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THe arrow on the linked picture is much closer to the usual joint.
And you MUST treat the hyperuricemia.
So whether it's gout or not causing that constant pain your course will be the same, allopurinol
or probenecid (I'm guessing the latter) to get you a low normal uric acid. If it IS gout then your foot pain will be cured.
Have that pee test to see how much urate you excrete in a day.
cjeezy said:
Hi Veg,
Any updates on your status/treatment?
Sorry for not replying earlier. I had typed a long post but I lost it thanks to hitting the back button. Then I had PC probems etc etc.
Ok so I finally went to the Rheumatologist at the hospital for my appointment. I was well prepared with timetable of pain, blood readings, X-rays, my lifestyle and possible treatment. Doc was impressed with my thoroughness and smiled. He checked my feet properly. Pushing the bottom of my toe with his palm was a sure way of recreating the pain. Anyway he said that he is very sure that I don't have Gout. He straight away remarked that my feet are bit flat. He also noticed that the gap between my toe and the second finger is large (scroll up to see photos). As a result proportionally he thinks that my feet are bit wide towards the front. On the right foot he found some hardened skin underneath which he said supports his theory. Although it was on the non problem feet. Just for the record left toe main problem foot. Right toe semi problem foot.
He said that there is no way I have Gout. Gout attacks don't last for months on end like I have specially first Gout attack. Chronic Gout later on could give constant pain. In my case he thinks it's not Gout so question of Chronic gout does not even arise. He thinks it's mechanical problem and a shoe insert would take care after 2-3 months of use.
He then called the head Rheumatologist who checked me and concluded the same thing. I asked him about my high blood uric acid reading. And the head Rhumetologist said that if I had gout then those readings would be cause for worry. As what I have is in no way gout so those readings are not relevant. He said relation between blood uric acid and Gout is very complicated and not straightforward as some would liek to make it out. In my case it does not matter anyway as what I have is not a Gout attack.
Long story short I then went to have my feet measured and scanned to get a shoe insert made. I have been wearing an insert in my shoe for last 2+ months but I have not noticed any consistent change. First week felt bit better but afterwards it was same as always. It's coming to 9-10 months since I first noticed the pain and since then I have constant mid level pain
I will be making another appointment and going back to the hospital to say that the foot insert did not solve the problem. He did say wear it for 3months. Thing is I am not noticing any real difference after 2 months so I doubt it will change suddenly.So to recap-
– In total 3 Rheutatologists have seen my feet. The two at the hospital and the one I went to see privately.
– All three say that my feet are wide at the front and slightly flat.
– All three say I don't have Gout irrespective of my above normal uric blood acid readings
– All three refused to have my joint fluid taken because they say there is no Gout like swelling to extract anything from. “You don't have gout”.
– I have been eating tons of Beans, Mushrooms, peas and it makes no difference to my toe pain. The sucker is there all the time constantly at 5 out of 10 pain level.
– I go gym regularly and that does not increase or decrease my pain either.
– Unlike typical Gout sufferers pain has never been so great that I could not squeeze my toe (all of last 9 months)
– No extra pain in the morning or night like some Gout people mention.I am completely LOST and depressed about the whole issue!!!!!! I try to blank it out but having constant mid level burning type of pain sensation for last 9 months 24/7 on both toes is hard to ignore
At this moment I have no clue what I have. I thought the shoe insert would be the answer but so far it has failed.
Standard practice is not to treat high uric acid with no symptoms (asymptomatic hyperuricemia). Your symptoms are definitely not typical gout symptoms, so you either go down the ultrasound / MRI route (which is improving, but still not perfect) or wait for typical gout symptoms to show. It is a sad fact of life that gout is very badly diagnosed. Aside from the times when pseudogout, bursitis etc is misdiagnosed as gout, there are many cases where atypical gout goes undiagnosed. We have a weird situation where advances in imaging are showing that tendon and cartilage damage is much more widespread than previously thought, yet the swollen red great toe remains the standard diagnostic event.
