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Since you have gotten no answers so far, I’m going to give you two general suggestions even though I’m not sure understand why you originally shouldn’t have taken allopurinol or why you are now stuck on it.
First, in order to comment about your uric acid levels, one would naturally have to know about them (both before you took allopurinol and now).Second, do I understand correctly that you would like to eliminate foods that might trigger gout symptoms if you weren’t on allopurinol?
I don’t think that’s a good idea because, if your uric acid level is high enough that you can get gout symptoms just by eating the wrong thing, that level is probably high enough to cause problems in the long run even if you don’t immediately get symptoms from it.
Instead, you may want to try to eliminate or restrict the foods which tend to increase one’s uric acid (as well as trying again some of the stuff which helps to keep it low because their effects might have been masked by uric acid deposits which you have now eliminated). As long as you keep monitoring your uric acid levels, you should be able to lower your dose of allopurinol and see if you manage to compensate with dietary changes.I have for many years eaten no meat, fish or seafood and I’ve never taken any protein supplement.
There is plenty of protein not only in lentils, beans and such but also in grains as as well as in other seeds. Even leafy vegetables contain protein. But sugar and oil do not.
Depending one one’s tastes and habits, it’s certainly possible to fail to eat enough protein but the challenge for adults eating no animal products but who can afford a reasonable diet and have no special needs is not so much to reach an adequate total protein intake but to eat enough of every type of protein. Soy seems to be helpful in that regard (as well as contributing nicely to one’s total protein intake).From the abstract you linked to:
“none of the six epidemiologic studies identified provided any evidence that soy intake was associated with circulating uric acid levels”
and
“on the basis of the existing data there is no reason for individuals with gout or at risk of developing gout to avoid soyfoods”
Which is of course not to say that soy doesn’t make any difference but it certainly seems like it usually makes little difference when consumed in moderation.
As with many other foods, there is however a risk involved in eating too much of one thing, especially if you have a health problem such as gout. The risk is of course much greater when consuming extracts, powders and other supplements.Did your doctor tell you why you should be taking Feburic at breakfast?
Others might be interested to know because that’s not what all doctors recommend.It’s good that you are planning to monitor your uric acid in the future. It’s better to have the test too often than not enough.
And since you are experiencing a variety of symptoms, the next time you see your doctor you might also want to ask about the various drugs which only help with the symptoms. Trying such drugs when you are having different symptoms might help you and your doctor to determine if they are likely to be caused by the same thing.If two eggs a week is all the animal food you eat, it may not be sufficient for you to look at your total protein intake. For all I know, you might need specific proteins from soy.
I also don’t understand how you could eat so little protein to begin with. Are you only counting supplements?
If you are practically vegan, surely you need soy, lentils, peas and such and shouldn’t restrict your consumption too much because you’re afraid of purines. It’s not even clear such foods are a major factor in determining how much uric acid there is in your blood.Has your blood been tested for uric acid only twice? If you have more test results, please consider posting them as well (Keith might be able to make use of them). I’m no expert but 7 is not very high and “a pain of about 6 for 10 mins” doesn’t sound like typical gout symptoms to me.
Besides protein, eggs contain a type of fat your body may not be used to and the metabolism of fat seems to play a role in inflammation. Whether or not you have gout, I would not rush to blame your symptoms on protein. And if you have gout, you don’t need to stop eating eggs.Finally, about the side effects of feburic: this may seem obvious but you could try taking the pill at a different time during the day.
There are also other drugs people use to lower their uric acid levels which may or may not be suitable for you.There are common non-meat foods with more than 30% protein content such as soybeans and some hard cheeses, even before discounting stuff like fiber and water which doesn’t figure into this ratio. And once you do remove the other stuff, eggs for instance have a ratio like 2/54/44 (don’t quote me on this, I’m guesstimating) and partly-skimmed milk ought not to be very far from the target. So at least if you’re not vegan, you ought to be able to achieve the target… but at what cost and to what end?
I wouldn’t follow slavishly what a study did, especially if it required using “powders”. What’s their justification for the protein and fat levels?
