Gout Diet Blog

I had my first attack 2 years ago which was controlled withVoltaren and Allopurinol.After 6 months my doctor reccommended with an adequate diet i couldcut out Allo……..so i did and was fine until 2 months ago when ihad an attack.I am currently experiencing an attack where the gout hasspread from my big toe to the next one along. This makes itimpossible to walk at all. The big toe attack came 1 week ago. Itried Gout cure pills which were a waste of time and for 2 days havebeen on Colchisine (3 a day). But the swelling has not gone down 1bit in either joint. How long would one reasonably expect Colchisineto take effect before going back to the doctor and should i betaking it still if it hasn’t worked yet?

Just wondering if anyone has any ideas re: why allopurinol (with initial use)canprecipitate attacks. I’ve searched and found lots of sources that sayallopurinol maycause attacks at first, but nothing explains why this may be the case.

A Medline search of Allopurinol Adverse Effects in Humans retrievedover 500 citations; a search limited to Allopurinol adverse effectsbeing a major topic of the article retrieved about three hundrdedcitations.

Admitedly many of these deal with a hypersensitivity reaction, somedeal with other drugs interacting with allopurinol and many deal withcertain pre-existing viral infections and allopurinol however I thinkit might be wise to consider allopurinol to not be totally withoutdangers.

Please note that the units I quoted for my wife’s urate levels ( e-mail ofNovember 4th) were in milli mols per litre, which seems to be standard in the UKwhile in the States the unit is milli grams per decilitre. To convert theformer to the latter multiply by 16.6 or 100/6 to be exact. This means that her0.39 in UK units is equivalent to 6.5 on the American scale and her 0.3 is thesame as 5 in the States. I guess this makes her a marginal candidate for goutand we hope that allopurinol will lower

Anyone had any experience of getting gout after being on ‘waterpills’for a number of years?

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.

“…RECENT FINDINGS: The first quality indicatorsfor gout management have been proposed. SelectiveCOX II inhibitors, as well as traditional NSAIDs,are effective in acute gout. A new xanthineoxidase inhibitor, febuxostat, and pegylateduricases are in clinical trials. SUMMARY: Thetherapeutic aims in gout include termination ofthe acute attack as promptly and gently aspossible, prevention of future attacks,prevention or reversal of complications of the,and prevention or reversal of associated featuressuch as obesity, hypertriglyceridemia,hypertension, or alcoholism.”

I know allopurinol happens to interfere withxanthine oxidase but is this its primary mode ofaction? Would xanthine oxidase disruption belikely to affect a fungus?

I went to the doctor today and he told me not to take “allopurinol”during an episode of pain from my Gout. To only drink a lot of waterand take pain medicine. I have read on this site that you shouldstart or continue taking it during a painful episode. So has otherdoctors told you all to take it during an episode?I went off of my allopurinol and changed my diet and my uric acidwent down to 6.2. I stopped eating meat, shell fish, spinach,cauliflower, and mushrooms. So when my doctor and I were talkingabout me stopping allopurinol he said do not start taking it if youhave a painful episode wait until it is over.

Allopurinol is the only prescription drug that I take so it is easy forme to remember how much it costs.

The first time I needed to have a prescription filled I went to Walmart.Makes sense, right? - their prices are better than anywhere else. As itturned out the store I went to was out of it and the druggist suggestedthat I go to K-mart for the best price. It was about $10.

By the time I needed some more a month later K-mart had closed thatstore and sold its pharmacy records to Winn Dixie, a local supermarketchain, so I went to Winn Dixie and the price there was about $11.

The third month I decided to try Walmart again and I was charged about$15. I thought that was a lot but I had already ordered it, I was out ofit, and I didn’t want to have to do any price comparisons.

This time I went back to Walmart and asked the clerk how much it wouldcost. $18. “Prices sometimes go up.” I told him I’ll shop around first.

I called Winn Dixie and the price came up $9 and change. Just to makesure they didn’t make a mistake I called Ekart Drugs and their price was$11 and change.

I called Walmart back and asked why their prescription would cost twicewhat it would be in a nearby pharmacy in a supermarket. The druggisttold me that it is because their drugs are better.

That gave me a good laugh but it also told me a lot about Walmartsupposedly having the lowest prices. Signs in their stores say they willmatch any price but I guess that doesn’t apply to the drug department.

o allopurinol does not do anything to the uric acid you already havein your system.

Then why is is effective on gout?

Because it stops the formation of new uric acid. Remember, your bodyis in a steady state of digesting food to make urate and digestingitself to make urate and this urate load is usually handled by thekidney and excreted when it is made. In us gout sufferers, forwhatever reason, and there could be a multiple set of reasons, theexcretion part, does not work as it should. Some people have aelevated rate of making the uric acid, but even these people end uphaving excess uric acid in their system and must get rid of it.

Thus, allopurinol stops the production of new uric acid. It doesnothing for the removal or breakdown of the uric acid you alreadyhave.