The path of gout pain is not so simple. What gives it the excrutiating edge over other painful conditions is that the cells that try to “kill” uric acid crystals soon get overwhelmed, and their call for reinforcements creates the conditions that take “ordinary” inflammatory pain up to the next level. This can be mitigated in an “anti-inflammatory environment”, just as it can be magnified in a pro-inflammatory one. Doctors are proud of their anti-inflammatory drugs, and new interleukin blockers (basically, stop the call for reinforcements). But many similar compounds, absent in meat, are plentiful in fruit and veg. They might not match the strength of commercially produced medications, but they can certainly have an effect. Obviously, I cannot say for certain that you have gout, but if you have, you are clearly doing too much good to get the sympathy of the medical profession. Don't wait for Xmas – get the prawns and pork, steak and sweetbreads on the table now!
Or perhaps not.
Irrespective of the gout issue, it seems quite clear that you have a mechanical toe problem. The foot has many tiny bones and other bits and pieces (note my overpoweringly professional medical terminology
). These are often hard to view on x-ray. I question whether a rheumatologist is the right specialist to see in these circumstances. If there is no improvement at the 3 month mark, I suggest a foot specialist rather than back to the rheumatologist.GP the thing is that I might have slight mechanical issues but I am convinced that it is NOT what is cauing me this pain. Mechanical problem in my opinion should create more pain when I do mechanically intensive things like running in the gym or walking a lot.I just don't see any clear relation between mechanical movement and increase or decrease in pain.
> I suggest a foot specialist rather than back to the rheumatologist.
I will go back to him once more just to give him a chance. All the heavy hitting medical equipment is in the hospital anyway. By the way what do you mean by a foot specialist? Are they more specialized than rheumatologists?
The problem with disagreeing with doctors is that you are in a very disadvantaged position. They control the diagnostics and analysis, so no matter how right you may be, they can say what they like, and you cannot disprove them.
I simply try to think what I would do in your situation. Since a doctor who specializes in rheumatics (inflammatory conditions) has stated that the problem is mechanical, then that implies to me that it is outside his specialism. Mechanical problem indicates orthopedics, so I guess the title might be orthopedic surgeon?
Sorry to be a bit vague, but it is completely outside my experience. As I've said before, I have no medical training, but a good knowledge of gout. I fear biasing my advice because of my limited perspective, so I am thinking what is best to do if it is not gout. I'm clutching at straws really, hoping that a specialist from a “mechanical” discipline might also want to pass the buck, and do a joint analysis to find out exactly what is going on in there.
Perhaps a holiday to Spain?
From Annals of the rheumatic diseases 2008:
First metatarsophalangeal joint aspiration using a 29-gauge needle.
Sivera F, Aragon R, Pascual E. Rheumatology Unit, Hospital General Universitario de Alicante, Universidad Miguel Hernándes, Spain.
OBJECTIVES: To asses the clinical feasibility of aspirating symptomatic and asymptomatic first metatarsophalangeal (MTP) joints with a 29-gauge needle in order to obtain a synovial fluid (SF) sample.
METHODS: All consecutive aspirations of first MTP joints performed within our department were prospectively recorded. The procedure was considered successful if SF volume was enough to perform a crystal search. Crystals were identified using a polarised light microscope (magnification x400) with a first order red compensator. Pain was recorded on a 10-cm visual analogue scale (VAS).
RESULTS: Aspirations were attempted in 33 first MTP joints in 31 patients. SF was drawn from 30 of the joints (91%), with little difference between asymptomatic (89%) and inflamed joints (93%). The technique was well tolerated (mean VAS 1.74). Urate monosodium crystals were identified in 22 samples (73%) and another sample contained calcium pyrophosphate dihydrate crystals.
