Trouble maintaining hydration on allopurinol

Posted , 7 users are following.

I've been taking allopurinol for almost 6 months now, and I'm kind of concerned about my hydration levels/kidney function. It seems like I really struggle to stay hydrated even if I skip a dose of allopurinol for a day. My urine is really dark yellow, and water just goes right through me in a very short time. If I drink water, my urine is clear for one or two trips to the restroom, but I quickly get dehydrated again in a matter of hours. All I drink is water all of the time, and I drink at least 3-4 liters/day.

I can't help but feel that an underlying kidney problem triggered the gout. Is this a totally normal side effect of allopurinol? 

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12 Replies

  • Posted

    Gout is often a kidney issue. If that is your case, then you should ask your doctor about Fabrixat which is easier on the kidney than allopurinol. 

    It seems to me that unless you are living in the tropics, you’re already drinking a lot. I’d get your kidneys checked out by your GP and any issues see a nephrologist.

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  • Posted

    As always, thanks for the quick and insightful reply Rustygecko! I'm planning on this, but I wanted to make sure that I'm not overthinking things, or that it was a normal side effect. I guess what bugs me the most is that I have a strong feeling that I have something bigger going on that caused the gout. 

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  • Posted

    Just to ask the obvious question - this was NOT a known problem before you started on allopurinol?
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    • Posted

      Good point! I don't recall having this problem before, and it does kind of coincide with when I started the allopurinol. It seems like the color/dehydration is increasing over the past few months. Sometimes it is dark enough that it actually burns a bit.

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    • Posted

      I think it is worth discussing with a doctor, maybe immediately by phone?  Then he/she can tell you if it's worth a visit?  In the US all the insurance companies are pushing very hard to encourage us to use their remote-doctor services.

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  • Posted

    I always thought if urine wasn't straw colour then drink more water as a general hydration rule. so is it that your dinking it all really fast. then stopping for rest of the day. or sipping throughout the day? 

     

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    • Posted

      I drink throughout the day - not on a perfect schedule, but it isn't horribly spaced, or too excessive when I drink. What is throwing me off is that I noticed a big change with hydration in the past 6 months, but my hydration intake hasn't changed. I've got an appointment booked, but it is a few weeks out. We'll see how it goes. 

      Off topic, but is it normal for gout to cause lasting pain & a deformed joint? It's almost 6 months since the gout attack, and my joint is still visibly larger (2x) than the other foot, and it has remained tender to the touch. Not painful, but tender. It's not red, and it feels like it has a hard buildup under the skin. 

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    • Posted

      Ross, there's nothing "normal" about gout in the first place!  So continuing symptoms are reason for concern, even if it's not critical.

      ?On the hydration, I know I sometimes drink a ton of iced tea at lunch, and usually feel better when I do.  So, maybe try just a little more, and a little more often.  I've recently gotten hooked on these little Perrier cans, come in about six flavors, no sweeting, and for water, it's pretty good stuff!

      ?

      ?Maybe also balancing the electrolytes is an issues, if you drink and pass so much water, have a few potato chips along side, with sea salt if possible, a few almonds, maybe some banana.

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  • Posted

    Hey all, there's SO much contradictory info on gout its like no one wants to give a straight answer (or maybe they just don't know?)

    So here's my story. .. I know I'm a newbie but I was officially diagnosed a few months ago with gout but I was blind to the signs before. I had pains in my ankle multiple times last year, thought it was old football injury as I still run a lot. Had a few too many beers over this past Super Bowl weekend and my elbow started hurting (they say gout rarely happens that bad first time in the elbow), thought it may be carpal but two days later couldn't stand pain went to emergency middle of night and they said I had gout. Checked in with primary doc 10 days later after nothing but fruits, veg and tons of water and no alcohol, blood pressure went down, lost 6 pounds and they put me on allopurinol which I didnt take as I read about it and it sounds like it just masks the problem and maybe makes it worse. I continue to exercise and monitor my food. Watch fructose, no beer, no gravy, no sodas, cut back on aspirin and no fatty meats or fast food. Celery seed extract, Vitamin C, Nettles and fish oil and tons of water (take half your weight in ounces) have totally worked for me. I, and this is just me talking, still enjoy red wine and a good vodka with lemon or lime. I also put baking soda and lemon and or lime and occasional apple cider vinegar (yuck) in my water. Again I'm newish to this but hope I can help at least one person. The pain I had in the elbow, I never want again and for anyone. But hopefully we all can live a great life eating and drinking all (okay not allwink we want without having gout take over our lives. Cheers! We got this!

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    • Posted

      Hi Brett!  There may be issues with allopurinol but I don't think it "masks" anything, it's pretty well understood that it controls the uric acid and how that all works.

      If you've been taking the celery seed constantly, that may be just about as good - for gout.  There is also something called pseudo-gout, and it is not caused by uric acid (at least not directly) and it does not respond to allopurinol or celery seed.

      Have you ever had a blood test for uric acid levels?  That will help understand just what's what.

      There is no diet, and no drugs other than painkillers, for pseudo-gout, but it usually goes away after a week or three, and it's generally (for me) not quite as painful as the "real thing", though saying it's 8 instead of 10 isn't exactly a party.  Pseudo-gout in upper foot and ankle puts me on crutches even when the pain is "only" a 6 or 7, it's just impossible to walk on it, though I've walked on 10-level pain with regular gout.  Very character building!

      Doctors don't really know what you've got without extensive tests that are seldom done, even a high blood urate level is not proof of anything - though it's highly suggestive.  And it may be the high urate level promotes pseudo-gout too.

      My two cents.  Glad you're feeling better - and know about celery seed!

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    • Posted

      Thanks for your reply and info. Pseudo gout sounds horrible. I wish you all the best dealing with that and I will research that as well. I will follow up soon with Dr. for blood tests. Not sure how happy she'll be as I haven't taken any of the allopurinol. But if uric levels are fine... thanks again!

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