Uric Acid Levels query

[Benedict]

Hi all

Some advice would be greatly appreciated.

I had a gout attack (9 out of 10 pain-wise) a few weeks ago in my big toe. I was my first major attack since my first one at 25. Anyway since the attack I’ve completely cut out meat and fish, no alcohol, fried food, have been eating in moderation…I’ve had chicken probably 4 times in 3 weeks, am losing a pound week.

Had a blood test last Friday and the results I’ve been give are simply 0.54 (mmol/L I assume) which equates to 9mg/L on the handy calculator on this site. Since then have been on 2 * 0.5 mg colchicine and ibuprofen when needed.

Two questions
1. currently I have really weird tingling sensation all over the front part of my gout foot – could I be having a silent attack? And am I only avoiding a flare up due to the Colchicine?

2. have not started allopurinol yet but I’m thinking of starting 100mg daily and increasing dosage after a month since my urate levels seem to be in the dangerous category. My doctor doesn’t believe I should start until a few months gout free but I have 6 weeks supply of it at home. Will taking the colchicine (and ibuprofen) alongside the allopurinol decrease the risk of another flare up (caused by the allopurinol)?

Thanks

[Keith Taylor]

1. Uric acid crystals are attacked by your immune system and other cells every day. When a critical number is reached, your immune system starts a process called phagocytosis. I call this “calling in reinforcements.” Most gout sufferers call it bloody agony! In between that reaction, and no noticeable reaction there is a range of symptoms. Tingling, pins and needles, numbness, itching, and redness are all common.

Note that the other cells I referred to are ones which were destined to replace bone, cartilage and tendon. Because these cells get caught up in the battle, these tissues do not get repaired, leading to joint damage.

Colchicine stops, or limits phagocytosis, so what you are experiencing is nicely described as a silent gout attack. Hope you haven’t got copyright on that, Benedict, because I will be using it in future.

2. Start allopurinol as soon as possible to reduce the time you are at risk from gout attacks – silent or otherwise. Research in 2012 proved that previous advice to wait until gout flares have subsided before starting uric acid lowering is wrong. Colchicine and ibuprofen will deal with your current attack, and allopurinol will not affect that. You should always Start Allopurinol Quickly, But Carefully.

[Benedict]

Thanks for the advice Keith, much appreciated.

[Gilles Corno]

Hello;
I have been following this site for years, not always here reading things, but still working on my gout condition nevertheless. Using the UA testing kit, and the gout journal to record my results, I have had some highs and lows in my test results and spirit as well over the years. I have been trying to control my gout via my diet. Back in 2012, I was down below 6 all the time, and sometime after my uric acid level jumped to above 6, all the way to nearly 9!!! I was having slight gout attacks about every month, requiring Alieve for 2 – 3 days to calm things down. Recently, reading on the nutritional front, I remembered that back in 2012, when my uric acid level was low, I was eating my fruit deserts at least 2 hours after meals. Since October 2014 to now, I went back to this practice. Surprise, my uric acid level suddenly went down to nearly 6 in 5 weeks, from 8,8!!! Medical fact: eating fruit immediately after meals, causes fermentation in the stomach which turns fruit sugars into alcohol. Some people having never consume alcohol life during have been diagnosed with liver cirrhosis. This is an important factor to consider.
My uric acid level will likely fluctuate in the next few months because of uric acid crystals going back in solution. My general joints condition right now is excellent, and event some arthritis flareups have stopped for the last 3 months. I do think that along with the change in my desert intake, I have also reduced my sugar intake over the last 4 to 5 months. Together, those measures are giving me results.
Thank you for this forum to allow me to share my results, it is part of the satisfaction feeling!

[Keith Taylor]

I’m not sure you can claim it as medical fact without some reliable evidence. However, I’m pleased you are getting uric acid under control.

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