month or so. I thought beef was my trigger after having a flare up in the ankle 2 days after having a burger but I had a further flare up 2 weeks later after no red meat or alcohol at all. The only thing I can think now is that if it is a food trigger it might be seafood as I had a couple of 'crab salad' sandwiches - basically crab sticks in mayo as far as I could tell.
3x 500mg colchicine for a couple of days sorts the flare up but it is pretty bad for the 48 hours or so before the tablets get it under control.
Not keen on moving over to allopurinol for life.
I am probably a stone overweight at just under 14st but very active at 43. My diet isn't bad, almost no alcohol possibly 1 unit per month and a night out on the drink 3-4 times a year when I will binge. Almost no red meat, lamb now and again and beef only once a month or so. I thought beef was my trigger after having a flare up in the ankle 2 days after having a burger but I had a further flare up 2 weeks later after no red meat or alcohol at all. The only thing I can think now is that if it is a food trigger it might be seafood as I had a couple of 'crab salad' sandwiches - basically crab sticks in mayo as far as I could tell.
3x 500mg colchicine for a couple of days sorts the flare up but it is pretty bad for the 48 hours or so before the tablets get it under control.
Not keen on moving over to allopurinol for life.
Glassman said:
I've been on Allopurinol. I got the big flare up they warn about when you start. Six months later, I got another. GP then suggested upping the dose which made me think hard about the way forward.
As you say, they biggest factor here is hydration. You can do yourself a big favour by drinking water and plenty of it. It's not always practical, especially during the colder months (speaking for myself).
My diet/staple isn't boring. I have quite a wide range of food that I enjoy. Yes, the meat and meat products element has all but gone, but sometimes eggs and fish maybe once a week. I'm enjoying my cooking and I'm planning meals more than I ever did (it's also very cost effective and less wasteful).
Age becomes a factor too; at 52 (or 43 + VAT) the inevitability of change is becoming more and more apparent. That said, diet isn't the only lifestyle change. I'm still playing sport and still in a physical job. Not being ruled by gout (and the attacks used to be quite frequent) means I am enjoying life a lot better without that affliction. The mild flare-ups usually come after a heavy sesh over the weekend.
The reason your GP suggested increasing the dose is because its not a simple one size fits all medication.As you say, they biggest factor here is hydration. You can do yourself a big favour by drinking water and plenty of it. It's not always practical, especially during the colder months (speaking for myself).
My diet/staple isn't boring. I have quite a wide range of food that I enjoy. Yes, the meat and meat products element has all but gone, but sometimes eggs and fish maybe once a week. I'm enjoying my cooking and I'm planning meals more than I ever did (it's also very cost effective and less wasteful).
Age becomes a factor too; at 52 (or 43 + VAT) the inevitability of change is becoming more and more apparent. That said, diet isn't the only lifestyle change. I'm still playing sport and still in a physical job. Not being ruled by gout (and the attacks used to be quite frequent) means I am enjoying life a lot better without that affliction. The mild flare-ups usually come after a heavy sesh over the weekend.
In an ideal world, they will start you on a dose then call you back after a period of time to check your levels again. This can happen a few times until the correct dose is found, then its monitored annually to ensure it's still appropriate.
The fact you've been on a dose of Allopurinol and still had flare ups suggests two things. Firstly, the dose wasn't high enough, and secondly your levels are probably very high. It's the second point that I would be very concerned about if it were me.
Not wanting to take meds is fine, as long as you understand the risks - has the GP discussed them with you?
High Uric Acid is a pre-cursor to a number of potential health problems, and most are pretty grim.
Glassman said:
I've been on Allopurinol. I got the big flare up they warn about when you start. Six months later, I got another. GP then suggested upping the dose which made me think hard about the way forward.
As the last poster mentioned, thats pretty much exactly what they do, though it sounds to me like your doc dropped the ball a bit. They want you on the lowest dose possible, so first I was put on 100mg allo for a month, then had another blood test, then they upped it to 200mg allo for another month, then had another blood test. That came back just where they wanted it so I stayed on the 200mg. Been there for a couple of years now and only had the one slight flare a few days ago. Seems to me that your doctor didnt really get that initial titration process done correctly.Glassman said:
Allopurinal didn't work for me. The next step would have been to increase the dose which made me step back from it. I suffered a few flare-ups meanwhile and the intensity seemed to increase.
I just dont really get that, unless you were having proper side effects from the allo, (and im not talking about the initial flare that some people get going onto it) why would you panic about the dose being adjusted according to your needs?If you're happy where you are with it living on veggies, fair play, I have no doubt that its generally more healthy, just, blah. As indicated also its still very very worth getting your current levels checked.
HotJambalaya said:
I just dont really get that, unless you were having proper side effects from the allo, (and im not talking about the initial flare that some people get going onto it) why would you panic about the dose being adjusted according to your needs?
Decided that I would rather not rely on meds if I could. Glassman said:
Hot weather - not hydrating enough: immobilised.
