January 29, 2015 at 1:42 am #19676
For years now whenever I have decided to have a ‘quiet week’ per se, it seems to only take 3 to 4 days before I get a twinge but bizarrely the last two attacks, which have been bad, have stemmed from abstinence and detox dieting.
I went on a fat-free alcohol-free diet after New Year and nearly 3 weeks later I am still suffering from a swollen knee. I haven’t been able to bend it fully at all. Every time I do my best to change my lifestyle, drinking and eating habits …this happens.
It’s like I have to have at least a glass of wine during the week when I don’t want to. I have not had any alcohol on Mon, Tues….now its Weds and I’m thinking that I better get the wine out…..or even a beer. But I know that beer is bad for me for inciting gout flares. At a loss and don’t know what to do for the best?
January 29, 2015 at 2:44 am #19685
Gout pain control and uric acid control are 2 different things. You cannot have gout pain without excess uric acid, but the crystals that cause the pain might be several months, even years, old.
Pain control is easy if you focus on pain control. Uric acid control is easy if you focus on uric acid control. If you mix them both up, you just get a painful mess that prolongs the pain and might make you worse.
The doctors are to blame! First thing they tell you when you go with gout is that you have to change your eating habits. They never tell you that this might make your gout worse, and they never help you to deal with it.
If you get uric acid safe, you will never get a gout flare again in your life. But, it takes several months to get rid of old crystals. You need a plan to deal with this.
As I said in your other thread: let’s create a gout pain treatment plan that works for you, and let’s create a uric acid lowering plan that keeps you safe. It’s up to you how you want to do it – just keep asking the questions until we get your gout under control.January 29, 2015 at 11:26 am #19689
thanks for your post. i get everything u say. sadly colchecine didnt work for me and at time s made me violently ill during the nite….tho i had probs taken too much out of desperation
u rite about getting uric acid safe, thats what its about. pain control is not posible, tho i have discovered a gel that is v good for the nite time when u wake up with pain. it soothes and gets rid of the throbbing so u can at least get back to sleep
at the end of the day i think it is more important finding a uric acid lowering planJanuary 29, 2015 at 11:26 am #19690
i have to say ytho that i have never had a flare last as long as 3 weeks 🙁January 29, 2015 at 7:13 pm #19695
A uric acid lowering plan starts with knowing your level. If you’ve not been tested this year, get a uric acid test today. If you have been tested this year, post your results, and we’ll work on a plan to make it safe.
Gout pain comes from your immune system, when it reacts to uric acid crystals. Colchicine works by poisoning your immune system. It has no effect on pain, but might stop it getting worse. Only ever take a maximum of 2 per day. If you leave it until gout flare has got serious, then colchicine is not much use. Anti-inflammatories will reduce swelling and pain. Compatible painkillers will block any remaining pain, if necessary. The 3-line attack always works, but you have to take the right strength, and get the right package for you. Sometimes it takes a while to find the right anti-inflammatory that works for you. Most gout sufferers here seem to favor naproxen, ibuprofen, or Indocid (indomethacin). Have you tried any of these, Mike?January 30, 2015 at 8:57 am #19697
Colchicine works by poisoning your immune system? id not heard that before. i know it is a poison and has been used since roman times. Are you suppoesed to take colchicine with your allopurinol? i thought it was to be taken at the onset of an attack. it never worked for me. for pain relief i usr 600mg iboprufen, the spanish ones or better still..the ‘jellies’ , the liquid capsules of iboprofen. to be fair even this isnr much good during the day but does work wonders if i wake up in pain during the nite.
you are right about the doctors…they really are clueless about gout and very dismissive. they will basically tell you to change your life style when in fact lifestyle only accounts for 1/3 of uric acid production.
i have been taking ayurvedic medicine for a variety of issues and it has been excellent. i am taking a new herbal medicine called shallaki so will see how i get on with that, altho shallaki, like the rhizome famly are anti-inflams so not sure of the effectivenes of ‘gout prevention’ effects.