CONCLUSIONS: A 29-gauge needle allows easy aspiration of the first MTP joint with only modest discomfort for the patients, and generally yields a SF sample of sufficient volume for crystal detection and identification. PMID: 17557892
[my bold] There are contact details for that study on the journal site: E Pascual, Dept. Reumatología, Hospital General Universitario de Alicante, c/Maestro Alonso s/n, 03010 Alicante; [email protected]
From the clutching at straws department – I wonder if Senor Pascual has any advice on what to do next?
And whilst you are in Spain, from Nucleosides, nucleotides & nucleic acids:
Asymptomatic hyperuricemia: impact of ultrasonography.
Puig JG, de Miguel E, Castillo MC, Rocha AL, Martínez MA, Torres RJ.
Divisions of Internal Medicine, La Paz University Hospital, Madrid, Spain. [email protected]
Thirty-five patients (23 males) with asymptomatic hyperuricemia for at least two years underwent two-dimensional ultrasonography of knees and ankles. Urate deposits (tophi) in tendons, synovium, and other soft tissues were detected in 12 patients (34%). Increased vascularity (inflammation) was evident in 8 of these patients (23%). Tophi were more frequently found in knees than in ankles and were especially prevalent in the distal patellar tendon. The presence of tophi was unrelated to the known duration of hyperuricemia (mean, 5 years). Ultrasonography allows detection of tophi and inflammation in a third and in a fourth, respectively, of asymptomatic hyperuricemic patients.
PMID: 18600510
to vegetarian guy: you say you were taking Berocca supplement which contained B vitamins and niacin among other things. i also was taking a supplement that contained B vitamins and niacin among other things. Isagenix. i had been on this for about a month and a half. could there be a correlation? i also had started a pretty vigorous exercise regimen of pilates 2 x a week, yoga 3 x a week and running 3 x a week.
gigi said:
to vegetarian guy: you say you were taking Berocca supplement which contained B vitamins and niacin among other things. i also was taking a supplement that contained B vitamins and niacin among other things. Isagenix. i had been on this for about a month and a half. could there be a correlation? i also had started a pretty vigorous exercise regimen of pilates 2 x a week, yoga 3 x a week and running 3 x a week.
Well I do take them but not very regularly. There have been long periods when I did not take them and it did not change my toe pain level. My B6 and B12 levels are in the normal range but on the lower level side hence I take Berocca or cheaper multi vitamins sometimes. I have been reading about side effects of Berocca and I don't have other mentioned side effects. Well apart from joint pain (toes only). I don't have pain in any other joints though.
I called the hospital and the next available appointment was in early January so I took it. Wasted money on these shoe inserts and they do jack for me! Maybe they help slightly.
I have been wearing canvas shoes as their soul is thin and very flexible. I can get on with daily activity but if I wear my older Addidas shoes whose soul is thicker then I have problems walking as pain on the toes increases noticeably. It's amazing how shoes I could wear all the time before are almost unusable now.
Someone with a wide foot front needs a wide toe box. Few shoes are made that way, in fact one might think, just looking at most shoes
that most people have only one or two toes.
My toes are the widest part of my foot by a wide margin and next comes the dimension accross the bunion.Obviously given the need for a WIDER toe box the worst thing one could do is to add anything like an orthotic which makes the
whole works even tighter.
Barefoot is best but I guess most places frown on that at work unless one is a lifeguard…or a porn star.
I am finding that a pair of sheepskin Ugg boots are the most comfortable footwear at the moment. I only have a pair of cheap imitation ones, but am seriously thinking of treating myself to the real thing for Crimbo. Fortunately, I don't have to wear a suit for work.
vegetarianGuy said:
Post edited 12:45 pm – December 10, 2009 by vegetarianGuy
I have been wearing canvas shoes as their soul is thin and very flexible. I can get on with daily activity but if I wear my older Addidas shoes whose soul is thicker then I have problems walking as pain on the toes increases noticeably. It's amazing how shoes I could wear all the time before are almost unusable now.
