Keith’s GoutPal Story 2020 Forums Please Help My Gout! uric acid levels normal

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  • #19702
    uptownbob
    Participant

    here’s a puzzle for you….i’ve had the seriously painful ” cry with the weight of a sheet’gout so i know what it’s like.
    my brother also gets gout and we both have been taking allopurinol 100mgs for the last 15 years .

    i currently have gout in my right ankle and left toe joint and although it’s painful at certain angles i can walk or hobble.
    2 weeks ago i told my doc i was sick of all this so he put me on 20 mgs a day of prednisone for 5 days and upped my allop. to 200mgs day.

    he also ordered a very heavy duty blood test for uric acid levels which took about 5 days to process.
    it was CPR, ESR tests and urates…here’s the thing and this has happened before…the tests came back saying all my uric acid levels were normal.
    now, i know from experience i have gout and a few years back when the problem of mini-flares occurred i had complete foot ankle and toe x-rays and all the joints were spaced correctly so i apparently don’t have arthritis.
    question…how can i have a gout with normal uric acid levels and where are the purines coming and going from….even sid vicious would be puzzled??

    #19706
    Keith Taylor
    Keymaster

    The real puzzle is how can a doctor get away with medical negligence for 15 years.

    The only reason for taking allopurinol (or any other uric acid lowering treatment), is to make uric acid safe.

    Normal is not safe. Normal is a useless laboratory statistic that says “Hey, we tested 372 people, and the average uric acid was 6.2 mg/dL. Applying Normal Distribution statistical analysis, this gives a Normal range of 5.1 to 7.6 mg/dL. (Obviously, not real numbers, cos it’s all b*ll*cks)” Medically, this is meaningless, and dangerously misleading. It has puzzled me for years that doctors can be so blind to this. When you tell them, they look at you askance. sid vicious had a word for these people, and I’m going to start a private forum so I can have an appropriate rant at this obscenity.

    uptownbob, you haven’t told me your uric acid level, but you do not really need to. It is over 6mg/dL, which is the maximum allowed for gout patients. 5 is safer because it gives you a safety margin for natural fluctuations. I always advise a year as low as possible to get rid of old crystals as fast as you can.

    Uric acid lowering treatment is like anesthetic during surgery. You keep measuring and adjusting the dose so it’s right for the patient. Anything else is dangerous.

    It’s great that the rest of your bloods are “normal.” Normal is good for kidney function and liver function tests, and all gout patients should get these whenever uric acid is tested. Normal for uric acid is meaningless.

    Post your exact uric acid result here, and let’s get a plan to make sure 2015 is the last year you ever have a gout attack.

    #19707
    uptownbob
    Participant

    ESR which very detailed…normal

    cpr normal 5

    urate 5

    so you see the mystery…all levels normal but i have gout which is diminishing but still seems to travel around my foot in twinges but the ankle is improving

    #19708
    Keith Taylor
    Keymaster

    Are you sure it’s mg/dL? I’ve assumed you are in USA, but you won’t be the first here who has mistaken 0.5mmol/L for 5mg/dL. Also, I have no medical training, so other tests don’t mean much, but your second line doesn’t look right! CRP?

    #19710
    uptownbob
    Participant

    sorry..yes..CRP ..something to do with inflamation…nope ..am in nz

    #19719
    uptownbob
    Participant

    apparently the CRP is 5 mg/L (<5)…whatever that all means?

    #19734
    Keith Taylor
    Keymaster

    CRP is an inflammation index. It is affected by many things, and not very useful as a diagnostic tool. However, it is useful to track it regularly, as spotting significant changes early can prompt your doctor to more specific investigations. Important when you take allopurinol or Uloric, but probably useful for any meds.

    I’m far more interested in your other abbreviation – nz.

    New Zealand labs that I have seen use mmol/L for uric acid test results, but there could easily be others that use mg/dL. The number needs a scale, otherwise I’m clutching at straws here. There are reasons for gout flares at 5mg/dL, but my advice will be much more relevant if I am certain about the numbers. Also, some earlier results, would be useful.

    For any other visitors reading this. Keeping a diary of uric acid test results is one of the best things you can do for gout management. Record the date, number, and units of measure. Even better, record it in your Personal Gout Profile, on the page that shows when you log in.

    #19761
    Keith Taylor
    Keymaster

    Hey @rob-pharazyn I just realized I missed a point on Facebook.

    You asked:

    just posted a question on the forum but forgot to tick the “notify me of emails” box..it’s still in moderation so is it possible for you to tick the box

    I replied:

    Just tick it when you respond

    What I should have said was:
    Just click the Subscribe link at the top of the post.

    It works for all posts, and is conveniently located next to the Favorite link. It’s good to mark favorite topics, so please can everyone do it at least once a week! Clicking Favorite in the gout forum is similar to clicking Like in Facebook, only much nicer. 🙂

    #19765
    uptownbob
    Participant

    thanks keith…i’ll get a copy of my latest bloods and send you more data..yep, nz is new zealand…middle earth…paradise

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