Gout, but not as we know it.

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After a few false starts at diagnosis, a urine test showed at high level of Uric Acid. My GP has started me down the route of treating me for gout. But something doesn't feel right. I have painful feet and ankles, my toes are  particularly painful but I don't have obvious extreme attacks, nor do I get the classic inflamed redness. I do have highs and lows, on days when it is worse my knees, elbows and wrists also come out in sympathy. I have often heard gout pain compared with child birth - if so, I don't understand the fuss. Mine is more akin to a dull toothache. Is this just another way that gout presents itself, or can high uric acid cause other conditions?

thanks

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  • Posted

    Gout in my case is dull pain. When you get the sharp pain it's when the uric crystals have solidify in one spot. I, get it in my toes with pain & slight inflammation. It sounds like it could be pseudo gout as well. Either way it's gout.

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  • Posted

    Was the urine test a one off sample or an analysis of 24 hour total urine?

    High uric acid causes a host of problems, including kidney stones and kidney damage.

    Long term high blood uric acid can cause damage to the heart for examples.

    How long have you been having these symptoms? Is this long term or recent?

    Do attacks tend to start in the night?

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    • Posted

      It was the second one-off sample. Bloods were taken at the same time and were all clear. I have had the symptoms for a number of years, and the last time they were investigated the only recommended treatment was to take a vitamin D supplement. The symptoms have progressively got worse with time - still not cronic dibilitating pain, just the sort that wears you down. I don't really have "attacks" either, but do find it worse first thing in the morning and during the evening. Which suggests to me that normal daytime active helps.

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    • Posted

      Firstly it doesn't sound like classic gout but it can have strange forms. People do have gout which just grumbles on.

      However uric acid in the urine could be a sign of gout.

      Are you taking other medication like a diuretic?

      If it is gout it needs the "art" of diagnosis of the doctor. I'd guess it is certainly a form of arthritis but which is not clear.

      I don't know what others think. It would be interesting to know what it is in the end.

      If you are in this constant aching state have you not been to the doctor all the time.

      One piece of good advice is drink plenty of water.

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    • Posted

      Thank you rustygecko and Sochima822  for your comments.

      The urine & blood tests were conducted under the supervision of my GP. I have just started a course of Allopurinol, so I guess we'll see if things improve over the coming weeks.

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    • Posted

      Allopurinol is not really a course, it's a way of life. The patient normally takes it all their life.

      I am afraid your GP seems to have done things which indicate it is beyond his / her paygrade. Giving someone allopurinol during a gout attack is one, and doing a blood urate test during an attack is another. ***If I were you I'd definitely ask to be referred to a rheumatologist ***

      Allopurinol in the short term creates gout attacks, which is why it is recommended not to begin taking during a gout flare. Did you GP tell you that or that you should be very careful of any skin reactions to allopurinol? You should begin on 100mg and probably increase to 300mg if all well in 20 days. (Do not take it at all if you are from China or SE Asia).

      You should probably have some colchecine to go with the allopurinol to calm down your immune system (assuming that your kidney function is good and you have no problems with your intestines). If not colchecine you definitely need something doing the same job.

      While the allopurinol will give you gout at first - if you do have gout - after a couple of months you will surely improve and maybe less.

      Good luck.

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