I can't agree more. I have said in one of my earlier post that one of the big challenge for me is shoe selection everyday morning. None of the shoes that I use to were before are of any use at this time. I am wearing 4x wide shoes with a supporting sleeve that relieves my pain in the toe. All other shoes give my toe immediate pain.
It is amazing. My doctors also tell me the same thing – some mechanical problem, not gout, though they agree gout was present in the initial stages. My pain point is also exactly the black spot on the toe you have shown in one of the pictures. When the toe is bent upward, it pains at that point.
On the days I have to wear a leather shoe for some urgent client meeting, it becomes a bigger challenge. I always carry extra 2 pair of shoes in my car which are somewhat wearable for short durations and extra sleeve all the time as I never know when will I need them.
It is frustrating at times.
This thread is really long.
>It is amazing. My doctors also tell me the same thing – some mechanical problem, not gout, >though they agree gout was present in the initial stages.
So you have confirmed Gout then? I hope you are getting it treated along with your mechanical problem? I don't even know what the hell is truly wrong with me. I am 100% convinced that I have something more than “just” mechanical problem.
Is your pain roughly constant 24/7?
10 more days to go to my next appointment. Why do I feel that I will never get to the bottom of this unless I put an axe to my foot? Sounds really tempting I must say.
I was suspected of gout as Colchicine was helping though I never took more than 2 tabs a day and my SUA level was 9.2. I never had typical gout pain and it was over a period of few days that the pain got set into the affected foot. The whole episode started with my toe stubbing and fracture.
I have taken treatment for gout as well as fracture. Currently, I am on 300 mg Allopurinol, my SUA levels around 4 and physiotherapy for toe injury.
I do not have 24 hrs pain, I get pain in the toe when I walk in certain positions and the injured / gouty foot positioning is not as correct as the other foot, which makes my walking difficult. Overall, my main struggle is going on with the foot as the load is unevenly distributed, which cause me pains. I am also not able to wear any shoe that I was wearing before the gout / injury to the foot.
It is 7 months since it started and it is makes me depressed at times as will it ever be cured, but I am hopeful.
So I went to another specialist that I was referred to. Technical orthopedist section of a hospital. The specialist checked my joint and called the head of the team too. They concluded that it's not Gout but starting of arthritis of the big toe. They took me to ultra sound section as they are testing a technique of using ultrasound to try to see the thickness of cartilage as X-rays don't reveal that.
The ultrasound technician said that he did not see a huge difference between the more painful left toe joint cartilage thickness and the less painful right toe cartilage thickness. The specialist wanted to be present there too so he arrived later. He seemed more interested in the technique than me. So he thinks it is early phase of big toe arthritis.
The ultra sound technical said the difference was simialr to 1.23mm against 1.27mm for example. She was not convinced of any big difference outside the scope of ultra sound error.
Here is the thing-
My Canvas SUPER flexible thin soled shoes cause the least amount of pain when walking.
My Addidas stiffer soled shoe but still able to bend shoe cause the maximum pain when walking.
This confused the doc as stiffer soul normally helps in this case and flexible soul is bad for the joint. His superior came then and explained the reason the Addias hurt more is because they are not stiff enough ie. they still bend and hence put greater force on the joint. Stiff and bendable = more force on the joint. I need shoes that don't bend at all. Stiff as wood to protect the joint. Made kind of sense to me…..I think.
Anyway there is not much they can do now. They have a shoe section inside the hospital and they made me try some stiff shoes. I must say that if I wear my Addidas shoes then within few steps of walking I can feel greater pain. Their super stiff soled shoes did not cause similar pain after taking few steps. I don't know how it will be I wear for longer period though. They were very expensive and the choice was very limited. So I wil be buying similar stiff shoes from mountaineering/hiking/sports type of shop. Completely stiff with rocker effect soul to make walking possible despite the stiffness of the sole.
