GoutPal Interactive

Post edited 10:54 am – June 5, 2009 by GoutPal

It is important to get a proper sample to test.

The droplet of blood must be large enough, and placed accurately enough, to completely fill the [circular Edited as test strips now have different shaped cutout] cutout in the test strip. I have also seen uncharacteristic readings if I've failed to do this properly, so the best thing is to discard these results.

It is natural for uric acid to fluctuate – though the allopurinol you are on reduces the amount of uric acid your body produces, the level can increase from uric acid crystals in your body dissolving.

The important thing is to build up a good series of data over 3 months or so, including “official” test results from your doctor. This will enable you to have confidence that the allopurinol is doing its job, or signal a warning that your dosage needs to be reassessed.

As you say, time will tell. Importantly, this regulae testing is keeping you focussed on the most important number for gout sufferers.

Post edited 1:08 pm – May 30, 2009 by vegetarianGuy

My monitor is brand new and have taken 6 readings on the same day so far. Results are all over the place.

Tests 1 to 4 taken between 11 and 11.15am. All done properly with thoroughly washed and dried hands. Blood drop fully covered the test area in all  tests.

test1- 309/5.1

test2-298/5

test3- 375/6.3 ( overflooded it with 2+ drops.)

test4- 375/6.3 ( overflooded it with 2+ drops.)

Two hours later after eating lunch-

(test 5 and 6 done at the same time)

test5- 470/7.8 ( overflooded it with 2+ drops.)

test6- 494/8.2 ( overflooded it with 2+ drops.)

Why 24 point difference between tests5 and test6 when they are only one minute apart? As cute as the monitor is I thing it should be used as a rough guide. I don't even know what to make of the fluctuations in the results.

My preference for 2 hours after eating to test for the effect of a meal comes from “Changes in serum and urinary uric acid levels in normal human subjects fed purine-rich foods containing different amounts of adenine and hypoxanthine”, which states:

Ingestion of all experimental meals caused an increase in serum uric acid levels at 120 minutes and this increase was more marked (about twofold) with haddock and soybean ingestion. In all groups, the postprandial[*] serum uric acid levels at 240 minutes were lower than those obtained at 120 minutes.

 Other studies seem to confirm this, but most data is locked up in the body of reports, and in most cases I can only afford to look at abstracts. (*postprandial used to stump me, but it just means “after eating” – I now drop it into conversation, looking both clever(my viewpoint) and a prat(everyone elses) at the same time.)

I'm not sure about overloading the test strips with over 2 drops of blood. I do remember that it takes a few tests to adjust the lancets to the best setting for your skin. After some practice, it is easy to get a single drop that covers the test strip indentation. I know that failure to cover that indentation produces very untypical results. The 24 point difference is only 5%, so this does not seem as significant to me as the fact that both results are over 420/7, and therefore risky. I found my early results fluctuated quite a bit until I got used to the test procedure.

Looks like I'll have to start over, as I got out of the habit when I lost my test unit when moving house last year. I have a new one now, so time for testing again.

Post edited 2:38 pm – May 31, 2009 by vegetarianGuy

A picture speaks louder than words. I took a close up photo of a perfect blood drop for the UASure kit test. Might help other new users. Is that an ideal drop? GotPal feel free to use the image.

P.S- This test gave me a 6 btw.

Post edited 1:12 pm – June 1, 2009 by zip2play

Basically vegguy, you are illustrating the problem with test kits.

Although I do not have diabetes, I got a glucose test kit on some almost giveaway deal just for sojme fun monitoring. Although I am following instructions explicitly and testing exactly the same way my readings even at the same time show too wide a variation.

That experience is precisely why I haven't sprung for the cost of a uric acid test rig.

Two thoughts on your testing:

1. Are you supposed to leave the drop or shake it off. It seems it's the blood wicked away into the gauzing that you want to measure (clear as mud)

2. Drop A seemed to leave a cleaner area in the upper right. Can that be an area with no blood and thus the lower reading?

(My experience with the glucostrips demands a ROUND reactive area about the size and shape of an actual droplet…this square gauzy looking reactive area is perplexing???? I don't think you are supposed to use any of these test strips with a standing blob of unabsorbed blood???)

But overall, if the strip you are using cannnot readily and dependably tell the difference between a uric acid of 6.4 and 7.4 it is relatively useless.

Did you opt for the Control Solution?

Okay,

I pulled up the online manual and looked harder at your droplets. On your lower reading with the samller drop that area of non-saturation seems to occur right over the electorde entry area and thus might show less conductivity…lower uric acid reading.

It is difficult to take an exact uric acid reading. Levels vary through the day, and at different sites in the body. These factors affect both professional and home tests.

Professional tests may also be affected by the time period between drawing blood and testing it.

Home tests, as you have shown, are affected by drop size.

I've asked the distributors about this, and they agree that variations are probable, as they are with glucose testing devices. They are not health care professionals, and cannot give any further advice about interpreting results. They have passed our comments onto the manufacturer, so there may be a response from them later.

I have noticed that the guide to the test meter recommends taking advice from a health care professional with regard to taking blood samples.

Personally, I have never sought such advice, but I'm happy to share my non-professional (? unprofessional ?) advice.

