Help avoiding gout on my birthday

Foot care
1

Hi all, its my birthday this weekend and will be celebrating with friends over a couple of bottles of red and some nice food. I know that this is likely to flair my gout and I'm looking at medication options to reduce the impact as well as drinking a lots of water to stay hydrated.

I am currently on 100mg of Allopurinol a day to reduce possibility of an attack but I also have access to 0.5mg tablets of colchicine and 25mg of prednisolone.

I know that the simple answer is to avoid triggers like alcohol and purine rich food, but I am willing to risk it to celebrate - your only 40 once right!

Any suggestions would be very much appreciated.

2

(Unlikely that 100 mg is a large enough dose.)

Increase the colchesine t two tabs for a couple of days before? 

3

Drink cherry juice before and after your celebration. It seems to work for me.

4

Pint of water between each glass of red wine! no excuses. 

5

As long as you don't do the worst - drink a lot of beer, eat a lot of herring - generally if you're on medication I think you can splurge for one meal every week or so, without triggering a flair.

​I'd recommend celery and/or celery seed, before and after, but I have no idea how that might work with allopurinol.

6

How long have you been taking Allopurinol?

Do you take it every single day?

Was your dosage ever reviewed?

Allopurinol can be the key to total gout free life ... other treatments can confuse things.

7

It’s interesting you ask “do you take it every day”.  Doesn’t everyone? It has a half-life of only 17 hours so we need it constantly.

I think his problem is he’s on too low a dose. (Which is common).

8

Indeed...everyday is correct...

I'm just making sure that he does.

There's a lot of confusion over the dosage and in particular how long it takes to become effective.

I have been taking Allopurinol for about 3 or 4 years ...... gout free.!

9

I m pretty much the same, and I had toohi growing.  All gone. I eat what I like.  Very occasionally I have a slight twinge and take a colchesine. But I’ve a tub of 100 and they’ll last me for years now.

10

Interesting...

I met a guy a couple of years ago .... youngish with bad gout...

His story: Was prescribed Allopurinol but after using it for a couple of months ... he stopped and then started again after a another few months ... no relief...

Totally WRONG approach.

Allopurinol can take over a year to work and people need to give it time.

My consultant (a specialist in the area) pretty much told me that lifestyle and diet was much less critical than the right medication, specifically, Allopurinol. 

 

11

Allopurinol is for life. Stopping and starting is useless. We produce too much blood urate due to genes+age+gender.  If you don’t bring blood urate down you will die due to heart / arteries/ stroke / kidney issues. Diet contributes only 15% of purines. Address the 85% and forget about diet. The solution is allopurinol (dirt cheap) or Fabrixat (expensive but generic forms by 2020).

All we can do for lifestyle is slim down stop sugar reduce alcohol and drink water like a fish. 

12

Rusty, I don't know about this "for life" thing.  My father was prescribed allopurinol about fifteen years ago just for the high urates, I don't think he even had an attack, and after maybe a year doctor told him to stop, and just hold onto the pills in case it changed in the future.  I think that's still a common treatment mode.

13

What age was your father when the doctor suggested he should stop the treatment? Am I correct in thinking he died?  

14

Also, how many attacks of gout had your father had?

Was it full blown very regular gout over a period of months or years? 

15

I believe my father had had one real gout attack that I know of, somewhat over ten years before the period I'm talking about.  He may have had a previous attack, I'm not sure - and he's been gone some years now so I can't ask him.  He had no further attacks for at least ten years after this event, and passed on in reasonably good shape up to his last days in his eighties.  I found the old bottle of allopurinol in his nightstand.

16

If he had only one gout attack he didn’t have gout. Anyone can have a gout attack if dehydrated for example.

Another reason for stopping taking allopurinol would be if the patient had kidney problems.

However, it is now known that keeping blood urate low is good for health and may have contributed to his longevity. 

17

Hi jtsmoose I will stay well clear of champagne. on my 60th birthday I had some bubbly to celebrate not a lot just for the toast. within 2 hours I was in agony In my foot.and had to go to bed.with pain killers.i have suffered most of my life with gout but it is a process of elimination food and drink that you can't have. and the old adage is one man's meat is another man's poison.hope you have a happy birthday.good luck.

18

What is your level of blood urate  David? 

19

hi rusty.good question that.not for a long time.when I have a attack I reach for the colchine. it does the trick.providing you take it at the first sign of gout.

20

david, having a reaction within two hours seems remarkable to me, was a bit of champagne really the only dietary transgression in the previous 48 hours?

​Just activity and even stress can contribute to metabolic production of urates, or as rusty suggests, even dehydration.

​For me, when not on celery seed, if I have a single bad meal, I cannot recall that along being enough to trigger an attack.  Again for me, as I've analyzed things after the fact, it takes a couple of bad meals over a couple of days and then, well, it's hard to say but I'd think more like 8 to 24 hours, before an attack began.

​Not counting attacks I could not account for, some of which I believe have turned out to be pseudo-gout.