So there is where I stand currently. If you remember my X-rays were normal according to everyone who had seen them. Althought the X-ray has a comment section where the X-ray department had written everything normal…..very slight irrelevant “bone scelorisis”.
So looks like I don't have Gout. Not sure if it was better to have Gout or this
I definitely have higher blood uric acid levels but all docs have said I should not worry about that Ultra sound also revealed that I don't have any build up of fluid in the joint. Which is a good sign with regards to infection or fluid build up that occure in Gout patients. Hence easier to draw the fluid to test from the little joint. For a joint without any extra fluid buid up it is close to impossible to draw liquid for testing. Which different specialists have repeatedly told me.
To conclude I really don't know what to think of last 10 months or what I really have. I will go with big toe arthritis for now I guess and buy the super stiff soled shoe. Hope that helps a bit but looks like I will be going down slippery and painful slope of arthritis if the doc's diagnosis is correct. In my 30s and body already falling apart.
Hi vegetarianGuy,
I have gone through more( and still going through( than 75% of similar stuff that you are going through now.
I will write more details later but only wanted to tell you that though they told me similar arthritis stroy, I have been able to reduce my pain to a large extent and walk much better now.
This is what doctor at the X-ray place wrote about my big toe-
“Inconspicuous bony structures without osteolysis or sclerotic changes. No degeneration in the Big metatarsophalangeal joints. Appears normal to the sesamoid. Normal position. No soft tissue swelling”
I found this chart online. Could I be on Stage 1 hence nothing in the X-ray? Although my joint pain is constant and hardly vague. Granted not extreme pain but based on the chart I think something would show up on the X-ray if it was athritis.
haracteristic Findings By Stage Of Hallux Limitus Symptoms External appearance of the joint X-ray findings Treatment Stage 1 Vague joint pain No change evident No changes noted Dancer's pad or sub 1 cut out in an orthotic Stage 2 Increased frequency and duration of pain Mild dorsal exostosis Dorsal exostosis on lateral x-ray Carbon plate with Morton's extension. Possible joint revision. Stage 3 Pain with all activities Large dorsal exostosis Increased dorsal exostosis. Asymmetrical joint space narrowing Youngswick osteotomy with joint revision. Stage 4 Significant pain with any range of motion of the joint Enlargement of the entire joint Flattening of the joint with prolific spurring surrounding the entire joint Joint replacement, fusion or Keller bunionectomy Surely 'Hallux Limitus' just means 'a mechanical problem with the toe that we cannot diagnose'?
From my very limited knowledge of problems with this area of the foot, I suggest that your symptoms bear much more resemblance to a sesamoid or other mechanical toe problem than they do with gout. I remember earlier discussion on mechanical v rheumatological issues, but it seems that the mechanical specialists are not providing much help – unless of course the very stiff shoe is a reliable cure and not merely palliative.
It looks like your high uric acid is throwing up a gouty red herring, given the absence of any change in your condition in 10 months.
Though it pays to continue monitoring uric acid, without other indications of gout (i.e. painful swelling in other joints and confirmation of uric acid crystals), I cannot see how any gout treatment is going to help you.
I'm not throwing in the towel – but I think you need FootPal, rather than GoutPal – unfortunately, such a beast seems rather hard to find.
Utubelite said:
Hi vegetarianGuy,
I have gone through more( and still going through( than 75% of similar stuff that you are going through now.
I will write more details later but only wanted to tell you that though they told me similar arthritis stroy, I have been able to reduce my pain to a large extent and walk much better now.
Waiting for your reply
I will hold on to anything right now for hope and solution. I joined a foot health forum and posted my X-rays there. The doc there thinks just like all the Rhumetologists I visited that my X-rays seem normal. I just feel that Osteopathist saying that I have Arthritis is bull and just guess work.
