RA versus Gout

[Larry]

I have had Gout since 1985 and while at Mayo Clinic 12 years ago they diagnosed me with RA. When I was talking to the doctors I told all of them it feels like a Gout attack. In the past several months Mayo has developed a new way to detect Gout even if your Uric Acid levels are below the necessary point to cause another attack. With this test they determined that I have Gout in every joint of my body so that explains the constant pain I have had since they got the RA under control 6 years ago. I have increased my Allopurinol dosage by half a pill and eventually get the Gout under control. I am concerned now that with the increase I will be experiencing quite a bit of pain. This newest testing method developed by Mayo was a great relief for me and Mayo because none of them could say why I have so much pain with the RA under control.

[Keith Taylor]

Hi Larry – very interesting.

I have increased my Allopurinol dosage by half a pill and eventually get the Gout under control. I am concerned now that with the increase I will be experiencing quite a bit of pain

I don’t understand exactly what you are concerned about. Can you clarify? Also what are your uric acid levels?

[Ron Avery]

Hi Larry,

What was this new test that they used ?

Thanks,
Ron

[Larry]

Hello Ron the test is called Dual Energy Non Contrast CT Scan and they just developed this testing in the past 6-12 months so fairly new. They suggested that the Gout is through out my body and they said to increase my Allopurinol 1/2 a tablet but they did not say how often to make the increase. I waited for three months this last time and when I raised up the dosage I noticed an increase in pain but maybe when I get to a certain point it ight just give me some relief. The doctor also said the old sayings of Gout not going above the waist, Gout usually doesn’t attack larger joints, and when someone tells him that their problem feels like Gout he will believe them from now on and start testing to be sure. My concerns now are how more continued pain I will get and how often can I raise the dosage to get rid of it seems tome the quicker I raise the dose the faster the relief. Anyone that have any ideas please let me know.
Larry

[Larry]

Hello Keith sorry it has taken me so long to reply but we have been helping my wife’s sister fighting her cancer. I told Mayo for the past 12 years that my pain feels just like Gout and they said it cannot be because my Uric Acid levels are below the 5-6mg level. After the Dual Energy Non Contrast CT Scan they performed it showed that I have Gout throughout my body so that is the cause of the all the continued pain. My pain levels never go below the 8-10 level so had them confused because my previous RA diagnosis levels were gone so why all the pain. The doctor came into the office and told my wife and myself that when you guys tell me if feels like Gout he will have to listen more now that they developed this new testing device. We were so excited to finally hear the reason all the pain even though it wasn’t such a great diagnoses that I forgot to ask him how often I should raise the half a tablet. I am currently at 300mg and raised it from 200mg 3 months ago. I am considering going up a half a tablet about every 2-3 weeks until the pain quits. I fully understand the way Allopurinol works and the reason it will cause more pain until the Gout gets under control. I also thought about this last night that maybe I will take all 300mg in the evening so when the pain starts I might be able to sleep it off. I am just hoping and praying that I will get rid of the pain that has been so extreme for so many years. I cannot believe that the body can react to something like Gout and Mayo could not determine that this is what was causing it until now but I guess when my Uric Acid levels were that low they had to believe what they saw. Now with all the Uric Acid active in all of my body joints like it is wondering how long it is going to take to get it under control. Anyone with pain from Gout that is continuous I would tell them to consider asking Mayo Clinic for a test like I had to determine if it is in every joint. Any ideas on what I should do to get pain under control please let me know.
Larry

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