After 15 years gout getting worse

[momoy4]

I started having gout when I was in college–attacks happen when I gorge on food and when I eat high purine types. 3 years ago—-As I was trying to lose weight (i am 5'7″ at 220 lbs) and me being a vegetarian— the gout would also come back. A year ago–I would have an attack every month as I have been trying to lose weight and then gain back again (addicted to food). Last month the attacks have been vigorous—and then two weeks ago I would have an attack in the space of every 3 days after having fully recovered from 4 doses of colchicine. I've also developed some very light tophi in the knee, foot and finger area over the years.  I am very worried worried though as this might lead to something serious and life threatening.

Just a few facts on the table so you could understand my condition:

I am afraid of taking allopurinol as it might take a toll on my liver. For the past 15 years i have lived with this.

The only medication I take is colchicine during the early stages of an attack.

I take celebrex when colchicine does not work and when I've taken it (colchicine) in the late stages of an attack

I have tried baking soda, apple cider and celery supplements and they have no effect on me.

Questions:

Will this be life threatening?

Has my immune system broken down to have allowed the frequent attacks?

Hope you can help me goutpal. Thanks

[zip2play]

A lifetime of untreated gout from hyperuricemia will inevitably shorten the lifespan unless something intervenes, like a runaway bus.

Do NOT be afraid of allopurinol, it is FAR safer than either colchicine or Celebrex. To be 100% certain make sure that every doctor's visit you have a liver panel run along with your routine uric acid…and anything else you are testing for. Don't even go in for a cold or a flu shot without your blood draw. Tell your doctor ahead of time to ALWAYS run these so you don't have to remind him every time.

Allopurinol is among the least toxic of drugs for long term use.

Having an attack every MONTH for 2 YEARS seems like masochism to me.

(Yes, the small tophi are permanent reminders that gout is destroying your joints.)

You must change your way of thinking so that your goal is switched from relieving pain to maintaining a uric acid below 6.0… or 5.0 if you want to SLOWLY get rid of tophi.

[Tavery]

I am going to take a strongly worded stance to reiterate Goutpal's comments.

In particular I took exception to what the statement “I am afraid of taking allopurinol as it might take a toll on my liver”.

First off, a steady low dose of Allopurinol wont damage your liver. A simple blood test each year test by the doctor can confirm your liver is functioning as expected. If you did experience any change in liver function somewhere down the road you can always stop taking Allopurinol to see if it improves. When Allopurinol is determined to not be the cause of the liver issue you can always restart it (most likely at a slightly higher dose than what you were doing previously).

Secondly, by refusing to take Allopurinol and subsequently having attacks every single month, you are declaring to the world that you would rather be crippled than risk your liver. Allowing frequent and continued attacks will eventually degrade your joints to the point that you will lose motor functions, have constant pain and trouble walking. Just standing or going to the market will become a problem. Tophi will grow larger and larger on your hands, feet and other places slowly deforming them while they destroy your joints.

Lastly, sitting on the toilet every month doing internal blowouts from the Colchicine cant be real great for your body either.

Start with a low dose of Allopurinol. Get tested after a few months to make sure your body doesnt have any reaction and then start bumping it up until you get to 5.0.

Good luck!

[momoy4]

Thanks zip. Thanks Tav.

Your advice I shall follow and keep everyone posted. It's great to know that there is a forum such as this for misguided elements such as myself :-(.

I'm at the stage that even standing in supermarket for an hour or so precipitates an attack. Not good.

[zip2play]

Good muck, momoy.

Since you have had so very many frequent bouts, I recommend daily colchicine, perhaps 2 a day for a month or two, when you initiate your allopurinol treatment. If you start with low dose allopurinol  I would take the colchicine until you start getting low UA levels.

Personally I think the best way to start might be 100 mg./day for a week to test for any RARE hypersensitivity, and then go right to 300 mg. and test UA after a month, or else right to 300 mg./day to start. I am not fond of torturing patients with an ineffective low dose for months for no actual good reason. 

[Keith Taylor (GoutPal Admin)]

Tavery said:

I am going to take a strongly worded stance to reiterate Goutpal's comments.

---

Actually, zip2play's comments, but I agree wholeheartedly with everything that zip2play and Tavery has said here.

Allopurinol is the way to go, but always make sure you are getting uric acid tests to back it up. There have been many gout patients reporting allopurinol without any checks to see if it is correctly lowering uric acid levels. This trend of medication by guesswork must be avoided!

[momoy4]

Thanks GP.  Surely—-i have already stocked on allo—and once I get my blood test this afternoon will already start with a 300mg dosage. I'm quite worried as the attacks already happen every other day! I dunno if it's the lemon juice only morning routine that i've been doing since two weeks ago (they say lemon alkalizes uric acid–which is why pain appears ever so often) or maybe my immune system has gone bonkers. 🙁

[trev]

Gout is cruel in that your immune system is not going bonkers- it is very effective, but simply can't do the job due to a shortfall in the ability to deal with a metabolic imbalance.

This is  a genetically inherited trait -and not anyones fault.

Your dietary swings will have made this worse but now you have a good positive attitude to sorting the problem -concentrate on those SUA figures coming down  and thank your body and mind for pointing you in the right direction.

We're all doing our best likewise and want to see success… 

[d3x]

hi guys im now on 100mg ap for a week now, and im having an attack on my shoulders elbows and fingers all at the same time my question is is this the effect of healling?

[Keith Taylor (GoutPal Admin)]

Impossible to know without uric acid numbers.

100mg might be just enough to disturb old crystals but not enough to dissolve them quickly.

Best to start a new topic with some history and uric acid test results for a better answer

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