uric acid level tests

[Keith Taylor (GoutPal Admin)]

I have been on allopurinal (300mg) for over 2 miserable months now (the last month being the worst) and I have been reading about people getting uric level tests.  My doctor said nothing about me coming in for them.  He prescribed cholcine for the first 2 weeks. I even have been to the emergency room once where they gave me a shot of morphine and precribed prednisone (which I just now finished).  I can get refills for 5 more months of the allopurinal.  I have been taking a lot of ibuprofin and an occasioanal vicoprofin.  I have been on crutches for about two weeks and only now begginning to walk on my own, but with a limp. Should I be going in for uric acid tests? and do you have any other suggestions?

[Keith Taylor (GoutPal Admin)]

Oh davem, I hate it when this happens.

Allopurinol dosage is vital. If the dose is not taking you to around 5mg/dL then it is wrong. The only way you can know if it is the right dose is to have uric acid tests.

This does not mean that the gout attacks will disappear overnight. Gout attacks may continue for a few months as old uric acid crystals dissolve, but at least with proper dosing, you can be sure that the pain is not from new crystals, and that the end is in sight.

I recommend seeing a rheumatologist.

[zip2play]

You CERTAINLY need to be on colchicine for a FAR longer period than 2 weeks while the allopurinol gets a chance to stabilize your gout tophi because allopurinol can “shake up” those deposits and cause an attack even while lowering your uric acid load.  That doctor should be THROTTLED for giving your colchicne for only 2 weeks. But, in his defense, MOST people don't have attacks after starting allopurinol…but then who needs diagnosis by averages, eh?

Go to a rheumatologist and ask for a combo of allopurinol and colchicine for several MONTHS. Don't stop the allopurinol. After a couple months you will be able to drop the colchicine without fear…but always keep a bottleful on hand.

Yes, get a blood test as soon as possible (AND the colchicine) and make sure that with every routine visit you get your uric acid tested.

[Kvalhion]

I just started 300mg of Allopurinol.   Before I started, the last week or so I took indomethacin to help get rid of lingering pain from an attack that was several weeks ago.   If I start to feel an attack coming on, should I take a dose of the indomethacin to help stop the attack in its tracks?   The dose I have is 50mg.   According to the gout book I have, it says to take 100mg of indomethacin as soon as the symptoms start to try to prevent the attack, then 50mg 3 times a day until the symptoms go away.   Does this sound about right?

Here's hoping that I do not have any adverse reactions to the allopurinol. 🙂

[zip2play]

Kvalhion,

That's a decent plan, BUT I think you would be better off using colchicine rather than indomethacin. I've used both and there's no comparison. Cochicine gives you diarrhea, true, but Indocin can REALLY chew up your stomach, it's perhaps the very worse NSAID on your stomach lining. For me, it also caused a lot of dizziness (I took it for backache.)

Prophylactic colchicine will really prevent any attacks which is far better than dealing with them when they start.

Okay, that's the downside; the UPSIDE is that you may get the results I did…after starting daily allopurinol with nothing else I NEVER had another acute attack. Small tophi soreness yes, but never the horrors of the crippling  purple foot! So maybe you'll never need to know how well the Indocin works or doesn't work!

Good Luck!

[Kvalhion]

Excellent information!   I'd have to ask my physician for a prescription for colchicine.   For now I am hoping like you said — daily use of allopurinol and hopefully no acute attacks.   Right now I am alkalizing my water with small amounts of baking soda — about 1/8th to 1/4th of a teaspoon into a 32 oz jar of water.   I try to drink between three and four jars in a day.

I used a Ph strip and it seems the water is around 7.5 to 8.0 after adding the baking soda.  I should test to see what the water is beforehand.   I've had my blood pressure checked a few times and it doesn't seem to be elevating it, so maybe the small amount of baking soda spread throughout the day will help as well.

I tried many of the various home remedies and they reduced the pain but the pain lingered off and on for over a month.  The next thing I'll try is the black bean drink.  My feet arent too bad at the moment, which is good since I was able to work out for the first time in over a month on Monday. 🙂

Thanks for the advice!

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