Gout Pal Interactive

You ought to go back on allopurinol straight away.

Why did you stop? Was it due to side effects of taking allopurinol?

Allopurinol will get rid of the uric acid that is causing you pain in a few months, but you must keep getting levels checked each month to make sure they are below 6. Your doctor should alter dosage to get this right.

The other 2 meds will help with pain until the allopurinol has done it's stuff.

Do not stop taking the allopurinol under any circumstances unless advised by a doctor.

Esther said:

My doctor thought it may be arthritis so I had both feet were X-rayed and it was not. I am going back to see  her on 9/30. I am going to ask to see a specialist.

I think that the sooner you see a specialist, the better.

The prescribing guidelines for allopurinol are quite clear - do not start it during a gout attack, but once started, do not stop it if another gout attack occurs.

In fact, it is common for gout attacks to occur during the first few months of allopurinol use. See my allopurinol medication page for more details.
I think of these as “good gout flares”. I know that it is hard to think of pain as good, but it is a sign that you are getting better, as long as your uric acid level is below 6mg/dL. Direct your doctor to this page - I would appreciate her comments.

Esther, never apologize for long-windedness here

The more information, the easier to offer advice, and the better quality that advice.

Blood pressure and gout form a very complex relationship. There are different types of blood pressure tablets, and some should never be prescribed to gout sufferers, or those at risk of gout (high uric acid level without gout symptoms, or family history of gout). What tablets are you taking?

In “Effect of allopurinol on blood pressure of adolescents with newly diagnosed essential hypertension: a randomized trial.”, Feig and colleagues note that allopurinol reduces blood pressure. Though their subjects are not typical gout sufferers, there is no reason to doubt that the effects of lowered uric acid will reduce blood pressure also in older people, though there may be other factors causing high blood pressure that prevent this improvement. Therefore, it is important to monitor both uric acid and blood pressure during allopurinol treatment.

It seems to me, that your health issues are getting you down, and maybe you can't see a way out of it.

The thing to do now is think and, more importantly, act positively.

I do not feel you are going to get very far with your current doctor. Stopping and starting allopurinol, and prescribing diuretics to a gout sufferer are against the fundamentals of gout management.

See a gout specialist as soon as you can.

As many gout patients also suffer high blood pressure, gout specialists know how to deal with this problem.

Get fixed. Get active. Then you will start to enjoy your life again.

It may take some willpower from you to work with the doctor, and getting rid of the uric acid crystals that have built up in your body may take a few months.

But it will get better.

Dear Keith,

I just want to keep you posted my progress. I went back on Allopurinol right away after seeing your response. Went to see the gout specialist 2 1/2 weeks ago. The first thing I told him was your website. I told him that your site was the most helpful and not just repeating the same old info like others. He wrote down your website address and said he definately checked it out. Anyway,  he  increased my Allopurinol dosage from 200mg to 300mg + taking .6mg Colchicine 2x/day to decrease the chance for a flare-up.

Just as you said, my new doc told me that my family doctor was totally wrong on how to deal with my gout med.  I should have stayed on Allopurinol during the flare-up.

I told him that I don't feel well with the new BP med even though it lowered my BP to an acceptable range. Also the new med is 6X more expensive that the old one.  I asked him if there is any way I can go back to the old med. He said that the new BP med that I got from my family doc is also a diuretic. He said that it is possible for me to go back to the old one if the Allopurinol dosage is increased. I'll have a lab test on my UA in Dec first then decide what to do.

Regarding the pain in my toes/feet, he didn't think it was from gout. He thinks tha I may have nerve inflammation from the arthritis in my hip and radiates all the way to my toes and feet.(I showed him the X-Ray report on my hip I had 2 years ago). He sugguested that I deal with one thing at a time .

Again, thank you so very much for all your support and suggestions. I feel much better now.

Hi Keith,

I am having some pain in my big toes but not sure if it is gout or my UA is up. Maybe you can help. I emailed my doctor but he is out of town.

The outside edges of both big toes next to the toe nail are red and shiny & slightly swollen. It feels like I have been walking in shoes that are too tight. No other areas has swelling or pain.

I had this symptom before when I was off Allopurinol. It lasted for over 2 weeks. I had this symptom again about 2 1/2 weeks ago after I eat a hamburger(first burger in over 4 months). It lasted a little less than 1 week.

Last Saturday, I went out for dinner and ate Chicken Masala with pasta. My toes got red & painful that night. It is still red & painful. I am still on Allopurinol & Colchicine as stated in earlier posting.

I drink at least 8 glasses of water + 2 cups of tea  a day. I eat very small portiion of chicken, fish or pork and lots of vegetable & fruits. 2 days a week I eat only vegetable soup and Quinoa salad. No meat.

What do you think? Gout or something else. Any suggestion to get rid of the pain? Thank you.

Thanks for your advice.

I did get a reply from my rheumatologist and he told me that it is not goutrelated. He suggest that I have nail infection from wearing tight shoes! I don't even wear shoes on a regular basis.

I thought he was excellent doctor. But after seeing his reply, I have my doubts now. I am scheduled for a follow-up RA test during the first weekin December and appt to see him a few days later. I am having pictures of my toes taken and will show it to him.

I feel that the redness & pain in my toes are small gout flares or at least it is food-related. I trust your advice more than my doctors. I really appreciate all the information on your website. Thanks again.