Yes it seems as if I don't have Gout. Unless I have some hybrid version just bubbling under the radar
Online a Doc said that maybe Bursitis could be the reason. I have looked into it's symptoms and does not look like it is that. I have taken online symptom quiz for Gout, Arthritis, bursitis etc etc and they all come to only 20-30% chance. Wtf do I have? (don't expect an answer just shouting out)
Mr Veggie
Being “new” to the club I fully understand your buzzing around in decreasing circles, I'm about to disappear up my own ass !
BUT as a professional chef by trade I do have relevent comments to make. We are on our feet 18 hours at a time so foot wear is Important .
Before you spend $300 or more on stiff hiking boots , try clogs ! Dr scholls has lots of them around and they are much cheaper. Dutch clogs are a bit too much but they have there moments.
I have also found that for around the house , I now constantly wear Crocs of all things. They provide me with a level of comfort that belies their pedigree, also pretty cheap.
Just my personal experience and may help you or others. I hope so
NEW DEVELOPMENT!!!
7th Feb Sunday– I was working through the night on my computer (which I do quiet often) and noticed around 6am that I was starting to feel bit more pain than usual. It was slightly further up the actual MPJ1 joint and towards the side of my toe. Also similar pain on the ball of my foot. I went to bed and woke up around 3pm. The pain has climbed to completely new level and more interestingly I can't bend my toe anymore. Through out last 1 year I have always had full movement of my toe joint and suddenly overnight I can't bend it. It hurt very much when I try to bend it. Actually I can't bend it even if I try to go past the pain barrier. It's as if the tendons have been cut and I have lost control of all the bending functions.
The ball of my left foot looks swollen and slightly reddish. The Orthopedist that I last visited said that I have “Big toes arthritis”. The pain is away from the MPJ1 now so I feel quiet confident that as suspected by me that he was talking bull just like all the other “specialists”!
I don't know what to do now or what my next step should be? Who do I see? Do I go back to wise @ss Rheumatologist who were clueless? Am I finally having a proper Gout attack or is it non Gout related? I really don't know who to see now nor what the hell I really have
Following from my last night post……
……I have absolutely clear photographic evidence now. Left foot is lot swollen and definitely red in colour with dash of blue. It is also warmer to the touch compared to right foot.The cross marks show where I have hardcore pain. I cannot put my body weight on the X mark. Absolutely not as it hurts badly. This is completely new and higher level of pain compared to last 10-11 months.
What do you guys think?
Veggy- I was thinking, before your pic., that you were definitely sounding more like a gouty ! Wry smile…
I didn't respond as you had many previous advices and indications that it wasn't gout- and I didn't feel able to respond usefully.
However, your pic is a beaut for a gout book- as Zip would agree, as he might be planning one- from previous comments on my pics.
The doubt is still there though, as the swelling looks too far under the foot [for my experience anyway] and it still quite possible you have another, unspecified, inflammatory condition.
It's impossible for non medicals to diagnose here- you have to take a professional approach and go for further opinions, if up a dead end with current support.
Sorry you are having no luck in nailing this so far – as with knowing what 'it' is helps plan dealing with 'it'.
All the usual gout treatments for inflammation should hold good. All the same- go easy on self treatments!
Hopefully you know them all by now.
.
trev said:
Post edited 12:10 pm – February 8, 2010 by trev
However, your pic is a beaut for a gout book-
It's a beauty ain't it?
I was starting to lose credibility round here. I bet you guys were starting to think that I was moaning too much and dreaming up the pain LOL Well the volcano burst and I am covered in hot lava for all to see.So I went to ER today as I was not able to walk. Lady Doc was not sure what was causing this. She thinks it could still very well be non Gout related.She thinks that Gout attacks come and go suddenly and 10 months of non stop pain sounds rather strange and not typical Gout modus operandi.