Maybe I’m not thinking outside the box but my guess is that there aren’t enough healthy non-meat foods with the right ratios to allow for a reasonably varied 40/30/30 meatless diet inclusive of all the healthy foods low in protein and/or fat you’d want to eat.
On the other hand, if the general idea has merit, you ought to be able to get fairly close without bending backwards. Surely there’s nothing magical about 30 as opposed to, say, 26!You shouldn’t focus too much on the fact some people have achieved an UA reduction with that diet because:
-one’s UA level is not determined primarily by the carbs/protein/fat ratio of one’s diet and people have reduced their UA without eating so much protein and fat
-you have to compare the diet’s effect on UA with the effect of other diets as well as with your previous diet(s), not with whatever the study participants ate before that study
-gout symptoms during the process of UA reduction aren’t driven by UA levels alone and I bet there’s for instance a reason gout patients are told to watch the fat they eat (I’m not saying all fat is bad though)I don’t know how the forum works and whether this will appear at the right place but in reply to #2924 (and other posts)…
I think you’re jumping to conclusions and, just in case, I want to make sure you aren’t doing it in part on my say-so. I wanted to warn you about one possible outcome but I don’t know why lowering UA through diet would necessarily need to take years.
It’s an (very common as far as I can tell) inability to lower UA enough through diet which might make improvements very slow. And I have no way to know how much of a UA reduction you could expect from a serious diet in your particular situation. I doubt anyone can make a good guess you without a lot more information and additional medical tests.
If you try a diet and get many more blood tests, it shouldn’t take years to get an idea of what a diet can or can’t do for you.
Then again, why not help the process with UA reducing drugs if there is no medical reason for you to avoid them and you have no fundamental objections to using them? If you really have gout and get on an effective diet, I would not count on your luck to avoid symptoms completely. In all likelyhood, UA reducing drugs would help you not just with the pain but also would reduce the need to take other drugs.
For what that’s worth, my rheuma is of the opinion that one shouldn’t be afraid of discontinuing UA reducing drugs… provided of course that there is a sound reason to do so and that one’s UA is going to be monitored afterwards.In my non-expert opinion, it makes sense (as is common practice it seems) to wait until you get more than just one flareup to worry about tests, specialists and other drugs.
However, your ability to manage the problem with Ibuprofen shouldn’t be a reason to be complacent. This class of drug can work wonders but they are also potentially dangerous and you could possibly paint yourself into a corner by relying on them for too long.
Furthermore, if you succeed at mitigating the root cause by losing weight and being careful about what you eat and drink, you could possibly end up with a milder chronic condition which becomes more difficult to diagnose over time.
To clarify: I’m talking about years, not weeks.
In any case, you’ll want to repeat that blood test if you can afford it. Results can vary quite a bit from one test to the next.The medication in question is so far as I know not a UA lowering drug but an NSAID, a class which commonly does more damage than moderately high UA. Unlike UA lowering drugs, people should ideally not take an NSAID for very long.
Sure, your UA can go up and down for no obvious reason after you’ve lowered it modestly through diet. Whether the fluctuations might primarily be due to dissolving crystals or to metabolic variations I can’t say (I’ve never done frequent tests or owned a testing kit).
In my opinion, you may need to be very patient if you can’t get your lowest readings under 5.5. Don’t let more frequent (if less severe) symptoms discourage you but make sure the medication you’re taking is something that you’re going to be able to tolerate on a long-term basis.In addition to what Keith said:
-one advantage that comes with taking colchicine as a course is that it is effective from the very start of a flare (no waiting for you to notice the problem, to take the pill and finally for the pill to work its way into your system).
-if you are taking colchicine ad hoc, discontinuing it too early after a flare (or lowering the dose too quickly) may lead to a comeback or to new flares.
-if you are cleared to take 1.0 mg per day you may want to try to take only 0.5 as a course and the second 0.5 ad hoc.Colchicine is something you will have to experiment with a bit (within individualized guidelines provided by your doctors) for best result with the lowest possible dose.
Loads of drugs can raise your ALT, not just Uloric. Among gouty pills, NSAIDs in particular can make it go through the roof.
