Gout

Aleve at first sign of gout. Works for people I know.
 
Aleve (naproxen) and Indocid (indomethacin) are both anti-inflammatory medications used for acute episodes. Colchicine is the medicine used historically for acute flares and is very effective as well. Fructose is not metabolized into uric acid but it does use up ATP in the course of its breakdown and the resultant AMP is ultimately broken down into uric acid. Fun fact is that humans are the only meat eating animal that doesn't have the enzyme which breaks uric acid down. In fact, almost all organisms have it except for us and great apes who are wise enough to be vegans! Some sort of a curse on us!
 
OP here. Thanks for all of the informational responses. They helped a lot.


My foot is painless today! Dr. says lab results indicate elevated uric acid. If it returns they will look to Allopurinol to relieve pain. Need to stop by local military hospital at my convenience and get an x-ray on the foot. Will take care of that in a couple of weeks.
 
I was diagnosed with gout in my right large toe 3 or 4 years ago. I've taken Allopurinol and Colchicine (that's likely misspelled) daily since. I'm tempted to drop the Colchicine. Even though my blood work looks good (I don't think it was ever over 7), my toe aches constantly and has limited the shoes I wear.

My exercise each day is about a 4 mile walk each morning. That is so hard on that toe, but the exercise so far has been worth it. There is swelling in the joint that never goes away. I'm afraid I let this go too long before the Rx and have permanently damaged that joint.

I didn't know about the sugar. I'll work on reducing that as much as possible. My downfall is white wine, and I know I'll not give that up (at least I don't plan to right now). Maybe I'll add the tart cherry juice and see. I take a Tart Cherry supplement pill and if that helps, I sure would hate to do without it.
 
I learned a few things about gout. None of this is new, but I hadn't found it before.

Gout can be caused by either hypothyroidism (by lowering kidney clearance of uric acid) or hyperthyroidism (by increasing uric acid production).

Lithium may help keep uric acid in solution. This should prevent crystals from forming. A typical dose is 5-10 mg at each meal (15-30 mg/day).

Vitamin C may increase uric acid clearance in the kidneys.

A few weeks ago I had a pretty severe gout attack in my right foot. It was a higher level of pain than I've seen before. I was already taking 5mg lithium. I increased to 10mg/day, but it didn't seem to help much. I may try a higher dose.

It turns out my need for thyroid hormone had decreased and I was taking too much. I've been gradually lowering my thyroid dose over the last couple of weeks, and my foot is much better.

I hope someone out there finds this useful.
 
msieweke said:
I learned a few things about gout. None of this is new, but I hadn't found it before.

Gout can be caused by either hypothyroidism (by lowering kidney clearance of uric acid) or hyperthyroidism (by increasing uric acid production).

Lithium may help keep uric acid in solution. This should prevent crystals from forming. A typical dose is 5-10 mg at each meal (15-30 mg/day).

Vitamin C may increase uric acid clearance in the kidneys.

A few weeks ago I had a pretty severe gout attack in my right foot. It was a higher level of pain than I've seen before. I was already taking 5mg lithium. I increased to 10mg/day, but it didn't seem to help much. I may try a higher dose.

It turns out my need for thyroid hormone had decreased and I was taking too much. I've been gradually lowering my thyroid dose over the last couple of weeks, and my foot is much better.

I hope someone out there finds this useful.
Click to expand...

NOT a Doctor here but after 50 years of dealing with severe gout one thing I've learned is any change in meds can bring it about.

What often happens is that purines hiding quietly in your system can be leached out by gout 'cures' and actually cause an attack. Cherry juice or Alopurinol will do this to me.
 
This is part of the reason I keep detailed records of:
everything I eat or drink, including time of day
supplements
morning pulse
morning body temperature
sleep time and quality
exercise (including pulse during)
mental, physical, and emotional state through the day
body weight
unusual physical symptoms (gout, cramps, etc.)
medical test results
and several other things

Sometimes a change takes days or even weeks to show all its effects. I've been tracking most of this this data for 7 years, so I can look for long-term patterns. Sometimes I only recognize a pattern after it has appeared several times. I'm occasionally confused when a symptom is similar for deficiency and excess.

