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Gentlemen (and the occasional post-menopausal lady I guess!),
First of all thank you to all that post and provide information to this forum - I've found it an incredible resource for learning about these conditions.
I'm a 36 year old man living in California, 5'11" tall and weighing 190lbs (13.5stone). I am in decent shape, exercise regularly and eat a healthy diet (rarely any of these high purine foods). I do drink a fair amount of alcohol (until recently) - a couple of beers, maybe a glass of wine or two and a whiskey night cap most everyday. I do eat marmite on toast every morning which I've shockingly just found is one of the foods to avoid (thank you UK factsheets!) I gained a fondness for Vegemite after spending some time in Australia! I'm super active and played competitive sports until pretty recently. I'm an avid swimmer, runner, hiker, biker etc.
About 2.5 years ago I woke up after sleeping with my foot in a weird position to excruciating pain in my ankle. Believed it was a weird tendon irritation from sleeping in a weird position. Doctor suggested gout but I totally blew it off as something that only happens to corpulent middle aged men. Nothing came up on X-ray. The pain went away in a few days and I didn't think much else of it.
A little over a year later I had a very similar thing happen in my other ankle. Then about 6-months ago I woke up with a very similar thing in my elbow - again nothing on X-rays and physical therapist I visited thinking it was a tendonitis issue was baffled. The elbow pain lasted a couple of weeks and was especially painful at night. But then with NSAIDs and rest went away and has been totally fine since.
Currently I have a similar issue going on in my left big toe which at first I thought was an injury as I did roll over on my toe joint playing sport. The pain in this area though is what led me back to thinking it's possibly gout. The joint pain seems to be instigated by some sort of minor injury each time. As I'm so active I've just sort of believed up until now that it's aches and pains of getting older after some kind of sporting activity I've been doing. The pain has been quite bad but nothing compared to more severe gout flare ups I've been reading about.
My brother (2-years younger) has similarly had some strange joint pains the last couple of years and was recently tested high for uric acid - he suggested I get my levels checked. So in between this elbow flare up and this toe flare up I did get tested about 3 months ago. Uric acid level was 8.9 mg/dL. Which I didn't really understand at the time but now I looked up these results I understand that it is well into hyperuricemia (high blood uric acid greater than ~6mg/dL) territory. And the genetic link here seems pretty obvious.
So not sure I really have any specific questions but just wanted to hear any thoughts the community may have on my situation. I am working on drinking plenty of water each day. Doctor has suggested some dietary changes and reduced alcohol and test again in a couple of months time to see if it's a continued high level. Will then discuss plan for the future. Allopurinol (for long-term uric acid reduction) and colchicine (for flare ups) will be discussed. I am hesitant to sign up for a lifetime medication unless absolutely necessary. The thought of long term joint damage, not being able to be physically active, chronic joint pain, and the cardiovascular risks from hyperuricemia scare the crap out of me. I feel like I'm way too young and healthy to be having these types of conditions....so really just trying to make sense of it all.
Thank you all for your time.
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