My median ALT reading over more than 20 years has been 104. Amusingly enough, my median reading before I developped joint problems was also 104 which goes to show lots of non-phramacological stuff such as booze can affect liver tests as well.
Such tests should be interepreted in context. So while my results might reassure you as to how high 70 really is, in your situation they may actually signal a problem. Ideally you’d compare your latest result to a baseline test done before starting UA-reducing drugs. If your doctor isn’t too worried about 70, consider trusting her judgement. She may ask for another liver panel before long if she doesn’t know whether 70 is within your normal range.
Good luck curing your arthritis!Emailing test results is unfortunately still a big no-no in some parts. Some day, a bureaucrat will learn how widespread “unsecured” VoIP is and will freak out…
In the meantime, I get results in the old-fashioned mail and type them in back into a computer.Distraction also helps with any annoying side-effects of pharma. Definitely underrated.
Hi,
It seems there is some evidence for cherries lowering UA. But we’re probably talking about a whole lot of cherries on a daily basis if you want to get a significant effect out of that… at which point I would be concerned about cost and possibly side-effects.
There is apparently also evidence for milk and yoghurt being useful. If you’re not allergic to this stuff or something and don’t overdo it, the worst case scenario as long as you also pursue proper treatment would be that you’ve treated yourself to a placebo.
The least harmful thing you can do I think is to make sure you drink a lot of water (within reason) as well as to follow reasonable and generally-accepted dietary recommendations such as favoring a variety of vegetables over hamburgers.I’ve been told that UA can unusually high as well as unusually low during an attack. In any case, there are other confounding factors and some data is better than no data. But I guess waiting before a test would make sense if you can only afford one.
And in answer to your earlier questions, slow buildup is possible. In particular, it seems flares can get worse as they move between different parts of the joint (or to the joint proper from a connected part – I’m terrible at anatomy) if you count that as buildup.
I found general-purpose anti-inflammatories have a way of dialing the symptoms way down without getting rid of them entierly at which point it becomes easy to have anything misdiagnosed as a routine one-off problem.
In any case, I can’t diagnose myself so I wouldn’t even dream about diagnosing you remotely.Hi KK,
For what little that’s worth, at one point when I was prescribed an inadequate dose of colchicine by a GP I got flareups which moved from one foot to the other and back every few days.
There are also other drugs besides the ones you mentionned which people use for gout symptoms. But maybe you can’t take them (your doctor ought to know your situation best).
Unless you couldn’t afford it or something, I think you should have had an appointment with a specialist earlier.
I hope you get better soon!My GP has prescribed me analgesics (including stuff you can’t obtain legally without a prescription) even when I didn’t need them right away. All it’s ever required is being somewhat argumentative and in one instance some talk about getting the stuff from another doctor.
I once let an attack develop before trying to stop it with colchicine alone. It’s very slow but it works. Of course I can’t prove that the attack wouldn’t have gone away on its own but then I can’t prove it was gout to being with. There are lots of things we can’t prove but I don’t know why colchicine wouldn’t work if you give it time. I agree NSAIDs seem to work much faster but what about people who don’t tolerate them?
There is also the controversial matter of how much colchicine is effective and whether that amount is going to vary from patient to patient. As with other drugs, GPs may not be confident prescribing a large enough dose.Intriguing. Have you ever tried to quantify the variance due to the hour at which you eat the day before? Wouldn’t the makeup of the meal affect that as well? If the effect is large, Johnson’s diet readings ought not to be compared to routine readings.
Hi Johnson!
For what little that’s worth (I’m no doctor or any kind of expert), I wouldn’t have been very surprised by a somewhat low reading. It’s useful to have objective data and to keep records over the long haul but I think it’s easy to over-interpret a single test or even trends that seem consistent over a month or two.
Looking at my results over a few years, I see a couple under 6 here and a couple over 8 there. These are tests performed at my GP’s practice. I can’t explain these changes whether it be in terms of diet, drugs, weight, weather or exercise and my rheumatologist tells me they aren’t significant. Regardless of test results, I certainly expected a flare up at any time and did my best to be prepared.I hope I’m not intruding my commenting here by the way. Apologies if I mis-stepped.
