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Hi there,
Know this is my first post but really after some after advice from you guys.
Suffered from gout since I was about 25 / 26 years old, 29 now. I think I’m definitely more prone to it (perhaps hereditary)
as I have a good BMI and go the gym so not overweight. After my last attack around six months ago, which for the first time was
in my ankle joint and more generally more severe to my attacks in my toe joint, I decided to go on Allopurinol.I’ve been on Allopurinol for around 5 months now, 100MG once a day. My question is this: Do I raise the dose to 200MG?
I’ve had regular blood tests to determine uric levels and they do seem fine (4.2 or something last time) however I have a Tophi
on my right foot on the joint of the big toe. It still doesn’t seem to be going down……..I’d like to get the Tophi reduced for obvious reasons as I am only 29.
Thanks for any help guys.
Cheers,
Adam.I do not know much about tophi because i don’t have it luckily but i know it takes a long time with low UA to dissapear.
I take same ammount of Allopurinol as you (35 years old) and when you keep your UA level below 5 i guess it’s pointless to raise a dosage. Just be patient with your tophi, when your UA level is good crystals will disperse.Cheers Cujo, thanks for the reply.
I might just leave it for the time being then. I was thinking I might also try get referred to a specialist by my GP as
I’d like to try to understand why I am more prone to it than other people. Does anyone else have any experience of this?
Keith, not sure if you have?Cheers,
Adam.I am a 30 yr old started having gout attacks at 25. I do not have tophi but I know that hereditary factors and high puerile foods and alcohol contribute to the frequency of my attacks. I seem to have more attacks in the warmer months than the cooler months. I would also suggest that the kind of activities you perform in the gym should be such that they do not put lot of pressure on the ankle/toe.
@waterfall-manc, danger alert!
I’m guessing you are in the UK, and somehow linked to the wonderful city of Manchester. That means that your uric acid test results are probably in mmol/L and the value is more than likely 0.42 which converts to over 7mg/dL.
Short answer — get dosage increased to the max until tophi shrinks, then relax dose to achieve a maximum uric acid level of 0.30mmol/L (5mg/dL).
As I did, you might have trouble persuading your doctors about this. Just ask them to either check the latest recommendations from British Society for Rheumatology, or ask to be referred to a rheumatologist.
Oh boll****s
i honestly thought i was getting it under control, gutted.
ill give them a call now Keith. Thanks so much for the input, I wouldnt have known.
Will update after I have spoken to my GP…. they really are clueless about gout arent they.
Had to really push to get referred to rheumatologist.
needed new blood tests, still at 0.41 mmol/L. only been on 200 mg for around a month but seriously thinking of upping it to 300 mg. apperently 900 mg is the most you can
go on.For anyone reading, check out Keith’s uric acid levels chart. Very useful. As mentioned above by Keith my GP also recommended being below or on 0.3 mmol/L so some way to go.
I had a similar problem at my group practice. 3 doctors saw 0.40 to 0.42 mmol/L and said I was OK. I told them I wasn’t because professional rheumatology guidelines see 0.30 as the maximum (0.36 in exceptional cases). Eventually found the perfect GP who listened, agreed, and moved me up to 900mg allopurinol over a few weeks. I explained I wanted to go as low as possible for a few months because tophi had started to appear on my elbows.
Only trouble now is, I have to move doctor because I’ve moved out of the area. I hope I don’t have to do battle again, but I’m prepared if I have to.
@waterfall-manc, I hope you get to 0.30mmol?L or lower soon.
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