reoccuring mild gout flare

during my first 4 weeks in the attack i have been on a monk diet no meet, alcohol, sweets, lentils and only eat veggie and rice. however still cant lower my uric acid. but after taking the febuxostat i was prescribe it went down right away like 5 days and down to 4.4. but still what bugs me is this stiffness and if i walk like 1 hr slight limping. i get this mild gout flare. iam afraid there is more to it than gout although all my test are normal except my uric acid. its been 17 days since i took febuxostat. wish i could already walk as iam the provider of the family and cant stay too long on hold

almost like every week i get this mild gout flare. and when i started taking febuxostat my wrist has a slight pain but does not affect me much as it is almost to slight to notice is this normal?

Allopurinol is a great drug (I use it). This guy is on Febuxostat which is more effective than allopurinol - it’s a more modern drug and MUCH more expensive. In the UK Febuxostat is the second line treatment because allopurinol works well and is £1 or so a month. 

Another advantage of allopurinol is it’s been around for something like 50 years so they know that it works long term. 

I’ve been on allopurinol and wasn’t happy taking it for the rest of my days 

so I tried getting super fit tea total but to no avail looks like it’s time to give it a proper go to give me kidneys a break and joints but I have heard of 

febuxostat and I’m going ask my gp about it .

plus I’m in me fifties now last ten ye@rs been a bit of a pain .

I tried getting super fit too - has no effect.

As for Febuxostat- it does the same as allopurinol- reduces blood urate by changing the purines into a chemical which is flushed more easily. You’re still on it for life and still have the same side effects caused by flushing urate from the blood. 

If you have had gout flares for ten years you are already in gout influenced heart attack territory. I’d do something about it PDQ.

thanks btw febuxostat in my country is not that expensive like 10$ per month. i was prescribe the lowest dose of 40 mg. how long will i have this reoccuring gout flare when taking uric lowering drug?

thanks mate. i am not over weight, also i dont drink much alcohol more like ones every 2 months but now i think even that has to be cut of. btw whenever i rest my foot or whenever i sleep. i feel like the side of my foor near down the big toe is getting thick and a little tingly is this normal? i am still new to this gout thing as in the past a diclofenac can knock it down in 2-3 days

Febuxostat costs US318.15 for 30 x 40 mg tablets. Somebody (the government or an insurance company) is paying the difference between your price and the $10. In the UK too someone prescribed Febuxostat would pay about $10 but the state would pay the rest, hence why the state prefers allopurinol which does the job perfectly well.

To answer your question - the gout flares usually continue for 3 months to several years. However the vast majority it’s closer to 3 months with it dropping off after.

The reason for the blood urate lowering therapy is not just  to stop the pain - the high blood urate not only destroys joints, but it damages the lining of arteries which leads 10 years down the line to heart attack stroke and kidney damage. 

Of course if you are 97 a potential heart attack in 2028 might not seem like a big deal

    :-) 

Pain killers are not addressing the underlying illness. It’s like giving a guy a brain tumour pain killers and not removing the tumour. 

The underlying problem is hyperuricemia - high blood urate - which over many years incideously attacks the arteries bone joints and kidneys. The long term danger is heart attack and stroke. If you take blood lowering therapy and get your blood urate down to under 3.0 (or close to it), you can eat and drink normally. (There are other reasons for not drinking every day, but I like you drink once every month or so, and believe it does no harm. Indeed I drank 1/4 of a small glass of beer with Sunday lunch and got a pleasant buzz from it). 

thanks i would keep taking this uric acid lowering drug. but iam planing to take colchicine with it like 2 tablets a day for 2 weeks is it going to be alright?

Yes, thats perfectly ok and normal - take them together. In the UK the advice is to give the colchecine for 3 months (most GPS seem reticent to take this advice).  When you run out - ask for more - I get 100 a time - lasts forever. The tabs are less likely to cause diarrhea if taken every 6 hours after cutting the tablet in half (not easy - they are tiny). I wouldn’t take them more than needed - if the symptoms stop - stop the colchicine, and start again at the first twinge.

One thing to be aware of - colchicine works by calming the immune system attack in the joint. If you get an infection - then stop taking the colchicine till it’s gone as you’ll need your immune system working on all four cylinders.

Good luck.

Oh - A**drink plenty of water**. During an attack I used to find resting my foot in *very* hot water worked. Others find cold works. Others alternate hot and cold. 

yup i am keeping my body hydrated. i always tought gout as just the pain in the feet and would only last a week now my eyes are opened there is more to it. will keep record pf my progress thanks.