I seek to find a repeatable routine for testing, so I usually allocate a time just before breakfast. I wash and dry my hands, then get the meter, test strip and lancet ready, together with a sheet of kitchen paper, or tissue.

I have tried various settings on the lancet, and found the one that suits me. This setting consistently gives a drop of blood large enough to test. I find this is painless, and easy to reproduce – i.e. no arm-twirling or other blood flow inducing exercise required. Other people may find a different routine suits them, but repeatability is key to consistent results.

I perform the test, wipe my finger on the paper, and use it to wrap up the test strip and lancet for disposal. That is my test-focussed routine, which is now recorded for posterity as the Prick 'n' Go routine.

When interpreting my results, I tend to disregard any unusual highs and lows – a technique which is common in many a scientific investigation, though I do not apply accepted statistical formulae.

I have only used this routine to assess my weight loss, when I found a correlation between weight loss and lower uric acid. I may still attempt to use the meter to do interval testing after eating, but I know that this will require similar focus on establishing a repeatable routine, and discarding unusual results.

All of this may make you wonder if it is worth bothering with a test meter. I have strong sympathies with the view that the variations render such testing useless. Having said that, I have never questioned my doctor or hospital about the repeatability of their test results. Personally, I prefer to use the device, as time permits, to give me some confidence that, on average, any lifestyle changes I adopt are having a positive affect on uric acid. Quite frankly, this pales into insignificance if you get proper medical support for allopurinol, or some other urate lowering therapy, with follow-up care ensuring your uric level consistently falls below 6mg/dL.

I realise, VegetarianGuy, that you are  in the rather strange position of not having a clear diagnosis, and so your goals for using the meter might be different from most. All I can suggest is that you continue to establish a stringent testing routine. Set a time (or times) for doing the test, then focus on establishing an exact routine for taking the test. Iron out any aspects that make the procedure awkward, eg use a table, avoid testing certain fingers that rarely produce an easy to transfer drop of blood.

Focus on the routine. Then review results to investigate possible reasons for anomalies as well as any trends.

vegetarianGuy said:

 Btw I went gym first time yesterday after 3 weeks. Did only for half an hour of weights (no cardio). Tested one hour later and my readings were 16 and 11 Must be the lactic acid in my blood. This morning my readign was still 10.6 I did a control solution test and it came as 5. So monitor is working ok.  All this is just screwing with my mind so I will just act as if nothing is wrong with me unless  I get hit by a proper Gout attack. Till then I will stay away from the forum as all this is not good for my mental health.

I forget the exact medical term but it seems you are getting obsessivly overwatchful. Ah, the term is hypervigilant.

I would imagine that there is a chance that after a workout, if one destroys enough muscle cells that enough uric acid can be liberated from nucleic acid breakdown that free uric acid might soar…but 16 and 11 seem just off the pale.

If you must ultimately wait for an attack for control then you have wasted your money on the test rig. If I were you I would try to execvise that money back guarantee if there is one.

(Lactic Acid SHOULD not affect your result)

I realize that you are frustrated with the test but don't let it drive you to the very IMPROPER way to deal with gout…by taking action opnly AFTER an attack.

P.S. I saw that illusion and see that the electrodes both ultimately go under the drople…the first pictures looked like the area around the drop were for wicking away fluid to the electrodes, perhaps wicking plasma out of the whole blood.

My considered decision after reading these posts: the test rig is not worth buying.

The only thing I can think of off-hand, is to arrange regular “official” blood tests. I'm not sure how easy this will be for you given the previous professional responses that you have had.

Have more tests already been arranged or are your doctor and rheumatologist simply leaving you to see what happens next?

Post edited 10:39 pm – June 4, 2009 by vegetarianGuy

GP the Lot No: is US201C, Exp Date 2010-07

Well the GP said that he is “confident” that it's not gout. So that was end of it. The rheumatologist I went to privately and he said that my uric acid readings are high based on the GP readings I showed him (one from central lab and two from GP's local tests). Rheumatologist said that he does not think it's gout as my swelling was not severe and did not look like typical Gout swelling. He said the best he can do is for me to come back in 3months and he will do a blood uric acid test on me locally.

Btw the machine my GP uses locally involves taking around 1-2 small tea spoons worth of blood in a plastic cone shaped thing. Then he puts it inside a mixer looking machine. I could not see the machine properly as it was behind the counter. I wonder if at the main lab they use something similar or if they have even better machines?

Yes I am thinking of getting my blood officially checked regularly as well. Should not be too difficult as long as I pay $. What would you reccomend? Every month or every three months?

vegetarianGuy said:

 Btw I went gym first time yesterday after 3 weeks. Did only for half an hour of weights (no cardio). Tested one hour later and my readings were 16 and 11 Must be the lactic acid in my blood. This morning my readign was still 10.6 I did a control solution test and it came as 5. So monitor is working ok.  All this is just screwing with my mind so I will just act as if nothing is wrong with me unless  I get hit by a proper Gout attack. Till then I will stay away from the forum as all this is not good for my mental health.

I guess this could also indicate certain chemistry from body exercise could probably either increase the solubility of UA in blood or release certain anti-inflammatory agent which could tolerate the UA crystals, however, provided such exercies isn't so intense to physically traumatize any already inflammed joints and sets the inflammation on fire.