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Gout attack in April, but would like to avoid drugs due to possible side-effcts.

Posted , 6 users are following.

Birdman
Birdman

I initially had painful fingers, which swelled up after doing some manual work. I have been diagnosed with Raynaud's syndrome, and often have cold hands, but this was the first time they actually properly hurt. The swelling went away after a week or so, but the pain (often at the joints, and different ones at different times) remained. I play a lot of guitar, so they do get regular work outs.

The day before I was seeing a spcialist, I woke up with a painful (to the touch) knee - swollen, warm to touch - classic gout symptoms in other words. The specialist said as much, and as my father has gout, it seems a done deal. It took about a month for everything to get back to normal, and my hands did eventually get better (coinciding with summer, so they didn't get cold as much).

So here's my dilemma. The specialist was very keen to put me on Allopurinal (100mg for two weeks, 200mg for next two weeks, then 300mg from then on). I was also prescribed Colchicine (2x500mcg tabs a day). I have checked up on possible side-effects of these drugs and it has given me quite large doubts about taking them. My job means I am away from home a fair bit, and side-effects like stomach upsets,drowsiness and so on would be a major problem for me when away with work. It's tough enough without these added problems! So, I feel I can't risk it. I was hoping to find a two-month gap in work where I could do the course given to me, but it just hasn't happened yet. I was supposed to go back to the specialist after two months for further tests, but I keep putting back the appointment in the hope of getting a two month window to try the drugs, though even then, I'm really not sure about taking everything. I haven't had any further attacks, though have felt a couple of twinges in my big toes from time to time. I have increased my water intake, cut down my beer and alcohol (though far from cut it out completely) and haven't eaten meat/fish in 25 years. I used to eat a lot of spinach and asparagus, which I have more or less cut out after reading they can cause problems. Also got into taking a tablespoon of apple cider vinegar daily, and eating lots of cherries when they were in season.

So at the moment there may be a possible two month window in being away with work, so I may be able to try the drugs route. As stated though, I am not at all keen on them, so am not sure if should go back and see the specialist and see if my lifestyle changes have helped my uric acid level, or put back the appointment again and try for the two months on Allopurinol and Colchicine.

My initial urate level was stated as 0.42mmols/l in April, during the attack. I think that equals 7.0 on the scale used here. I am 47 years old, with a BMI of 22. I had another blood test taken in June when I was prescribed the drugs, but since I haven't been back yet, I don't know the results of that. During that visit, he did x-rays of my hands, which were normal. Ultrasound of my knees revealed "bursal thickening and a mild amount of fluid in the deep infrapatellar bursa" with "the main abnormality is a hyperechoic deposit in the distal patellar tendon insertion consistent with a tophaceous deposit". If that means anything to you!

So after writing that epic, I am hoping to get some advice on what course of action I should take. From my reading of posts, I realise some people favour the drugs, some people favour the diet control. I'm quite simply not sure! All opinions would be very much appreciated. Thanking you all in advance!

0 likes, 20 replies

20 Replies

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  • nexia201
    nexia201 Birdman

    Posted

    Yours might be bursitis which is still effect of gout which was high at 7 during an attack as during attacks leves in blood get lower. I started with cholchicine twice daily then when my attack was over started allopurinol 300mg daily and continued cholchicine for 3 months and my very long attack went away. I dont know what you are expecting cholchicine to to to you because the only side effects i get is bloatiness and gas . so i would reccomend to try cholchicine when you have 2 days at home to check the effect on you then you see from there if you continue to taje them or not
    • Birdman
      Birdman nexia201

      Posted

      Thanks for your reply. It's more the side-effects of the  Allopurinol I am concerned about- there seem to be some fairly grim tales about it on here (though admitedly, it's the Internet, there are grim tales about everything!). My worry is that once I start taking it, I have to keep taking it until the course is complete (or at least that's what I was told) as suddenly stopping will bring on a gout attack. So I picture myself stuck away from home, with work responsibilities, making a choice between some bad side-effects, or a gout attack.

      I've not had another attack since April, though I do feel some small twinges from time to time in both big toes, and both knees feel a little painful on occasion

  • W-H
    W-H Birdman

    Posted

    I have been on Allopurinol for many years now. 7-8year I think. I am fit as they come. First 1 month or so was difficult, in the sense that I felt drained, tired and sleepy. It was the body getting used to it. Since then not one attack. I am extremelly sporty so my body is under extra stress but still rock solid. I run mountain marathons.

    If Allop was a woman I would marry her :-)

    If you avoid taking Allop you would indirectly be signing your own death sentence. Gout is a silent killer.

    Many people will say go on good diet and it wil fix your Gout. No it won't! Lack of attack does not mean Gout is in control.

    Yes good diet should be part of your lifestyle irespective of having Gout or not but diet alone won't fix it.

    Trust me!!! I was a Vegan long before I got Gout. Think was Vegan 10 year before I got Gout. Still am a Vegan btw.

    You will read lot of crap online and forums. Don't play with your health.

    Go on Allop...things will get worse before they get better though as Allop will cause the release of past uric acid crystal build up, this might cause attacks initially.

     

    • rustygecko
      rustygecko W-H

      Posted

      You are absolutely right. Gout is a slow silent killer. As for all the herbs and avoiding this that and the other - just take the allopurinol, except your kidneys aren't doing as well as they were, and get on with it... and drink more water.

  • rustygecko
    rustygecko Birdman

    Posted

    While some people have the side effects of allopurinol and colchesine you describe, most don't.

