Recurring gout

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  • #15522
    Sheldon
    Participant

    About 2 years ago I started taking Urolic 80MG. As expected my gout got worse over the next 7 months. It went into my feet, knees and hands. Then it stopped completely. No Gout. My Uric acid levels dropped to the very low end of the range soon after I started Urolic and as far as I can tell are still low although I am due to test it again soon. About 2 months ago my gout started back up in my feet and one knee. The pain varies from day to day but it is always there. My diet is excellent but I cut down substantially on seafood, however, this didn’t make a difference. On the recommendation of a physician I took Diclofenac 75MG. 2X day for 3 weeks. It did nothing. I was told that combining other gout type anti-inflammatories would interfere with the Uloric. I have thought about switching to Allipurinol but am very hesitant to do so. Any comments or suggestions are welcome.

    #15526

    I don’t know how long you’ve had gout.
    I don’t know what your uric acid level is.
    I don’t know what your uric acid blood test history is.
    I don’t know if you have any visible tophi.
    I don’t know if the pain you are currently experiencing is gout, or something else.
    I don’t know why you have been prescribed diclofenac, as other NSAIDs such as naproxen, indomethacin, or ibuprofen are generally considered to be more effective for gout pain.
    I don’t know what “other gout type anti-inflammatories” means.
    I don’t know who told you they would interfere with Uloric
    I don’t know why you are hesitant to switch from a new drug to one that has been field-tested successfully for decades.
    All in all, I don’t know much at all.

    A rheumatologist would probably know all these vital facts, or find them out, then reach a conclusion.

    #15534
    healeyguy
    Participant

    You’re challenges and questions are along the lines of my own. As some background, I do have some small tophi on the outer rim or helix of my ears. These are my “canary in the wharf” and are very sensitive to change. When they get sore or sensitive (due to swelling), I’m usually in a gouty phase.

    I don’t know how long I’ve had gout….I was diagnosed about 12 months ago after a flare up in my right toe. However, I’ve had the tophi on my ears for years and have had the toe flareup in the past which I mistakenly diagnosed as a consequence of a broken toe when I as young (currently 53).

    About 1 year ago, I started taking Allopurinol. I monitor my UA every second day (at home) and once a month I go for some bloodwork where my UA and Kidney functions are all tested. I’ve been using Indomethacin to deal with periodic joint and tendon pain (very effective). Like you, when I first started taking Allopurinol, the Gout pain increased substantially. I do not eat read meat or seafood and my beer intake is quite low….1 or 2 pints per week.

    My UA levels have dropped considerably over the past year and, with the exception of perhaps 5% of the time, my UA levels have been below 300 and averaging 250 over the past 6 months. I have not had a “severe” inflammation for quite some time.

    HOWEVER, on most days (60% of the time), I do have nuisance pain in my fingers, heals, elbows and knees. Not debilitating but, irritating and restricting. I believe that the tophi on my ears shrank in size over the summer (anecdotally – hard to measure). Recently, while my UA levels have not changed, the tophi on my ears have begun to be painful and the nuisance pain has increased and become more frequent.

    I would have thought that after one year of reduced UA levels and diet change my symptoms would have improved. Unfortunately, such is not the case and now, I’m wondering if this is my permanent condition. I thought (perhaps mistakenly) that once I flushed my body of UA, my nuisance pain would diminish.

    At this point, I’m at a bit of a loss as to what to think. Is this my new reality or, am I still “flushing” my body?

    I’d love to hear other people’s experiences just so that I can get some idea of where I’m heading and what my future looks like.

    Paul

    #15550

    Paul, if I were you, I’d arrange to see a rheumatologist. Everything you say makes me think your gout should be under control, yet you still have pain. There are only 2 explanations for this.

    Either gout is not under control, or you have another health problem besides gout. A rheumatologist can investigate these possibilities and hopefully provide some effective treatment.

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