Have a very painful and swollen knee (hard lump just above the cap). The last time this happened was the summer of 2017 whilst on a beers and mussels jolly in Brussels (which didn't help either).
What was the dose of allopurinol you were on and what did the Dr want to up it too?Have a very painful and swollen knee (hard lump just above the cap). The last time this happened was the summer of 2017 whilst on a beers and mussels jolly in Brussels (which didn't help either).
I’ve been on 200mg for 16 years now and not once have I thought of coming off it, the thought of having another gout attack sends a shiver through me.
Maybe it’s time to reconsider?
Tony Angelino said:
I am still trying to get to the bottom of my 'trigger' and as to whether there actually is one or not.
I am probably a stone overweight at just under 14st but very active at 43. My diet isn't bad, almost no alcohol possibly 1 unit per month and a night out on the drink 3-4 times a year when I will binge. Almost no red meat, lamb now and again and beef only once a month or so. I thought beef was my trigger after having a flare up in the ankle 2 days after having a burger but I had a further flare up 2 weeks later after no red meat or alcohol at all. The only thing I can think now is that if it is a food trigger it might be seafood as I had a couple of 'crab salad' sandwiches - basically crab sticks in mayo as far as I could tell.
3x 500mg colchicine for a couple of days sorts the flare up but it is pretty bad for the 48 hours or so before the tablets get it under control.
Not keen on moving over to allopurinol for life.
What about chocolate? That seemed to be mine. I had three big flares in 2013 before I was found to have gout - once at Easter, once at Father's day and one just after my birthday in November. Excessive chocolate consumption was the common theme (not very good at pacing myself with a box of choccies I am probably a stone overweight at just under 14st but very active at 43. My diet isn't bad, almost no alcohol possibly 1 unit per month and a night out on the drink 3-4 times a year when I will binge. Almost no red meat, lamb now and again and beef only once a month or so. I thought beef was my trigger after having a flare up in the ankle 2 days after having a burger but I had a further flare up 2 weeks later after no red meat or alcohol at all. The only thing I can think now is that if it is a food trigger it might be seafood as I had a couple of 'crab salad' sandwiches - basically crab sticks in mayo as far as I could tell.
3x 500mg colchicine for a couple of days sorts the flare up but it is pretty bad for the 48 hours or so before the tablets get it under control.
Not keen on moving over to allopurinol for life.
)! Been on 100mg allopurinol since end of 2013 and not looked back. Still need to keep hydrated but only had pretty minor flares once in a blue moon since then (generally when I overdo the chocolate again) and nothing like those bad old days of 2013.plfrench said:
Tony Angelino said:
I am still trying to get to the bottom of my 'trigger' and as to whether there actually is one or not.
I am probably a stone overweight at just under 14st but very active at 43. My diet isn't bad, almost no alcohol possibly 1 unit per month and a night out on the drink 3-4 times a year when I will binge. Almost no red meat, lamb now and again and beef only once a month or so. I thought beef was my trigger after having a flare up in the ankle 2 days after having a burger but I had a further flare up 2 weeks later after no red meat or alcohol at all. The only thing I can think now is that if it is a food trigger it might be seafood as I had a couple of 'crab salad' sandwiches - basically crab sticks in mayo as far as I could tell.
3x 500mg colchicine for a couple of days sorts the flare up but it is pretty bad for the 48 hours or so before the tablets get it under control.
Not keen on moving over to allopurinol for life.
What about chocolate? That seemed to be mine. I had three big flares in 2013 before I was found to have gout - once at Easter, once at Father's day and one just after my birthday in November. Excessive chocolate consumption was the common theme (not very good at pacing myself with a box of choccies I am probably a stone overweight at just under 14st but very active at 43. My diet isn't bad, almost no alcohol possibly 1 unit per month and a night out on the drink 3-4 times a year when I will binge. Almost no red meat, lamb now and again and beef only once a month or so. I thought beef was my trigger after having a flare up in the ankle 2 days after having a burger but I had a further flare up 2 weeks later after no red meat or alcohol at all. The only thing I can think now is that if it is a food trigger it might be seafood as I had a couple of 'crab salad' sandwiches - basically crab sticks in mayo as far as I could tell.
3x 500mg colchicine for a couple of days sorts the flare up but it is pretty bad for the 48 hours or so before the tablets get it under control.
Not keen on moving over to allopurinol for life.
)! Been on 100mg allopurinol since end of 2013 and not looked back. Still need to keep hydrated but only had pretty minor flares once in a blue moon since then (generally when I overdo the chocolate again) and nothing like those bad old days of 2013.I had prawns at the weekend so if I don't have a reaction in the next week or so then it looks more likely it is beef so I will try eating some more a couple of weeks later. There is also the chance though that there is no trigger food and it could be related to my arthritis and AS.
I have been eating lots and lots of cherries in the last week or so, these keep the levels at bay I understand.
