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Gout Diagnosed and Thought/Idea Finding

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CRMS
CRMS

I've been stricken and hobbling with MPN related gout?? Yesterday I attended a clinic at hosp. The Consultant diagnosed gout, plus a cellulitis infection and prescribed 4 days, 12 x 500mg, of Colchicine.

Which will deal with the current gout flare up. I also have Polycythaemia Vera Rubra since 2000s and a side effect is gout, partly due to faster red blood cell breakdown, more uric acid, and peripheral blood flows.

Urate was 372 and Urea 5.1, which are in the normal Oxford University Hospital

ranges - 210 - 420 umol/ltr and 3.0-9.2mmol/ltr.I think other ranges include 3.4-7.0 mg/dL, where 6 is considered the start to take allopurinol. Looks like 372 and 6 are about the same at 88 & 85% of the upper limit, so I am right on the cusp. My Docs aren't really considering allopurinol at this stage. And as I am off to France next week till November, I don't really want to start a new drug.

The exact gout mechanism is a bit of a mystery, even with the PV faster red cell demise. The gout flare ups until now, have only happened in the summer heat. In August 2020 in France in 35C and again right foot.

In July 2018, also 38C heat in France, I emailed my Medical Practice with a pic of a swollen and very right foot red middle toe, which we now reckon was gout. I can only think it is local foot dehydration due to heat that is the main trigger. Foot pulses are strong though.

So I am taking steps to mitigate against gout with more hydration and reducing alcohol to 14 UK units a week - I was only just above that with alcohol free days, and checking diet. I think my diet is pretty moderate and balanced. I don't have sweetened fizzy drinks, apart from tonic twice a week. I do have some high purine foods - seafood once a fortnight and fish weekly but I don't think that is excessive.

A runner's forum also mentioned adding sodium bicarbonate to drinking water to buffer the uric acid. I do this when telemark skiing to buffer the thigh lactic acid build up, so I will try the same.

Although hobbling is painful, cycling is OK so I can still get around.

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