She remarked that my left foot was hot to the touch. She will be ordering reports from all the specialists I visited to form a fuller picture. She took my blood to conduct various tests. She gave me Ibofrofen 400mg tablets for next 3-4 days. After which I am supposed to take 300mg Alluprinol dose for a month to see what effect that has on my readings. She said that if Alluprinol works then we know it is Gout. If not then we know it is non gout related. She will be calling me next week. She did seem clued up on the whole.
Anyway the pain is flattening me. Walking is impossible. I went to ER by taxi but came back by public transport as I had to pick up Alluprinol from pharmacy. Big mistake as the trip home was torture and comical. I am really drained so I am hitting the bed.
P.S- Can only one month of Alluprinol 300mg use show noticeable reduction in blood uric acid levels? I mean enough to judge Gout as the cause?
Hi vegetarianGuy,
My apologies as my response to earlier posts is still pending. I will write more details soon as your case is almost identical to mine. Your pictures are almost replica of my foot few months back( except that it was right foot in my case), exactly same type of swelling and almost same spots of pain.
And I also suffered the same way like you did, which made my walking impossible. I will try to locate pictures of my foot and load it for you to see and compare.
And my diagnosis was also all too much confusing( it is still) but I took treatment for Gout and mechnical problem both and things have improved.
I will write more details soon. Just going to attend an urgent meeting.
Utubelite said:
Hi vegetarianGuy,
I will write more details soon. Just going to attend an urgent meeting.
Do not worry 🙂
Ok after another 6 hours of sleep the difference in pain is like night and day. I can press areas which I could not even touch earlier today.So Ibuprofen did it's work by the looks of it. My foot is still puffy but not as much as before. I am not sure if the pain has actually gone or the pain killer is masking it. Can a Gout attack calm down within 12 hours? Or does this calming down point away from Gout?
If I pulled a name out of the hat for your description VegGuy, it would be 'Psuedo'gout – though it usually attacks in the knees.
Have you had your Calcium levels checked?
trev said:
If I pulled a name out of the hat for your description VegGuy, it would be 'Psuedo'gout – though it usually attacks in the knees.
Have you had your Calcium levels checked?
Don't think my calcium levels were ever checked. Unless the ER Doc is testing that too. She has my blood currently. Do you mean calcium in blood or in bones? Not really clued up on calcium side of things or how the readings are taken. I will Google it up. I do understand 'Psuedo'gout though. I don't know how relevant it is but I have hardly eaten dairy stuff in years. Some cottage cheese once in a while only.
VERY VERY INTERESTING DEVELOPMENT-
I just woke up and decided to check my blood uric acid levels. Guess what? I thought I was dreaming when I saw the reading so I re did the test. Holy batman they were in 5.6mg/dL range. What is so special about that reading you might ask. Well in 40+ readings that I have taken over last one year (including the ones at the GP's place and one single reading from 2007) I have never got a reading below 7.13mg/dL (7.13mg/dL was my lowest ever until today). My average readings have always been in 7.5 to 10mg/dL range!!!!!!
My conclusion? —> As we know that during a Gout attack the blood uric acid reading drops so the case for what I had one day ago being a Gout attack strengthens. Do you see any merit in my thinking or am I wrong?
P.S- No I have not started taking Alluprinol yet. I will start it on 13th so the above reading is without Alluprinol.
P.S 2- One day before the attack it was 7.3.
I never realised you had such high steady UA readings, VG!
Have you kept that quiet , or I have I just missed it?
On the calcium, I think it shows in the blood but haven't read it up lately, like you intend.
Anyways- if you are soon starting AP you will find out more as it kicks in hopefully. It will be interesting to see whether you escape further flares now you are over the worst of the last attack.
It does seem , though- that was a huge drop of UA from previous readings without any treatment.
PS: If you want to help gout, dairy is no bad thing, especially if you're low on protein.
Where DO you get yours from normally? Protein , that is…
I do eat fish sometimes and quite lot of varied nuts.
Good luck with the meds, anyway!
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