so, thanks again for gettinf back. today i can feel some improvement…the worst could be over. i think the jump in doseage may have prolonged this attack….QUESTION IS: hOW TO I MANAGE MY URIC ACID LEVELS CORRECTLY NOW. I HAVE TO RID MYSELF OF THIS CURSED DISEASE!!! on my last blood test the uric acid levels results werent included so i dont know what they are right now, but they were 6 a few months ago and i guess my average is 5…i struggle to get them down.
next week i am going to a holistic practitioner to discuss gout. i am fed up with the doctors now
speak soonJanuary 30, 2015 at 8:59 am #19698
Here is a very good article concerning gout…one of the best I’ve ever read, and I’ve read a lot:
Doherty, Michael, Tim L. Jansen, George Nuki, Eliseo Pascual, Fernando Perez-Ruiz, Leonardo Punzi, Alexander K. So, and Thomas Bardin. “Gout: why is this curable disease so seldom cured?.” Annals of the rheumatic diseases (2012): annrheumdis-2012.January 30, 2015 at 3:48 pm #19699
Excellent find, Mike. Every sentence on that page shouts why I run GoutPal. I have reviewed the full Gout Doctor article on GoutPal.com. Also, I changed your link to my article because the article you linked to is no longer available.
To all gout sufferers, everywhere:
Not long after I started this forum, a wise man said you have to train your doctor. After a few years, I realize the truth of it. That begs the question: “who will help me train my doctor?”
The conclusion of that article reads:
There is a wide variety of barriers to effective care for gout, which is a very common and uniquely curable, chronic inflammatory arthritis. These barriers largely reflect commonly held negative stereotypes of the patient with gout and poor knowledge and interest in gout among doctors. Appropriate education, possibly assisted by recent drug development and new scientific evidence is opening a new ‘window of opportunity’ in gout management and should improve the standard of care.
To which I respond:
We can overcome the barriers to curing your gout. These are personal barriers that require a personal approach. I do not blame you for these barriers, but I will help you recognize them, and help you learn how to deal with them. I’ll help you educate your doctor so that he knows what is the best form of gout treatment for you. We will create your own ‘window of opportunity’ to manage your gout easily, and improve your quality of life.
What are your barriers to living gout-free?February 13, 2015 at 7:16 am #19875
Wine During Gout Attack
Hi again Keith,
2 weeks now i have been on the increased dose of 300mg. i am still suffering. when it seems to go it then moves back to the knee from the foot etc. i have stopped taking the 300mg because i noticed the pain arriving a cpl hours after taking it. i am now back on the 100mg. i made this decision myself and have rang the docs to get me a referral to a specialist. i went for a blood test the other day because i was suffering so much. that was tuesday. today friday i rang for the result and to my horror it was 7.4 or 440 umols. that is the highest ever!!! when the docs said to take 300mg they should have said to wait until my attack was completely gone.
the thing is , i am now very down and it is upsetting my relationship with my partner. i never have any good news for her and i am trapped in the house all day. i get out for drives and small walks but my life as i knew it has gone. the walks upset my joints, knee or foot. i feel nothing but anger welling up inside me now. yeterday i just got stuck in to a cpl beers and polished off a bottle of wine…i just didnt care anymore…STUPID!! but i needed a release. i am crying by myself and sometimes with my partner thru frustration really. this is no way to live a life. i feel for those poor people that are permanently crippled. i have had 5 weeks now. all the docs say is that it takes time for the allopurinol to work but it should not be 2 weeks surely
i take a lot of natural ayurvedc meds, i drink fresh lemon juice with bi carb 4 times daily….so plenty fluid. ive cut back on the alcohol, had x-rays showing no damage… i just dont know what to do but then again i should have done something about it years ago. i used to get an attack once a year back then……at my wits end here keith and thanks so much for your superb website!!
February 16, 2015 at 10:15 am #19904
A couple of apologies first @halfwayline15 :
1. Sorry for delay – it’s been a very hectic 3 days for me, and today I’ve got lots of catching up to do.
2. I got distracted by your excellent gout info find on Medscape, and I never noticed your question about colchicine.
Many medicines are poisonous, but the good effects outweigh side effects if the dose is right.
If you are new to allopurinol, or increase the dose, preventative colchicine is very good. Take one at bedtime. If any sign of inflammation when you wake up, take another. Maximum two per day, but avoid colchicine if you have any infection, or are likely to come into contact with people who have any infectious disease.
