I suffered terrible gout about four times from Jan - July, took indomethacin, colchicine, you name it. I only got over the last lengthy attack after going on steroids for five days (highly recommended for a short period.) I finally started on allopurinol, 100mg for three weeks with colchicine, then 200mg for three weeks, then 300mg after which the colchicine stopped. I am now on allopurinol 300mgs a day. I have had my blood tested every month by my GP and my uric acid level is now well within "normal" levels. I am to continue taking 300mgs for the next three months and then have another blood test.
Yes, I may get gout again and I realise I have hopefully found a treatment not a permanent solution BUT having had a clear few months after 6 months of terrible pain the message is do not despair - get over your current attack and if you can start allopurinol. So far it has worked for me - keep your fingers crossed for me!
Good news!
Yes the treatments normally do work, eventually, on the attack and on the prevention.
Do you have any idea what triggered it in the first place - could you trace any foods you ate that turned out to be on the "bad" list?
For me it seemed to be dehydration more than anything. If I exercised and didn't rehydrate gout usually followed! My diet was never high in purines, only the odd pint, but my dad and brother suffered from it as well so hereditary prone I guess. Incidentally, both on allopurinol for years without another attack.
The "odd pint" is pretty high up on the bad list, especially if it's like the Guinness Stout I like to drink when I have any at all. Two or three a week and that could trigger something. Unless you're on allopurinol. Do your dad and brother have an odd pint, and get away with it?
As I said earlier, I am on allopurinol now but "the odd pint" was just that.... I am not a drinker...if I had five pints in a month it would be unusual. Have had a couple of nights out since starting allopurinol with no ill effects (touch wood). I am sure with me it was the dehydration combined with the steady build up of purines.. For about ten years I could go 6 or 12 months without an attack, have one and it would clear in a few days while taking indomethacin. It was only the prolonged period of problems at the start of the year which convinced me to start taking allopurinol. My father and brother drink far more regularly but haven't had an attack since starting allopurinol years ago. Everyone responds differently to medication and I guess they are very lucky. Like I said, it may come back, the point of my message was just to give some hope to others who are in pain and worried.. I know I was for a long time.... And like I said, if you cant shake it with the usual meds, five days of steroids were miraculous for me after weeks of problems earlier this year.
Incidentally, I got in America once and saw a doctor on my insurance. He gave me v strong painkillers, steroids and said if it wasn't fixed in 5 days he would inject the joint. Half the problems here are GPs prescribing treatment X, then treatment Y, all of which can takes days to take effect.. if you get the chance, go nuclear!
See also advide from experts .... take the drug and be patient.
https://medlineplus.gov/druginfo/meds/a682673.html
I don’t understand why your doctor had you on any other drugs.
The standard treatment is allopurinol (300mg usually works), for the rest of your life, with colchicine to stop any flares.
Over the first few years the excess monsodium urate stored in your body will be flushed out, leading to a possible reduction to a lower dose of allopurinol.
In the meantime drink plenty of water and not too much alcohol.
Good health!
Oh dear.. let's be careful here.
I never stated allopurinol had "fixed" me. I carefully repeated in each thread I was aware the gout may return.
I am unsure where the confusion and half truths are in my posts.
Incidentally, I did not start allopurinol immediately because I did not want to take medication for the rest of my life when for many years the problem was an annual inconvenience for 5 days and little more.
For that same reason nor did I deem in necessary to see a specialist. Gout is a common condition with recognised treatment and preventative pathways which work for the vast majority of patients. If everyone with 'normal' gout saw a senior consultant the health service would struggle to accommodate them and the consultants would be richer than Croesus!
As is sadly often the case on this forum, a message meant to give a little hope has become a topic of contention which, for readers new to the condition, must alarm them more than help them and dissuade them from contributing or seeking advice.
I stopped coming on here a few months ago when I started reading posts from interested amateurs how gout was an indicator of much deeper health problems and would inevitably prove fatal. It was terrifying.
My message is the same - I have started allopurinol, I did not immediately get another gout attack (as can be common when starting the medication). I am aware I am not fixed, the gout may return but for now, I am delighted to have started allopurinol with no ill effects and seen a speedy reduction in my uric acid levels from very high to 'normal'.
I am going to celebrate with nine pints of stout, some sweetbreads, shellfish and offal. The last sentence was a joke.
Facts: there is not ordinary gout and some kind of special gout. There is only gout. Gout is not a disease, but the symptom of anderlying genetic metabolic problem. Hypeuricemia - high blood urate. The fact of having high blood and gout untreated doubles or triples your chance of death. High blood urate causes widespread inflammation throughout the body causing a variety of insidious disease processes. Perhaps the worst of these is the damage to the lining of the blood vessels, hence the high levels of heart attack and stroke in gout sufferers.
There is a cure for gout - lower blood urare. A combination of drugs and blood test will keep it under control for life.
You are an example of why perhaps gout sufferers should see a specialist- either your doctor didn’t bother to explain to you the health implications of non treatment, or you failed to understand him. This is very common as at least 70% of those suffering from gout take no medication, have the occasional gout attack and then have heart or other problems. By the time somebody suggests treating the high urate the damage is done.
As for your reduction of your blood urate from high to normal, again this is a common misconception by GPs who don’t bother to read the guidelines sent to them by NICE. Normal is ok for a non gout sufferer. A gout sufferer needs to have blood urate brought down to low (under 4), for optimum health as this will flush out all the crystals in the tissues.
Additional training is available for GPs but they don’t take it up. The reason senior researchers in the field suggest for this is because GPs see it as an old man’s disease of little interest and is not at all sexy. They appreciate the long term health implications if pushed, but discount them
because they will take a decade to hit, and it never appears on the death certificates.
The top guys are very frustrated trying to get these messages through to GPs.
I respectfully sometimes wonder if you actually read the original post..... "be patient", I have stated in every post I am aware this is not a quick solution and the gout could return.
My apologies for mis-understanding.
Ahh rusty. you remind me why I left.
I was defining "normal" gout as gout which was periodic, responded to medication and did not result in long-lasting tophi or permanent joint damage.
More than one million people in the UK suffer from gout. If every one of those went to see a specialist the system would collapse and what would a specialist advise to 99 per cent of patients who walked through his door? Exactly the same thing as a GP, the usual immediate treatments, start allopurinol, diet awareness etc and monitoring uric acid levels.
Yes gout is a red flag of a potentially deeper problem but in the vast majority of cases the treatment and solution for it remains the same. If there are obvious underlying other health issues which could be contributing to gout (such as obesity, alcohol consumption etc) any responsible GP would advise on these.
As the biggest contributor of this forum I respectfully suggest you have a responsibility not to terrify people. You could respond elsewhere to the statement "I have a cold sore" by saying, "no, you have herpes simplex 2 which cannot be eradicated from the body and is a potential indicator of Alzeheimer's and Bell's Palsy."
That would also be accurate, but also terrifying.
The longer term effects of gout on mortality are still being researched. I am not going to get in a google war of second hand research but will settle for this: "Although gout and hyperuricemia are related to several conditions that are associated with reduced survival, no prospective data are available on the independent impact of gout on mortality."
As for gout doubling of tripling my chances of death, the chance of death is absolute for us all anyway my friend.
Peace.