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Nobody,
So true. Your point is well taken. I will start the Allopurinol at a low dosage to start. You bring another question to mind: how often should one take blood tests to monitor things? This time the doctor (rheumatologist) told me to wait a month to take my next test. Also, how often should one get uric acid tests done? I bought a UA monitor, but I’m not to sure about the accuracy of the results. Overall, the reviews were good. However, several people seemed to complain about fluctuating results. For example, I took it one time & got 11.2. Seconds later a second reading was 4.3 Then 5. So, I don’t put much stock in the monitor.
Pi4a,
So happy to hear you got everything under control. I hope everything works out with your hips as well. I am still in the thick of the battle myself. I have the Allopurinol, but as I have mentioned here on the forum, I am concerned because of already elevated liver enzyme numbers. I know the answer is to work this out with a doctor, but it has been next to impossible to get an appointment at the present moment (COVID-19 concerns, I suppose) & the phone tag with the doctor’s office has proven fruitless. I finally have an appointment with my GP this weekend. However, I’m afraid she will pass everything off on the rheumatologist who has not been very helpful at all. I tried to switch rheumatologists yesterday but was told I would be considered a “new patient” & wouldn’t be seen until next year!
Well, anyway, I’m always happy when I read success stories like yours. Gives me hope, & hope right now is golden.
The Battle Royal continues.
Well, I saw the podiatrist. He went over X-rays & my history (I saw him a couple of years ago when I had my last battle). He explained that I need to really sit down with the rheumatologist & nail down a plan of attack. He was aware that I have not seen the rheumatologist in the office, everything has been over the phone, & it’s just been “take the pills.” He read all this in the notes in my file. So, he gave me a steroid shot directly in the joint. It was excruciating, but gave me a few days of relief (bliss). Unfortunately, that reprieve seems to be over. This morning the pain, swelling, & stiffness reared their ugly heads once more. I plan on changing rheumatologists today & see if I can get an emergency appointment with someone right away. I know none of this is easy, but I have to be as proactive as possible.
I agree I need pain management, but I have another question: does gout usually last this long? And is it usually this hard to lick? I ask because you mentioned the swelling, etc. would eventually, naturally go away. This is over a month now. My father has attacks, but they normally go away in a few days to a week at most.
I, too, have the same fears. I’m three weeks in an episode, & this flare up is getting the best of me. I have been taking prednisone, which helps temporarily. But the next day, before the next dose, the pain & swelling try to come roaring back. I’m not eating much cause I’m afraid everything (beans, mushrooms, nuts, etc.) will cause the situation to get worse, so I’m dropping weight. This is a mess. I have the Allopurinol, but since my liver enzymes were elevated, I’m terrified to start taking them as well. By the time this is over, I will need counseling on top of Allopurinol. I have an appointment with a podiatrist the end of this week. I don’t see the rheumatologist until the end of the month. I’m truly in gout hell.
Gl Gopro,
Thank you for your response. It is always helpful to hear from others & to find out what they have done to combat this issue. I am sorry to hear about the loss of your brother. My sincerest condolences to you.
I have also found some success using cold therapy, even if only temporarily. I found that it took down the swelling, which in turn reduced the pain. However, at the height of the attack, this wasn’t enough to give me long term relief. But I still use it faithfully because any relief from this kind of pain is welcome.
I’m glad to hear you are doing better at the present moment. Yesterday (& this morning) are the best days I’ve experienced in 3 weeks. The pain is down significantly, & the swelling is a lot better. The foot is not as warm to the touch either. It’s certainly not back to normal, & I can still feel those twinges, but any relief from that pain is welcome. I will continue using the cold therapy & plan on starting Allopurinol as instructed by the rheumatologist. I’m hoping to get this latest attack completely behind me. The last one was two and a half years ago. I recently invested on a uric acid meter & will monitor my UA levels like I do my sugar. Based on my last A1C results, my sugar is under control well. The problem now is that prednisone causes the sugar to spike significantly, so the sooner I can stop taking that, the better.
As far as the liver issue, I have been researching quite a bit. I will continue to try to keep my sugar in check & add exercise & healthy choices to my lifestyle. Hopefully, that makes a difference.
Here’s to a gout free day.
