Allopurinol and rat poison
I sympathise with your dilema but be of good heart. I have been on Warfarin(rat poison) around 5mg daily for 27 years following a stroke and atrialfibrillation.In 2000 I was prescribed Bendrofluazide to reduce hypertension which I didn’thave and “secondary gout” followed, in my elbows, hands and feet under my toesand in my big toes. My uric acid was tested at .39 UK mmols. Six weeks laterwhen I came off Bendrofluazide it was down to .3.
I persuaded my doctor to let me try Allopurinol in August 2003 on 100mg atfirst, then 200mg in January 2004 and now on 300mg from the middle of thismonth.My situation has improved slowly, attacks increasing in frequency (almostdailyin the early hours of the morning) but mercifully decreasing in severity anddur-ation and my recent uric acid test showed .2 so something is afoot (so tospeak !).
I have never had a synovial fluid test and doctor and rheumatologist say Ijust haveosteoarthritis, but I know that pain very well and this one is somethingelse….mind-blowing in fact. So far I tolerate Allopurinol well. I have given upGlucosamine sincehearing of its shellfish origin and, in fact, all supplements and vitamins togive Allya fair chance and until I am free of attacks I shall keep to a non-purinediet. I’ll keepyou posted.
Melodie Butler on August 30th, 2007
Thank you so much. It is good to find someone else out there with myproblem.
I tried glucosimine a while back because a non-gout friend told mehow much it helped her joints. It helped a bit after 6 weeks oftaking it and then….gout! Shellfish can cause an attack.
I am glad to hear from someone taking Warafin (generic Coumadin).PLEASE keep me posted on your progress. In the future, I may decideto change doctors and go on allopurinol and take a chance but at thispoint I don’t have the privelege of that option and considering whatI’ve gone through in the past, wouldn’t take even the smallest chanceof going down the road I’ve been down again.
I’ve had the aspiration test that proves what I have is gout. I alsoknow that diet plays a part in an attack. Chicken wings, pizza orbeer guarantee me an attack that night. As this progresses, themiddle of the night attacks have moved on to morning and afternoonattacks too. Sometimes it comes on so fast I can’t believe it.
Best of luck with your situation and please let me know how things go.
Terrance Molock on August 30th, 2007
Congrats Freda!..yours are VERY tough calls..FORTUNATELY..more andmore Dr.s are taking..or at least willing to take the allopurinolroute..NOW without (as you had to)..drag them kicking and screamingto the allopurinol prescription pad.WHEN the u/a levels tell themotherwise. I have heard this TOO OFTEN!! where both individuals..andDr’s..start yammerring on and ON about how it can’t be gout becausethe blood level is less than the actual level of u/acrystalization.In your case..in the average level.Hey..been there..myu/a has NEVER been out of the normal/average level either.FORTUNATELYfor me..ALL the DR’s I saw..DID NOT even care what my u/a levelswere..they saw gout..and saw that a reduction in u/a levels wasnecessary..and took the right step..allopurinol.
Secondary gout..esp.with the attendent medication.
You can be pretty sure that if the allopurinol is working..thenyou have/had gout.
Gout is PRETTY common in the high 3’s to 4’s..matter of factthat “average” level..that is “red flagged” by the computers at thelabs..has been lowerred a couple of times.
Attacks around a level of 3..even down to a 2..you said theattacks started after medication..THEn the u/a level dropped..whenyou stopped the drugs..HMMmm..I personally think it is safe to saythat you personally get gout..got gout..when the u/a went from 3 to3.9..SOooo somewhere in that 3 to 3.9 range..you have to take out 25-30%..loks like the allopurinol did it.
Secondary gout..med.caused..can cause a LOT of u/a build upfast..getting rid of it..is the problem.NOW that you are starting toeliminate it..I am not sure whether you will need to stay on theallopurinol at that level.
It is known that gout likes previouslly damagedsites..arthritic.Here again..this is VERY common..gout..and not dealtwith..THEN osteo(or other kinds).Next thing we know is that there areBOTH at play here..From what I know..DR’s like to eliminate the goutfirst..easiest to do..with allopurinol..THEN try and deal with theosteo.Untreated gout and it’s related long term effects/permanentdamage..adding or combining other problems like osteo..THIS becomesEXTREMELY.difficult for Dr.s and patients alike to fix.
Thanks! for your post..and your attention to detail..esp. the u/a
Melodie Butler on September 1st, 2007
One thing I forgot. For those of you who haven’t had the needle inthe joint to confirm gout, first of all be perpared for more pain.
That’s not to scare you but be prepared. Secondly, for those of youon Coumadin/warfarin, it can cause problems because it can startbleeding in the joint, more than the normal that occurs in an attck.
My first test was done before starting Coumadin so I knew gout waswhat I had. During an attack, I had to see another doctor who wantedto test again but I protested because of the pain involved. Hechecked with the chief of staff and came back with the fact that Iwas smart not to have it done because it could have caused moreproblems. Please discuss this with your doctor if at anytime in thefuture he/she wants to do this test. We on Coumadin/warfarin need tobe more vigilant than others because little things that have nothingto do with anybody else, can cause problems.