Gout with Normal Urate Levels.

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Hi All,

Hoping for a little input with this, for the record I'm a reasonably fit male, late 40s, and not overweight with a healthy BMI, etc.

I first had what was considered to be a gout attack some 7-8 years ago in the stereotypical big toe joint, very painful and the GP prescribed Naproxen and basically to keep an eye on what they suspected was gout. I also had maybe 1-2 minor issues with pain in a couple of finger joints, though this was nothing compared with the foot.

After this initial attack I moved to a diet supposedly lower in purines and consumed vast amounts of water, this seemed to work and I was free of any further issues until 12 months ago, at which point I had another attack in my foot, again in the big toe. This attack was much worse and actually lasted several weeks, it eventually settled and I then had subsequent attacks in my other foot affecting several toe joints. The GP prescribed colchicine and Naproxen which helped. Since that attack 12 months ago I have had 3-4 further attacks which I have treated with colchicine. The colchicine does seem to halt things after a couple of days.

I will say that I do have sore feet much of the time, though not anything like the pain I experienced during these suspected gout flares. I do feel like I'm on the edge of an outbreak fairly regularly though, and certain things do seem to exacerbate this.

The GP has suggested moving onto allopurinol and I see the logic in this, but my uric acid levels do confuse the situation. 12 months ago my levels were tested a few weeks after my attack and were 380umol/l, and my most recent set of bloods a few weeks ago (again a few weeks after an attack) were just under 300umol/l. Both these results and especially the most recent set of bloods would suggest I am actually at the desired levels with regards blood urate, and Allopurinol would not be needed.

Has anyone experienced this before with having healthy blood urate levels yet still getting outbreaks? I would think at a urate level under 300umol the crystals would actually be starting to dissolve at this point?

Any input would be appreciated.


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