Time To Dissolve Uric Acid Crystals Depends On Gout Duration

I’ve explained about crystals on my uric acid crystal page. A new study looks at the time it takes to dissolve uric acid crystals. The report in the latest issue of the Annals of the Rheumatic Diseases concludes that there is a direct relationship between the length of time a patient has suffered gout, and the time taken to dissolve uric acid crystals.

Pascual and Sivera’s report, The time required for disappearance of urate crystals from synovial fluid after successful hypouricemic treatment relates to the duration of gout, looks at 18 confirmed gout patients.

All the gout patients were undergoing treatment to lower uric acid. All had fluid drawn from a joint (11 knee joints, 7 toe joints) every 3 months. Results showed that the number of uric acid crystals found in the joint fell significantly during the first 3 months. Patients with short term gout had all crystals dissolved in the first three months. For others, the decrease in crystals continued. All patients had all crystals dissolved after a maximum of 33 months. The length of time for crystals to dissolve correlated with the duration of gout.

Your Uric Acid Crystals

Have you undergone uric acid lowering therapy and been tested for uric crystals? How long did it take, and how long have you had gout? Let us all know by commenting below, or send me a private message on my Contact Form.

4 Comments

  • Danny Boy

    Hello I am new here but I wish I had found you so much sooner…I am 49 left the military a year ago….I have suffered for about 25 years but refused allopurinol……I am on it now though!!! 300mg But I am experiencing an almighty attack which has been on me since Jan 2012 and it is now March 09th….. The pain has reduced me I am ashamed to say to tears and at times made me think Life is not worth living when you are like this….Can you help me will the Allopurinol kick in soon ?? I have a large Tophi on my elbow as well…. I am usually fit and worry that this curse wll cause me to lose my employment….I have a family to feed….HELP

    • Hi Danny,

      You need to take control of this straight away.

      As you can see from the report I mentioned above, uric acid crystals can take months, or even years to dissolve.

      The first thing you must do is to make sure your allopurinol dose is high enough to dissolve crystals.

      As you have proved that you can tolerate allopurinal (some people have an allergic reaction to it), talk to your doctor about increasing the allopurinol to the maximum daily dose. This will get rid of tophi and other uric acid crystal deposits quicker, shortening the period of time you are at risk of gout flares.

      You must also be prepared for flares. At the first sign of an attack, take one or two colchicine, and repeat each day until the flare goes. If you catch it soon enough, the flare will last only a few hours. During that time, take an anti-inflammatory such as ibuprofen or naproxen. You can alternate this with other pain relief as advised by your doctor or pharmacist.

      I understand the pain you are going through, but please believe that these actions will clear your gout. I have shown myself that taking control, as I have described, is a very effective way of removing immediate pain, safe in the knowledge that, in a few months time, I will not need pain relief in future, and I will be able to lower the daily dose of allopurinol.

  • Paul

    Water water and water are the three most important things.

    I disagree with the prior comment that Allopurinal will help “dissolve” the crystals. It inhibits the formation of new uric acid in the blood but dies nothing to dissolve exiting crystals.

    I am the same age and also put up with it for years before seeking treatment.

    I suggest that you google “blood ph” and “gout” to look at foods that will help raise your ph. Then discuss it with your doctor.

    I am lowering my uric acid level and have been for some time. It hurts almost as much as the crystals leave

    • You are correct in saying that allopurinol does not directly dissolve uric acid. However, we know that a dose of 300mg is not sufficient to lower uric acid to a safe level for most gout patients. We know that increasing allopurinol up to the maximum 900mg per day will reduce uric acid levels for most people. We know that lower uric acid concentration encourages uric acid levels to dissolve. When replying to comments, I try to shortcut the explanations if I think it will help the contributor. In this case, the shortcut answer was to check that the dose was high enough. I should have made it clear that allopurinol dose needs to be set at a value that brings uric acid concentration to a maximum 5mg/dL (0.30mmol/L). Several months at a concentration well below this will shorten the length of time to dissolve crystals and thus shorten the period of risk for gout flares.

      Please can you discuss water/fluid/hydration in the hydration discussions. Please can you discuss pH in the alkalizing gout diet discussions. Use the search box at the top of each screen to find the relevant discussions, or start a new discussion in the Gout Forum.

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