November 19, 2010 at 3:01 pm #3459
I am 41 yoa. I began having gout attacks (one or 2 per year) in my late 20's. They were bad attacks, crippling. As time went on I could manage attacks (mostly with ibuprofen) better and could avoid full blown incidents. As time went on I tried herbal remedies, baking soda, ect.. with little success. With age the attacks became more frequent, again I could feel them coming on and could manage with handfuls of ibuprofen. By this time I had been to a few doctors and had colchicine at the ready and would use it if necessary, the nausea and diarrhea it caused was worth it to relieve an attack. Finally last year my local family physician talked me into allopurinol. For the past year I have been taking 300 mg plus one .6 colchicine. Life has been great, no attacks, no swelling, looser joints. At my regular physical my liver function tests came back elevated, nothing outrageous (AST @55, ALT @70 and GGT @80). I enjoy my beer, maybe 4-5 nights per week 6 to 10 12 oz, per day. The Doc, of course, told me to cut back on the alcohol consumption. I get a physical every year and have never have had elevated LFT's (liver function tests).
1.) Is time catching up with me? Can my body no longer tolerate the beer it once could?
2.) Can the allopurinol and colchicine therapy be causing the elevations? The only thing different from last year to this year is the allopurinol and colchicine
3.) It has been 2 months since the original tests, I went back today to give blood samples again and discuss with the Doc.
4.) If the LFT's come back elevated again, I think I will back off the allopurinol for 2 months and try and get by on 2 colchicine per day, get retested again.
5.) If the allopurinol is the culprit, do I try probenecid or Uloric?
Any thoughts? Thanks in advance
November 20, 2010 at 6:32 am #10646
Till you get your results due- try not to jump the gun. You need specialist advice to take these meds with kidney function loss.
There's a lot of discussion on various meds here that can apply differently to each taker- but one thing we all agree on is that alcohol is BAD for un-managed gout.
If you take this seriously by reducing your alcohol intake to minimal until your figures on SUA stay down ,and comfortably,- then the docs will think harder for you 😉 -and be more inclined to back off the meds, if causing side effects.
You definitely don't want the pain back, do you?
Don't forget your SUA readings for here- they are a big indicator.November 20, 2010 at 7:19 am #10647
Your liver functions are only slightly elevated, of no immediate concern unless they go up a lot more..
If I had to make guesses, in order of preference for cause:
1. Heavy beer drinking…who do you think you are, ME?
2. Too long on colchicine. Colchicine is a strange animal: it readily raises liver enzymes and yet it is often used to TREAT liver ailments, it seems to slow the progression of sclerosis, seemingly by its anti-inflammatory properties.
What I would ABSOLUTELY NOT do is quit the allopurinol. Is is probably having little to do with your liver enzymes but a LOT to do with controlling your gout. You will regret stopping it for a couple months and restarting. That is a GUARANTEED way to provoke a serious gout attack.
So see if you can cut the beer drinking to 3 bottles, 3 nights a week (I know, not easy) for a month and retest, you might get an answer. Better yet, no alcohol for a month and retest. If still high, then go back on the sauce (maybe a little less) and stop the colchicine for a month and retest. You will have your answer.
If enzymes are still high only then CONSIDER a trial without allopurinol.November 23, 2010 at 10:20 am #10659
My doc called me back yesterday an advised all LFT's came back normal. The only thing I can think of is that the weekend prior to my initial blood test I was out with some old college buddies two nights in a row on a bit of a bender. Maybe the abnormal (even for me) alcohol intake sent the tests up.
I was going to take your advice and remain on allopurinol no matter what the outcome of the LFT's were. I just called the pharmacy and ordered up a 3 months supply.
Trev and zip2play, thanks for your comments. Between this forum and working with my doc I am hopeful to succesfully manage my gout.
I do think it is important to keep aware of your liver function tests and UA levels going forward. If I didn't have the elevated LFT's I would not have been aware of the importance of my liver's health. Going forward I will closely monitor my UA and LFT's as part of managing my gout.December 22, 2010 at 2:13 pm #10810
Also, isn't allopurinol metabolized in the kidneys…so in theory at least, we should have little effect on the liver?
I would say for sure it might have been the “benders”February 19, 2011 at 9:55 am #11157
I have found that my liver enzymes (AST and ALT) are significantly elevated during an acute gout attack. The 300mg daily Allopurinol I take has not raised my liver enzymes, which is very important to me as I have NASH (non-alcoholic steatohepatitis) and I MUST keep the enzymes down. I do this with a “no alcohol, no high fructose corn syrup, low fat, no red meat, chicken or fish once a week” diet that I've followed for over 3 years. I keep my weight where it should be (I'm 6'1″, small frame, so I try to stay below 190lbs. This seems to work for me…February 19, 2011 at 1:12 pm #11159
I have been having gout type symptoms now for about 3 years. My uric acid levels have not been high. My ankle would swell and lock up. It would change from one ankle to the other, always in a different place/muscle in my foot. when my feet would hurt, my hands and wrists would also hurt, but not as bad as my feet. I would have to get out the crutches when it would hit my feet. My knee swelled up and locked up once. I had fluid buildup and a lot of pain. I had determined that tomatoes had something to do with my gout or pseudogout. allopurinol would not help any. 1200mg of ibuprofen would help a lot. colchicine (sp) would help, but about as much as the ibuprofen. I started noticing that the home remedies that some people would post on some of these forums had something in common. the things that they said helped, also helped detox the liver. I decided to try to detox my liver, so I googled it and found that Milk Thistle was the most recommended liver detox out there. I went to Wal Mart and got some milk thistle from the vitamins rack. It is 1000mg per capsule. I took one in the morning and one in the afternoon for 5 days. After the first day I was pain free. Now I just take one capsule a week, or, if I eat the wrong foods,I might take one if I feel any kind of soreness in my knees or ankles that isn't normal. It had been about 6 months since a flare-up. do a study of the liver, and how it filters the crystals our of the bloodstream. It was an eye opener for me. Hope this helps someone.