I didn't start doing this because of gout, but the data has been helpful in tracking what makes gout better or worse. My biggest trigger (and biggest weakness) is sugar. Until this last time it always got better when I cut my sugar intake. It took me almost 2 months to realize I was hyperthyroid, because the symptoms (other than gout) changed so slowly. And I can be a bit dense :).
 
I was trying to look-up how often gout strikes in non-foot joints. 5%, < 1%, ??
 
I don't know the statistics, but I had gout in my hip joints long before it hit my foot. It was like having tiny needles in the joint that would poke me if I bent my leg a certain way. I didn't know what it was then, and it went away on its own. Now when a gout attack hits my foot, my hips become a bit sore, but nothing like they were back then.
 
My wife had gout symptoms in her toe (to the point that I wheeled her into the doctor's office) just a couple of days after she drank beer along with eating a feast of various seafoods which she's not accustomed to doing. She was tested for high uric acid but the levels were normal. The doctor diagnosed it as 'pseudogout' and gave her some medication. The pain started clearing up almost immediately. That was over 5 years ago and the problem has never recurred. She now avoids large quantities of seafood.
 
bubba said:
I was diagnosed with gout in my right large toe 3 or 4 years ago. I've taken Allopurinol and Colchicine (that's likely misspelled) daily since. I'm tempted to drop the Colchicine. Even though my blood work looks good (I don't think it was ever over 7), my toe aches constantly and has limited the shoes I wear.

My exercise each day is about a 4 mile walk each morning. That is so hard on that toe, but the exercise so far has been worth it. There is swelling in the joint that never goes away. I'm afraid I let this go too long before the Rx and have permanently damaged that joint.

I didn't know about the sugar. I'll work on reducing that as much as possible. My downfall is white wine, and I know I'll not give that up (at least I don't plan to right now). Maybe I'll add the tart cherry juice and see. I take a Tart Cherry supplement pill and if that helps, I sure would hate to do without it.
Click to expand...

You may have arthritis in the big toe knuckle. They can carve it out. CHILEE-ECTOMY.. Surgery is painful for a week or two but worth it. I had it done 14 years ago and am only recently having some issues with it. Ask your Dr.
 
Tough week for me.

Had a mild gout flare up in my ankle a week ago Friday. It wasn't too bad; in fact, I was wondering if it was just a mild sprain instead.

No such luck. On Monday night, it ratcheted into a major flare up. I was in bed for the next two days. I kept putting off going to the doc because it seems like I always go just as the worst is over and I end up paying for the visit and the Rx when I don't need it anymore.

I gave in and finally made an appointment Wednesday morning. But by noon, the pain was diminishing and I cancelled the appointment. Thursday, I was able to start getting around.

The kicker came Thursday afternoon. The DW had agreed to babysit the grandkids. I tripped on a toy that was left out and sprained the same ankle. Yep. I sprained the ankle that was still enflamed with gout. Wow, did that hurt!! :(

Today (Saturday) I am finally able to get around the house a little bit.
 
CoolRich59,

i hope you recover soon sprained ankles are no fun , and the gout complication would not be pleasant
 
Oz investor said:
CoolRich59,

i hope you recover soon sprained ankles are no fun , and the gout complication would not be pleasant
Click to expand...
Thank you - much appreciated.

I'm pretty sure alcohol is the trigger. I don't drink much, but recently we've socialized more than usual and I had wine or mixed drinks on several evenings over the past couple of weeks. I'm definitely back to full-time abstaining!
 
CoolRich59 said:
Tough week for me.

Had a mild gout flare up in my ankle a week ago Friday. It wasn't too bad; in fact, I was wondering if it was just a mild sprain instead.

No such luck. On Monday night, it ratcheted into a major flare up. I was in bed for the next two days. I kept putting off going to the doc because it seems like I always go just as the worst is over and I end up paying for the visit and the Rx when I don't need it anymore.