    Rather than just increasing up to 300 mg of allopurinol- a blood test should be given to see how it works.

    • Birdman
      Birdman rustygecko

      Posted

      Thanks for the replies rustygecko and GoutBuster. Especially interesting to hear from someone with a similar diet to mine.

      Yeah, I think the answer is to try out the allopurinol. Will just have to hope the I'm lucky with side-effects. Spoke with my father who has gout, and he is on allopurinol and has never had any problems. Since that is where the gout comes from, I'm hoping I'll also get the lack of side-effects, haha!

      I need to be away from home for 3 days next week, but am willing to take the gamble. If it floors me I'm in trouble though, so fingers crossed.

      I think the clincher has to be that just because I haven't had any more attacks, this does not in any way mean the gout has gone or is under control. I think this is the big risk with other methods. I worry it's there, behind the scenes doing untold damage. So, allopurinol it is!

      Thank you again.

    • rustygecko
      rustygecko Birdman

      Posted

      Allopurinol: start on 100mg for a week or so. There is a 10,000::1 chance of a very nasty skin reaction.
    • Birdman
      Birdman rustygecko

      Posted

      The prescription I got was 100mg for two weeks, then 200mg for 2 weeks, then up to 300mg "daily as directed" which I suppose is possibly for ever more! I've to go back to the specialist after 8 weeks to see how things are progressing.

    • rustygecko
      rustygecko Birdman

      Posted

      The 300 won't be forever (probably). 300 will flush out the urate crystals in tissues. Be prepared as the urates come out you may get gout symptoms (have colchesine on hand). After a year of no attacks you can probably go down to a maintenance dose of 100, with blood tests to keep an eye on it.

    • nexia201
      nexia201 rustygecko

      Posted

      Ok so im not on the 300mg forever the ? Thats what i tought ,they didnt mention that after a year free i would go down to 100 mg maintanance . but i will mention it next time im at the soecialist
    • Birdman
      Birdman rustygecko

      Posted

      Ah right, that's better then. I asked my father, and he is on 100mg a day, so hopefully this is how it will play out. I'm going to start on the Allo tonight. My prescription for Colchicine says "one 500mcg twice daily", which I think I'll stick to, but it is also feasible to only take them if actually feeling an attack coming on?

      Once again, all the replies are greatly appreciated.

    • rustygecko
      rustygecko Birdman

      Posted

      The Allopurinol might be ok at 100mg - you have to have blood test to see what level that puts your urate son at. (FYI I found my stomach tolerates it better if I allow it to dissolve before swallowing).

      As for colchesine - I've seen research that suggests that it is better tolerated if you cut it in half and eat one 1// every six hours. Colchesine •should not• be taken constantly as long term it damages kidneys. Take it during attacks and then lay off for a while and take again even on a twinge. If you have a bad attack I find it works in a couple of hours.

      The allopurinol will cause gout for the first year or two (as I'm sure I mentioned) so have the colchesine at hand.

      And finally....drink plenty of water to help your kidneys deal with the unrate the allopurinol and the

      colchesine.

      Good luck!

    • Birdman
      Birdman rustygecko

      Posted

      Thanks. Started last night, and so far haven't grown any extra heads or limbs wink

      I am supposed to take the Colchicine for the entirety of the Allo prescription, which is 8 weeks initally. Do you think this is too much?

    • rustygecko
      rustygecko Birdman

      Posted

      Colchesine is there to stop an attack of gout. As your blood will have lower levels of urate after you take allopurinol the bodies stores of urate crystals will be released into the blood potentially causing gout. The colchesine will stop the gout attack. However colchesine long term is toxic to the kidneys. The body needs rest from it. I'm sure it won't kill you in 8 weeks, and your doc is protecting you from a gout attack and probably you saying "this stuff doesn't work" and dropping it (70% stop medication). However, if you understand what the allopurinol is doing and realise the colchesine will protect you, all you have to do is take the colchesine as soon as you get the first twinge of gout. It has been shown that breaking the colchesine tab in two (not easy) and taking it 1/2 every six hours instead of 1 every 12, reduces side effects. By cutting it in half your kidneys are exposed to less high concentrations of the drug, which reduces toxicity. I've tried both and frankly colchesine give me no side effects.

      So, you can safely just take the colchesine as and when required if you know you may get a twinge of gout from time to time. Whatever you do - don't take more than the recommended dose of colchesine - it's toxic. If you get more of a twinge than you like - a small painkiller will stop it. (For heaven's sake don't use aspirin it's bad for gout!)

  • Guest
    Guest Birdman

    Posted

    Allupurinol has no negative effects on me at all, albeit I only take 100mg a day. The Colchesine however disolved my insides. I don't ever remember having diarrhea as bad in my life, and had to stop taking it.

    • rustygecko
      rustygecko Guest

      Posted

      The way that the Mayo Clinic suggest colchesine should be used is you take note how many doses of the drug you had when you got the diarrhea. Next time you take it, stop the course before you get to the number that caused the attack.
    • Guest
      Guest rustygecko

      Posted

      I was put on four a day, and after two days it made me lose about half my body weight I was so ill. My next gout attack was very bad so I tried it again using half the dose. Guess what, I lost half my body weight again. I have no doubt that it is great for many people, but it almost killed me
    • nexia201
      nexia201 Guest

      Posted

      I wish it made me lose some weight but nothing it has very slighy effect on me when i had 6 But made me lose no weight. My body get used to whatever i throw at it , even diets they work the first few days and then stop working
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