Gout Flares triggered by Statins?

[P Mb]

Hi,

I just wondered if anyone else has experienced flares (possibly) triggered by statins?

I’ve twice tried to take Atorvastatin and both times had really bad flares within a couple of months of starting – even when on 300mg Allopurinol.

Would be interested in others’ experience here.

pb

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Statins Reduce Gout Mortality

[Keith Taylor]

Hey pb ( @p-mb )I’m sorry that I missed your post and hope you are still reading this forum.

Triggers for gout flares are very complicated. But absolutely impossible to guess without knowing your blood uric acid level at the time of the flare. Because flares can be caused by new crystals forming (bad). Or by old crystals dissolving (good). Search ‘Allopurinol Medication: Why It Hurts To Get Rid Of Gout’ using the search box near the top of each page.

Anyway, the important thing is to get uric acid safe. Because then you can never have a gout flare once old uric acid deposits have dissolved.

Importantly, I started checking for links between statins and gout. Now I haven’t yet found links between statins and uric acid. But the revelation that statins improve mortality for gout sufferers is great news.

If anyone wants me to summarize more research on statins and gout (and/or uric acid), please let me know.

[P Mb]

Hello Keith,

Thanks for your response. It’s a complicated area to be sure. I’ve been poking about in research papers too, but completely off the original thread subject now – mainly about uric acid in the body when you’re hyperuricemic but *don’t* have attacks.

It’s interesting yet scary the damage that UA can do (eg: to tendons). Needless to say I’m back on the 300mg allopurinol – despite the side effects!

What I’m interested in now are the chemical processes – eg: the *negative* effects of xanthine oxidase suppression; one thing is for sure though – biologically, none of these gout pathways are simple!

pb

[Malik A.]

It’s an interesting question and certainly has me thinking. I started Atorvastatin a month or so ago and had my first attack in about two and a half years not long after. Might be a wild coincidence, but your post certainly has me thinking.

[P Mb]

Hi Malik,

Thanks for responding. There are anecdotal reports of statins causing joint/muscle pain. So my theory is that since uric acid tends to agglomerate at injury sites it’s that’s that triggered my attacks.

It’s just a theory, though – the whole ‘metabolic syndrome’ thing is very difficult to pick your way through when you’re trying to focus on one element.

I’m afraid I’m taking my chances with the high cholesterol now and only taking the allopurinol – that may well be medically inadvisable, but it’s my choice.
We’re all different – and I do genuinely wish you well with your treatment(s).
If you can find the time sometime in future, it would be good to hear how your gout gets on with your statin therapy.

pb

[Keith Taylor]

but it’s my choice. We’re all different

I think that neatly sums up my opinions on both allopurinol and Atorvastatin.

I remember an interesting discussion about statins in my 50s. It was with the one doctor who understood gout. Now that’s not relevant to the statin discussion but it made me listen to him more than other doctors who didn’t even understand what statistical normal distribution is (don’t get me started!).

His explanation was that during his time in practice he’d seen a substantial drop in heart disease. He put that down to decrease in smoking and increase in statins. Though he readily admitted this as a belief rather than a scientific study result. I interpreted his advice as part of the risk-reward balance that all doctors have to make decisions on every day. And as I could see no risks to taking statins, I take them.

Similarly, with allopurinol which I’ve studied in more detail. I’m aware that some moronic doctors will start with a very risky 300 mg dose. Fortunately, that’s never happened to me. Anyway, I cannot find any studies showing adverse effects when allopurinol is prescribed according to modern protocols. Also, I’m more aware than most people of the terrible damage that excess uric acid causes. So daily allopurinol is a no-brainer for me.

But if you look back on old forum discussions, you’ll see that it took me many years to realize that.

It’s worth repeating pb’s comment:

but it’s my choice. We’re all different

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