Uric acid testing
how often would you suggest doing tests? Is 6monthlyenough?
I eventually saw the rheumatologist in Dec after being diagnosedwith a gout attack last March. The GP tested at the time and thelevels were normal (as you would expect during an attack). The GPwas convinced it was gout as were a number of others who hadsome experience of gout who saw my foot.
The rheumatologist - who didn’t see me during the gout (if that’swhat it was) attack - tested again in Dec and levels were normal soshe doesn’t think it was gout I had last March. Didn’t give me analternative diagnosis either. From what I have learned I feel prettypositive it was gout regardless of what the two tests showed. Shealso x rayed my feet and said they looked fine. She also said itwas so unlikely because I am a pre menopausal female - age 45.The GP was only interested in me watching the purines I ate andprescribed Vioxx if I felt another attack coming on.
So my question is: how often do I request the uric acid levels betested to hopefully avert another attack?
Terrance Molock on April 28th, 2007
ideally on a first gout attack they take a joint fluidsample to confirm gout by actually seeing the crystals.This is oftennot done..gout does have some pretty distinctive characterisitics..
This whether done or not..a blood uric acid test MUST be done..
Most patients/Dr.s feel that a test now is pointless as it caneasily take someone with higher uric acid levels(who is more at riskfor gout) well into the normal range..THEN they often look andsay..see no gout..the blood uric acid levels are not high enough.Somewill argue that gout is impossible at that level because it simplycannot precipitate into crystals at that level.Problem is that thecrystals DO NOT precipitate in the blood..BUT NOT until the uric acidcrosses the interstitial membrane(flesh towards the joint/lining)ONCEenough uric acid gets into the joint fluid..there it accumulates andreaches it’s saturation point.crystalizing.
SOOoo..a blood uric acid BEFORE an attack..DEPENDING on the stageof gout..can of course be a pretty good predictor of risk.For goutsufferers..NOT UNDER OR CLOSE to an attack..beginning/finishing..ANYreading at the middle to high end of the average levels..FOR GOUTsuferrers is not good.
It really is important to get tests before,during,and afterattacks..ESPECIALLY during the early stages of gout.That way anaverage..as well as the level for attacks can be established.Then itis simply a matter of keeping the blood uric acid level 20-30% lowerthan where it was..AND into the low to medium average range..
As far as testing when you have no idea as to what level causesthe attacks..??
I’ld say if you have had a gout attack/attacks..then get atest.This test should be done during an average time in yourlife..not right after an attack..nor right before..nor during anydietary/lifestyle changes..if this one test is in the middle to highaverage range..I’d get another test..maybe somewher else..just toconfirm this.Now you have something to work with..you can be prettycertain that if you don’t lower this level attacks will come.
Ideally you’ld have several attacks and a LOT of tests to lookat..before,during,after..this gives you some better numbers to look at
A sort of standard is tests every 6 months..I feel 3 months isbetter..
If you decide on allopurinol then tests every 6 months areenough..even then..while on allopurinol especially in the first fewmonths these tests can become erratic as the old deposits are beingadded..which raise the level..OR no old deposits are being addedwhich can show again..a false low level..
Ya..the blood uric acid tests are really all that counts withgout.You get enough of them..and you do find the point at which youget gout.Then you just lower the level.AND KEEP IT THERE!