As I said, colchicine does nothing to reduce inflammation or pain, but it should stop it getting worse.
For the inflammation, you need maximum strength ibuprofen, or other anti-inflammatory. See doctor or pharmacist about the maximum dose. Whilst you are there, ask about a compatible max strength pain blocker. I used paracetamol (aka Tylenol or acetaminophen), but there are lots of other choices. You alternate the anti-inflammatory and pain-blocker every 2 to 3 hours, and get on with your life. The pain package will allow you to stay mobile, which is also good at reducing inflammation, so long as you do not overdo the exercise.
Stay hydrated, and avoid prolonged exposure to cold.
Mike, you are not getting gout attacks because of your allopurinol dose. You are getting gout attacks because your body is packed with uric acid crystals. You have to get rid of them, and allopurinol is your saviour – at the right dose.
Clearly. 300mg allopurinol is not enough, because it puts you firmly in Gout Hell Zone.
In that zone, around 6.5 to 7.5 give or take, gout crystals are partially dissolving and reforming. This is pretty constant, and it makes absolutely no sense in delaying treatment. There is nothing wrong with starting allopurinol, or increasing the dose during a gout attack. It makes no difference.
You need your own personal gout-strength pain package now, so stop messing about with low dose over the counter stuff.
You need allopurinol dose increased to get uric acid safe. Personally, I’d go for the max dose for a year, but that’s something you can discuss with your doctor.
Pain control now! Uric acid control soon! You’ll be out of Gout Hell Zone before you know it, and soon on your way to Gout Freedom 🙂February 17, 2015 at 2:39 am #19906MikeMGuest
No worries Keith
Tomorrow I am seeing a specialist and paying good money. I will let you know the outcome. I thought 300 mg was the max dose? As for pain relief I been using 600 mg liquid ipobrufen and I use a natural herbal gel. Hopefully I’ll get on the right meds, I need to get rid of this uric acid.
Btw, I must say that there are so many contradictions on the web about what not to eat and what not to drink. It’s ridiculous. One day you’ll read that caffeine in coffee is really good as it acts like allipurinol, then the next you’ll read it’s on a list of NO-NO’s :/
Cheers again Keith
Will keep you postedFebruary 17, 2015 at 3:05 am #19913
300mg is far from the maximum dose. There are several studies that show that this is the most common dose. However, that is simply because most doctors do not understand gout, and do not appreciate the dangers of under-dosing. In the States, 800 is the maximum recommended, and 900 in UK. I don’t know about other countries, but these are only recommendations anyway. Doctors can prescribe off-label if their professional judgment tells them that is best for the patient.
I recall some studies showing that allopurinol was safe at much higher levels, but I can’t remember where.
That brings me to your point about the ridiculous contradictions on the Internet.
But, is it ridiculous? If you get a group of people chatting about gout anywhere, you will always get differences of opinion. Those who tend to shout loudest are frequently the ones who have least worth saying. Never stops them though, does it. The Internet is just a bunch of people sharing their opinions. There is very little professional medical or nutrition advice available. Doctors and other professionals do not want to be associated with free advice. Besides which, they would be professionally compromised if they offered such advice without examination and personal consultation.
Internet pages are often worse than social chitchat because the written word lends an air of authority. However, greedy charlatans make a point of trying to seem credible in order to sell things.
You have to learn to be selective, and take the time to build up trust. Good things to look for are links to properly conducted studies. Be wary of people who make scientific claims, but then fail to refer to exact sources. I know that I have done exactly that here, but the context is different. On GoutPal.com I give references whenever they are available and relevant. Here in the forums, I write less formally, and give references when I’m asked.
One very significant point is that advice that suits one person, might not suit another. I’m not being helpful if I do not consider personal issues. That is why I now focus on this forum. As I have time, I’m amending pages on my main website to try and emphasize the personal nature of gout management.
This personal support extends to discussing things you have read elsewhere. You can learn a lot about gout from analyzing where people get it wrong. Please feel free to share any information you find. If you want to discuss a particular issue, it’s usually best to start a separate topic, otherwise threads get intertwined, and lost.June 26, 2015 at 1:20 am #21735
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