Recently diagnosed with gout

Paul

Couple of things - the test of 7.0 was it taken during or just after an attack, not during a regular checkup? I must say I had missed that you'd already had attacks.?

As for what's normal... some people have attacks once in a blue moon. Others have strings of small attacks. Others have attacks that go on for weeks and even months. Most (60%-80%) have attacks on their big toe, others Dont.  Some have attacks in the wrists, or knees or ankles and there are even some ooor devils in their backs. The panoply of symptoms is such that almost anything is normal....except maybe in the nose of outer ear. So yours is I'm afraid bog standard common or garden gout.

My last blood test was taken when i was gout free, it was 650 I think. This last attack is approx my 10th to 12th attack in 3 years.

Hi rusty - a genuine question... from previous posts is it correct you have had one gout attack and subsequently done extensive research online? No criticism intended but my inbox is filling up with your answers, the majority of which, it has to be said, are entirely correct and sensible, but I was wondering if I had misjudged your actual first person real life experience with the condition?

I am a sufferer of gout.

I had the good fortune to be told I had gout by a rhumetolgist (abroad) who told me that I should take it seriously as it's a killer condition long term. He warned me that average GP knows little about gout.

I started to read about gout and found conflicting info. I then started to read the original research papers. When I had problems I write to the researchers for clarification. (At one point I was thinking about writing the dummies guide to gout.  If I choose to do that I have two of them who say they'll proof read it. ) I think there's a lot of pseudo info online intended to sell product.

I am however an enthusiastic amateur / victim :-D 

As for your 7.0 - if the test was done during an attack - it's very high as the chemistry of an attack means the blood urate drops (hence why NICE suggest a 4-6 weeks delay before testing). 

Lol.

Your doctor doesn't like you does he? If you do that I can tell you, you will definitely spend time in the loo, and if you took them as he suggested every two hours x 12  you could well be dead with renal failure.

Understand this: colchicine is a great drug, but don't mess around with it.  The point where you get the running to the loo varies from person to person but my protocol is A1.

I'm assuming you are in good health, esp kidneys. No active infections. 

Drink water to flush your kidneys.

Ok, if you go online you can find the manufacturers dosing. They suggest 1 now one in one hour and one every 12 hours. I read a study where it was better tolerated if the pills (tiny) are cut in two and taken every 6 hours. I agre with that.

My experience is this. If I have a bit of a twinge I take one.  9 times in ten I'm ok. If I still have a twinge 12 hours later I take another.  As soon as I'm ok I stop. My doc gives me 100 tabs at a time. Don't abuse them. If you aren't in pain or swollen don't take them. You can mix them with Ibufren. 

NB it is reducing (not stopping) the activity of your immune system. If you get a cold or an infection don't take them; your immune system will be back to normal in 18 hours. 

I'm not saying they are dangerous - but treat them with respect.

Thanks Rustygecko. I think your right that my Dr doesn't like me. I'm still and even more so now extremely concerned regarding his knowledge of gout. I'll start researching Drs in my area (Manchester) as this is not acceptable. I've had 1 tab and i'll stick with that until 12 hours have gone and take another if needed. I'll keep you all updated on my progress.

Hi,

Your doctor does sound a little unprepared.

?Going from my own personal experience colchicine is used in two ways - as a gout 'preventer', 1 tablet a day for 2/3 months, usually while starting allipurionol - and as a gout "treater" when one has an attack. Here the dose is 4/5 tablets a day but at such high doses is usually limited to a maximum of 4 / 5 days which should help reduce the attack.

?Don't fret too much! 

The problem with 5 tabs a day is that a very significant number of patients will get "digestive issues." This is why NICE changed their advice to lower doses. The thing is some people can handle even 6 or 7 and some can hardly manage 2. What the individual has to do is find their personal sweet spot.

Great news.

My experience is - the moment the pain comes back (if), then wham in one colchicine. Stamp on it early (the pain, not your toe), and you can control it easy.

As for when you’d start, I’d start ASAP BUT to be careful .... wait say a week with it under control. As I said my doc gives me 100 colchicine at a time. You may need them over a period of a couple of months. 

Ignore the last reply.

I was just about to answer this question and it gave me the first question so I answered that (thinking it was somebody else ).

Allopurinol causing attacks: as soon as it begins to work. My guess would be any time but that’s a guess. Imho 10 tabs at a time isn’t enough. My doc gives me 100. NICE suggest you take 1 per Day as a protection but my experience is pop one as necessary.  You need to have a blood test after a few weeks to see if the dose of allopurinol needs to be increased (the normal dose will then be 300 for about s year, then down to 100), but you need blood tests from time to time.