Help with possible gout?

Good advice except the mechanism of action. Colchesine calms the attack of the immune system on the joints and crystals:

"Colchesine inhibits neutrophil motility and activity, leading to a net anti-inflammatory effect. This has proven useful in the treatment of acute gout flares."

Colchesine should not be used every day - toxicity increases with time. Every so often come off it a few days. Try to use only when needed.

Allopurinol will long term reduce uric acid levels, get rid of the deposits of crystals in the joints and organs, and act as a long term fix. Higher doses for first year, then low dose.

Good advice about not letting it rule your life. Once you get the meds you will get it sorted, even if you'll be drinking more water and less beer.

I have not been given gout medication, just some anti inflammatories which brought down the pain level when I first got this. The prescription was only for a week. However, there was still pain in the mornings when I woke up, but after about 15 mins of walking around I did not notice anything which is why for the next 2 motnths I did nothing. Then the other day the pain gradually started to come back and I went back to the Dr and he gave me some more anti inflammatories, the pain is not that bad, but still makes me limp when I walk. But even still, after about 15 mins I can usually walk normally with most of the pain going away.

It sounds to me like your level of pain was like mine (indeed I ignored it for a few years and just took Ibufren). However what worked for me was initially colchesine - stopped the worst attack of my life in hours, and long term I use Allopurinol which got rid of the tophi which grew in a matter of weeks (it also gave me tingling in my hands).

I've had this problem before, it relates to pseudo gout.

Colchesine is better tolerated if the (tiny) tablet is cut into 4 and taken every few hours.

I always reckon "hiding" a tablet in a piece of banana helps the stomach as the drug is surrounded by a big glob of starch which takes time to absorb.

There are alternative drugs to colchesine e.g. Indomethacin.

Bill, your gastric upset is due to over producing bad acid that usually when severe gets pumped out of the stomach. I'm surprised no one has bothered to check your stomach for acid build-up. In any event you should try to juice or eat cabbage. It heals anyone having gastric problems. My dad has had similar issues I juiced half a cabbage with 2 stalks of celery 1/2 green apple and after 3-4days of juicing his problem went away. But I continued to give him raw cabbage for the next 2 weeks. You can look it up online on yt. Search juicing cabbage cure stomach ulcers. Hope this helps.

Have you stopped the beer drinking?

What is the Dr s diagnosis?

I've been having a bad gout attack lately that is now in my heels as well.  It started in my big toe and has been hopping from joint to joint for almost two months now.  I was on prednisone (steroids, prevents inflammation) and was tapering off it for another condition when my "gout" kept getting worse and worse.  I'm back on a higher dose of prednisone and the inflammation has gone away for now, but I'm still in lots of pain.

A couple things I've heard from my doctors that may help:  

1 Uric acid levels are not indicative of gout.  

2 He's had me go in for X-rays today to see if it might be another form of inflammatory arthritis. You can't see the uric crystals in the scan but they can tell by wear patterns on your joints. You may want to look into that.

Hope you get it figured out!

"Uric acid levels are not indicative of gout."

Where did he buy his medical degree?

Some people can have low levels and severe gout. Some can have high levels and be perfectly fine

Some have low levels and gout symptoms simply because an incompetent doctor has done the test during a gout attack. Gout is caused by uric acid crystals. They do not precipitate at low levels - it's basic chemistry.

Some can have high levels of blood urate and appear to be fine - but the insidious effects of hyperuricemia will be happening and they almost certainly have gout coming their way.

Yes he went into it in quite a bit more depth. He's one of my country's top rheumatologists. Internet web chats made me think that the number I get from a blood test is the be all end all too. Which is why I asked the specialist about it. Mine number's low, which is why I went for X-rays to make sure, because it was presenting just like gout does (starts in the big toe).

I'll try to update in a few days when I get the x-rays back. There are other forms of arthritis besides gout. Which is what we're double checking.

Your numbers are low.

What is low?

When were the blood tests taken?

Which country?

He said low, never got the exact number just "low"

Blood tests a couple days previous.

Canada

Did you have any gout symptoms at the time if the test?

Ya, they looked like someone overinflated a latex glove.

I'm on prednisone for recently diagnosed Crohn's disease. But as I was tapering off them my feet turned into balloons and I had to rent a wheelchair. So I may have a unique problem. But as soon as I brought the prednisone back up the inflammation went away. Still hurts like hell through, but I can walk a bit.

Crohns is basically immune system attacking my colon. Gout is basically immune system attacking my feet. So ya, lots of swelling. Lots of specialists. Seems like just time and water and diet and various medications for me in the immediate future.

So let me understand this correctly.

One of Canada's "top specialists" had a blood urate test done while the patient had gout symptoms, and finding that the level was "low", came to the conclusion that the patient doesn't have Gout.

Very interesting. What every medical student should know is that during an attack of gout, the urate in the blood precipitates into the tissues causing the blood urate test to be almost useless because the levels fall to normal. (The reason is the excess mono sodium urate precipitates into the joints and indirectly causes the gout symptoms).

It is inconceivable that a person making these basic mistakes is a rheumatologist. If he or she is a rheumatologist then please give them my email address and for $500 an hour I'm prepared to teach them remedial classes.

Prednisone is an immune system suppressant and it is reasonable to expect that it will help both Chroned and gout. However your belief that gout is caused by the immune system attacking your feet is erroneous. Gout is not a problem of the immune system. The monosodium urate crystals in the joints are attacked by the immune system, causing all the symptoms of gout.

As for Chrones disease - get yourself to Thailand where I spend several months each year - IBS sufferers find there symptoms resolve. If the specialists in the field bothered to read research papers on the subject they would know why. But Id be surprised if Canadian specialists bother with latest research as they have trouble with the basics.

I stopped reading after your first paragraph. No one has told me I don't have gout

Why are you even on here? You're absolutely worthless for info.

Tell me what I said that was wrong.

I swtiched to gin and water with lemon, no more beer. That is why the Uric acid levels have gone down. I did just find out that a relative of mine who is 76 years old had been treated fro gout for over 30 years and he was also never able to get rid of the pain. However, he went to a new Dr as the one he had been seeing took a turn for the worse and can't pratice medicne now. The new Dr diagnoised him with psoriatic arthritis and propmt treatment of that has now allowed him to be vurtually pain free for the first time in 30 years.

My next Dr vist I am going to mention this as I have mild form of psoriasis. 

Horrible story. And a warning against the over confidence of doctors in their own ability.

Also - always get second and third opinions.

THanks. Yes I am aware that uric acid is not the only indicator of gout, as I beleive some people can have uric acid over 8 all of their lives and never get it. 

I hope you get your health issues sorted out.

Nobody has a level of 8 all their life. Some - even many people have a level of 8 for much of their latter life - and they don't get the symptoms of gout. Indeed there is debate as to whether this asymptotic hypereuremia should be treated (at present opinion seems to be against treatment). But if you consistently have a high level of blood urate you will probably get symptoms sooner or later (indeed I had a level of 9 for several years at annual checkups and remained symptom free). It would seem though that perhaps gout requires a trigger. What is clear though is that if you have lower levels of blood urate you won't get gout.