Hi Nobody,
Thank you so much for responding to my post. I am learning so much on this forum, and the information has been extremely helpful. It also helps to know there are others who understand what you’re going through. As far as dosages, I started by taking 1 Naproxen pill 500 mg and 1 Colchicine pill 0.6 mg daily. As I mentioned, this upset my stomach. So, after four days of that combination, the doctor switched me to a methylprednisolone pack: six tablets the first day, five the second, four the third, three the fourth day, tapering down to one tablet daily. But that had little effect, so she put me back on 1 Colchicine pill 0.6 and started me on 30 mg of prednisone daily. I did the 30 mg of prednisone for 4 days, then 20 mg for 4 days, then 10 mg for 4 days, along with 1 Colchicine pill 0.6 for the 12 days. While this lessened the severity of the attack, it did not “knock it out,” as I read some people said it did for them. I still have quite a bit of swelling in the toe and soreness (pain level is about a 6/10). Also, I noticed the knuckle of my right index finger was swollen and a bit painful as well. I’ve never had that problem before, only in the toe. The doctor seemed perplexed (for lack of a better word), as she said I should not be experiencing a flare up while on prednisone. This of course greatly saddened me. At any rate, after this, the doctor got the blood work back and saw the elevated liver values. In the past they have been within the normal range: 0-44 IU/L. This time, however, it was 87 IU/L. I looked back, and my numbers over the years were 22, 19, 31, 28, 26, etc. nothing over 41 in my history until now. However, I did have an image done about a year ago that showed some fat on the liver. At any rate, she told me to cut back on the colchicine and ordered a new test for a month from now to see if my liver numbers go back down. But my concern is that if I start taking Allopurinol, my numbers will remain elevated. You mentioned that all these drugs can “disturb” the liver. I was wondering if they are known to cause permanent damage or is it reversible after stopping the medication? (I assumed it was reversible since she wanted me to cut back on the colchicine to see if the numbers went back down. Am I right in my assumption?)
As for my age, I am 49. I weigh 160. I have always been on the thinner side (BMI 23.6), and I’m not of East Asian ancestry.
As for the Allopurinol dosage, she wanted me to start with 100 milligrams a day, but only after the attack subsided. As I mentioned, she was against prescribing Allopurinol to me during the flare up. Said it would only make the problem worse. So, I haven’t started it as of yet. She also wants me to continue the prednisone, 10mg a day only for a week to see if that gets it calmed down.
As far as diet, I have read that foods like mushrooms and asparagus can be problematic. I actually started the plant based diet to help with high cholesterol & diabetes. It actually did wonders for me in those areas. I did however read that eggs & dairy are beneficial in the fight against gout. I’m trying to adjust my diet even further to help deal with gout (UA) as well.
With that said, I would love to hear your thoughts on my situation and any other advice or direction you might offer. Thanks again for your assistance.
Hi all,
I am very interested in learning more about the side effects of these drugs, allopurinol in particular. I have been battling an attack for 3 weeks now (day 22). I was taking Colchicine and naproxen together, but it was upsetting my stomach, so the doctor switched me to Colchicine and prednisone. On my latest labs, they discovered that my liver values were elevated. I have never had issues with my liver values before, so the doctor reasoned that the Colchicine is the culprit. So, I have stopped taking it. However, she said once the attack subsides, she wants me to start taking allopurinol. But after searching around some (including some of the posts I’ve read here on the forum), it seems allopurinol can also affect the liver. So, now I am terrified of starting it. It’s an awful fix to be in: gout and what comes with that on one hand and viscous side effects of the medications on the other. I should add that I have been on a plant-based diet for years now. So, I don’t know what else I can do diet or lifestyle-wise to keep my UA numbers under control. (My latest UA results were 6.8.) So, I wanted to ask the good people on the forum for ideas and advice. What do you suggest regarding allopurinol, keeping my liver numbers in mind? And does anyone know if colchicine and allopurinol cause permanent damage to the liver or is this perhaps reversible?
Update: Woke up this morning and found the knuckle of my index finger swollen. First time I’ve experienced this. It was only in my toe before this.
Hi Keith,
Thank you so much for responding to my post. You don’t know how much I appreciate hearing from someone who knows what I’m going through right now. As for my primary doctor, I agree 100%. It’s one of the reasons I went straight to the rheumatologist this time around.
As far as discussions with the rheumatologist about treating the uric acid, she said she wanted to prescribe Allopurinol but not during an active attack. She said if I take the Allopurinol right now, it could potentially make things worse. So, she put me on the Prednisone in an attempt to “calm things down.” Once the attack was under control, she said, I could start the Allopurinol to lower/control the uric acid. That was the extent of our discussions about treating the UA.
I agree that what I am doing presently as far as taking the pain meds is not working and that I must learn how gout pain works and how to properly manage it. I can only say that I had been following the advice given to me. But recognizing that it’s not working is what ultimately brought me to the forum.
As far as safe uric acid levels, from what I’ve read, getting below 6.0 seems to be the target. Again, I’m not sure that’s the case universally, but that’s what I’ve come across so far. Is this the goal or would it be different for each individual?
As far as how to get the uric acid safe, I am willing to try whatever will work: drugs, herbs, diet, or a combination of all of these. However, if I could maintain it through herbs, diet, and lifestyle, I would prefer that over the long term. As I mentioned in my previous post, I don’t eat/consume many of the known triggers, and I have since cut out asparagus, mushrooms, etc. in an attempt to get out of the woods. I say that to say I am willing to make the necessary changes to get the uric acid under control.
And, yes, I would love to hear more about your experiences and personal journey. And if possible, I’d love to ask a question: What would you consider a logical plan to combat this problem and how would you suggest one deals with this in the short term, then in the long term? I’m researching day and night and gathering as much information as possible, so any help would be much appreciated.