Help and advice needed.

Sounds like good advice to start. I'd only add: drink water!

hi

Yes bang on right

Keep flushing out the kidneys and its got to help

Must ask, what was the anti inflammatory supplement ?

Allopurinol causes gout during the first months / years that you take it as it released stored monosodium urate crystals in tissues! The way to get the correct dose is to measure the blood urate 14 days+ after last symptoms.

Has your doctor been giving you regular blood tests? What were the results? This is an essential piece of information. If you have had two years with no problems the chances are the 600 mg (a relatively high dose) has cleaned you out. Your doctor should be checking your blood urate and changing your allopurinol dose in response.

correction max dose is 800mg/day assuming no liver disease

Excellent advice.

One piece of additional information: allopurinol has the side effect of *reducing* cholesterol.

Because of all the issues associated with hyperuricemia - it is probably good advice to generally get healthier and fitter....and above all... drink more water.

Unfortunately I did not benefit from the lower cholesterol SE of allopurinol

I'm not sure that allopurinol should be dismissed so lightly. There are millions of people taking it with no problem. The fear of it is based on the rare but serious skin rash when people first begin - especially if of Chinese Korean or Thai decent.

Most uric acid comes from the breaking down of our own cells, not our food.

Remember too that gout is not the disease - it's a symptom. Untreated hyperuricemia leads to a host of diseases (long term), as well as tophi, and joint destruction.

If you have gout and can tolerate the allopurinol why not take it?

I did the low purine diet & increased water intake I saw no improvement until I consistanly took my OPC3 on a daily basis. Everyone is different & the trial & error is probably most effective.

Forgive my ignorance but what is " OPC3"????

So you think that trial and error is better than science and blood tests and proper measurement of blood urate?

No issue with taking Allopurinol but if the uric acid can be lowered with all natural non-gmo supplement why not use it ??? I agree it is not a result of our food since I tried a low purine diet with no effect. Why must we always use drugs as a first line for treatment

It's a pill heavily marketed as a fix all in the USA.

Where is the evidence that states it is primarily a metabolic condition and not diet. And i do not mean a you tube video..

But if you aren't having regular blood tests how do you know if any treatment is working?

Not exactly sure what you mean Roger.

Do you mean the evidence that most of our uric acid comes from cellular breakdown and not from food?

Yes that was exactly what I meant.

A you tube video saying this is the case does not constitute scientific fact.

If that truly is the case then I think a lot of UK doctors need to be brought up to speed.

Also i was unaware that smoking is a contributing factor...

Anti inflammtorys dont work when the blood vessels are restricted for 1hr up to smoking 1 ciggarette.

Sorry for drifting off topic with the last statement. I think a lot of people may be ignorant to that.

Quick answer Roger.

Just look at the number of vegetarians and vegans with gout.

I ll get you a scientific article but they generally won't allow a link.

I was unaware of the link between smoking and gout. This being the case it's good as the number of smokers is dropping like a stone in the uk and USA.

PMCID: PMC3359272 review article provides the input on this if youre interested.

The main dietry contributor to high UA is high GI sugars (fructose maltose beer etc, rather than the purines from offal etc). However most elevated UA is related to low excretion of urates rather than high procution or intake.

 

"Also important to blood uric acid levels are purines. Purines are nitrogen-containing compounds, which are made inside the cells of your body (endogenous), or come from outside of your body, from foods containing purine (exogenous). Purine breaks down into uric acid. Increased levels of uric acid from excess purines may accumulate in your tissues, and form crystals. This may cause high uric acid levels in the blood. "

This doesn't have the importance of either but I'm on it.

Ah maybe this is why I was told, many years ago, to avoid nitrogen rich foods.

As promised. There's a lot more in the more heavy science literature. I remember one rhumatologist told me - as the vast majority of our uric acid comes from our own bodies, playing around with diet is like changing the deckchairs on the titanic.

Firstly, we have to understand where uric acid comes from. Animal cells (including human cells) have structures called DNA, which reside with the nucleus of the cell. This DNA is broken down into its constituents, called amino acids, when a cell dies through the action of the immune system. Some of these amino acids are called purines, which in turn are converted into other chemicals. Our body recycles some of these chemicals with those left over proceeding to become uric acid, which is in some ways a waste product that is then excreted by our kidneys into the urine.

It is a very complicated process but with this concept in mind you may understand why certain diseases are associated with high levels of uric acid. For example, if a person has a high burden of dying cells, such as occurs in certain cancers or in those undergoing chemotherapy for the treatment of cancer, then more DNA is broken down to purines, resulting in excess uric acid production.

Conversely, when the uric acid cannot be efficiently excreted, such as is the case with many kidney diseases or due to many medications that interfere with this process of excretion. This is particularly a concern with diuretics, which remove water from our body at the expense of other products such as uric acid. Rarely, a person is born with a defective step in uric acid metabolism, whereby gout develops at a young age, sometimes associated with a very strong family history of early and aggressive gout.

When the uric acid level is high in the circulation it is termed Hyperuricaemia. This situation is also strongly associated with obesity. It is believed that fatty tissue enhances the production of uric acid. Hyperuricaemia is part of the ‘metabolic syndrome’, which is associated with an increased risk of heart attacks and strokes.

We also obtain purine amino acids from our diet. It is estimated that 10-15% of our purine load is dietary in origin. Foods that are high in purine include offal, seafood (in particular crustaceans), red meat, and alcohol.

Who said I wasn't having regular blood tests?.