Tony Angelino said:
Just to update here after doing some research I've decided it best to lower my uric acid levels so I've now gone on the allopurinol. Took my first 100mg tablet yesterday, at what point did anybody experiencing a flare after starting on this drug up see it please?
I didn't - only a month in (blood test this morning to see if it's working) but no tablet induced flare like some people report. I've been sensible, no alcohol since October, watching what I eat as far as the "avoid" category stuff goes and drinking more water but, touch wood, all is well. Don't get me wrong, I had some mild discomfort in my toe, but nothing remotely like a debilitating flare where I couldn't walk etc
Will have to see what the numbers say to see if I need to shift to a higher dose or if the 100mg is doing enough.
Good luck!
Edited by thetapeworm on Wednesday 1st February 12:53
I got an ache in my toe joint after a week of 100mg but a couple of strong ibuprofen dealt with it the same day.
No issues since and I've recently gone up to 200mg without issues.
It could happen at any time during the first 6 to 8 weeks I'm led to believe but like this complaint everyone is different.
No issues since and I've recently gone up to 200mg without issues.
It could happen at any time during the first 6 to 8 weeks I'm led to believe but like this complaint everyone is different.
Can a symptom of gout be like having numb toes, they have almost no sensitivity unless I was to stub my toe on something?
My feet are generally quite grumpy, nothing like as bad as some of you on here, but a couple of my toes (not the two bigguns) often throb and my soles feel hot and uncomfortable.
My feet are generally quite grumpy, nothing like as bad as some of you on here, but a couple of my toes (not the two bigguns) often throb and my soles feel hot and uncomfortable.
Penny Pusher said:
Can a symptom of gout be like having numb toes, they have almost no sensitivity unless I was to stub my toe on something?
My feet are generally quite grumpy, nothing like as bad as some of you on here, but a couple of my toes (not the two bigguns) often throb and my soles feel hot and uncomfortable.
When I first started with symptoms for me it felt almost like I had something in my shoe. For all the world I thought I had a stone nestled under the first joint of my big toe pressing in when walking. Heat is certainly something I and many others experience though. Getting your uric acid levels checked via a blood test I believe is the only way to know for sure. My feet are generally quite grumpy, nothing like as bad as some of you on here, but a couple of my toes (not the two bigguns) often throb and my soles feel hot and uncomfortable.
As somebody has already said, there are many variations of symptoms, triggers and effective treatments and there is no one size fits all I have learned through shared experience.
Ok thanks for that, I often get the feeling that there's something between the inner and outer ball of my feet, better go get myself levels checked just in case.
I used to get Policeman's foot, but that was a few years back and that's improved massively on its own, it was especially painful when I first got out of bed, the first few steps were agony.
We've got a trip to Euro Disney in July, I need my feet to be 100% for the amount of walking that gets done when you're there.
I used to get Policeman's foot, but that was a few years back and that's improved massively on its own, it was especially painful when I first got out of bed, the first few steps were agony.
We've got a trip to Euro Disney in July, I need my feet to be 100% for the amount of walking that gets done when you're there.
Tony Angelino said:
Thanks all, I'll continue being sensible for the next couple of months before 'testing' it out with some beef that I now firmly believe is my trigger.
Blood tests will tell you all you need to know really, my levels dropped a fair bit on 100mg but not enough so regular checks advised until your at a safe level.Penny Pusher said:
Ok thanks for that, I often get the feeling that there's something between the inner and outer ball of my feet, better go get myself levels checked just in case.
I used to get Policeman's foot, but that was a few years back and that's improved massively on its own, it was especially painful when I first got out of bed, the first few steps were agony.
We've got a trip to Euro Disney in July, I need my feet to be 100% for the amount of walking that gets done when you're there.
It tends to focus around a joint and immobiliser it, it's fecking painful so It doesn't sound like gout to me.I used to get Policeman's foot, but that was a few years back and that's improved massively on its own, it was especially painful when I first got out of bed, the first few steps were agony.
We've got a trip to Euro Disney in July, I need my feet to be 100% for the amount of walking that gets done when you're there.
How's your general foot health footwear etc ?
I wear work boots most days and have flat feet so do suffer with aches and pains.
Tight calves can also cause havoc with the feet.
I was diagnosed with Bursitus week before last after getting a real big flare up on my elbow out the blue all of a sudden. It was really squidy and still is but going down by minuscule amounts each day, last week couldn't feel the elbow but slightly can now.
He put me on an AB (Fluoxicillin) based on it being potential infected bursa.
Last night I had my other elbow start to get similar pains, but luckily its not progressed....so I'm wondering if this could be Gout...does it feel itchy on the affected area? My skin has become really dry as well...oh and sweats at night last week were horrendous.
He put me on an AB (Fluoxicillin) based on it being potential infected bursa.
Last night I had my other elbow start to get similar pains, but luckily its not progressed....so I'm wondering if this could be Gout...does it feel itchy on the affected area? My skin has become really dry as well...oh and sweats at night last week were horrendous.
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