- This topic has 2 replies, 3 voices, and was last updated 11 years, 2 months ago by
.
-
Posts
-
Having read several posts here about the controversy of how low should UA target be, I thought some of you may find this useful. Yesterday, my rheumatologist told me to double my Uloric dose to 80 mg / day because he wants my UA target to be 3.0. He said normally his target is below 5.0, but in my case, he wants to go lower. Here's my situation:
* Was running 9-10 range for at least a year. Started on Uloric 40 mg (can't take Allopurinol) in January and within 2 weeks, level was 4.5, then 4.9 a month later.
* saw some significant improvement over the last couple months with the exception of 2 major flares ups. When not having flare ups, was able to get rid of the cane and walk almost normally.
* However, still had a major flare up in February and another one beginning of March. each lasted about a week.
* I had a kidney transplant 15 years ago, so I have reduced ability to excrete UA and I take an immunosuppressant called cyclosporine which also reduces the ability to excrete UA.
* So, he wants me to target 3.0 because
1. Even below 5.0 UA, I have had two major flare ups and
2. with my kidney and cyclosporine levels, I need the extra help.
(Incidently, this is probably not the typical flare ups due to the sudden lowering of UA. I had no flare ups during the first 2 weeks when my UA went from 9 to 4.5 or for the following 4 weeks).
He is the expert and it sounds reasonable to me.
BUT, achieving a 3.0 is not easy without also adding a uricosuric, if even THEN, which in your case is probably contraindicated.
Problem is that the lower the SUA the lower the excretion rate of urate…so lowering SUA is sort of self limiting.
- You must be logged in to reply to this topic.