I gave in and finally made an appointment Wednesday morning. But by noon, the pain was diminishing and I cancelled the appointment. Thursday, I was able to start getting around.

The kicker came Thursday afternoon. The DW had agreed to babysit the grandkids. I tripped on a toy that was left out and sprained the same ankle. Yep. I sprained the ankle that was still enflamed with gout. Wow, did that hurt!! :(

Today (Saturday) I am finally able to get around the house a little bit.
Click to expand...

Gout only occurs in your big toe! What you had was something else possibly "false gout". I had something similar in my ankle last week and 1/2. I originally thought it was false gout but it turned out to be much more dangerous. I developed cellulitis in the ankle,top of foot and could not walk for a week and a half. Wife took a photo and sent to the DR, doctor diagnosed it right away and sent over meds. Feeling great now! I never visit a DR, so this system works great!
 
i used drink ( usually binge drink ) before my heart adventure without ever having gout , but of course that doesn't mean the trigger doesn't apply for you ,

keep track and see if there are other potential triggers

i gave up drinking as the meds i am on effect me like two bottles of scotch ( on a full stomach ) and they cost a lot less than the scotch ( still 'hammered at a 90% discount ) LOL

good luck and good health
 
NYEXPAT said:
Gout only occurs in your big toe!
Click to expand...
I don't believe that's correct. Prior episodes have been in my big toe, but I suspected gout because of the intensity and consistency of the pain were way beyond a sprained ankle.

I just did a quick search and webmd says: "This [gout] usually happens in your big toe, but you also can have gout in your knee, ankle, foot, hand, wrist, or elbow." (link)
 
NYEXPAT said:
Gout only occurs in your big toe!
Click to expand...

Gout can occur in lots of places. The first place I had it was in my hip joint. It only caused problems when I moved my leg in certain directions, but it was amazingly painful. I've had it between the base of the 2nd and 3rd toes, also amazingly painful. Compared to those, my big toe is only a mild annoyance.

When gout is up, it also causes pain in my knees and lower back. Not a full-blown attack, but definitely gout. Any doctor who claims it only occurs in the big toe has no real experience with it.
 
i had a great aunt with gout back in the 1960s and she was very inconvenienced with it it certainly looked like most of her right leg was affected , but then much has changed in medical diagnosis
 
msieweke said:
Any doctor who claims it only occurs in the big toe has no real experience with it.
Click to expand...
I love my regular doc, and he definitely knows about gout, but he tends to be pretty dismissive when I see him. Either he hasn't had much experience with it, or he is unsympathetic because he's been after me for years to get my weight down and I have yet to make much progress.

I had one bad flare up on a weekend night and ended up going to an urgent care clinic. The doctor on staff took one look at me, left the exam room and came back with a small white pill in her hand. "Take this", she said. I don't know what it was, but in about 15 minutes I could not feel anything. :D I wanted to give her a big hug.
 
CoolRich59 said:
The kicker came Thursday afternoon. The DW had agreed to babysit the grandkids. I tripped on a toy that was left out and sprained the same ankle. Yep. I sprained the ankle that was still enflamed with gout. Wow, did that hurt!! :(
Click to expand...
Update: As the pain from the gout flareup and sprained ankle diminished, I started noticing a lot of pain in my knee.

I thought it was due to strain I'd been putting on the knee as I hobbled around favoring my ankle, but the pain got a lot worse Saturday night. I ended up going to an urgent care center and learned that, when I tripped on the toy, I tore the meniscus in my knee. :'(

My tough week is being renewed into next week. :(
 
CoolRich59 said:
Update: As the pain from the gout flareup and sprained ankle diminished, I started noticing a lot of pain in my knee.

I thought it was due to strain I'd been putting on the knee as I hobbled around favoring my ankle, but the pain got a lot worse Saturday night. I ended up going to an urgent care center and learned that, when I tripped on the toy, I tore the meniscus in my knee. :'(

My tough week is being renewed into next week. :(
Click to expand...

Looks like you are lining up for a scope job. Welcome to the Club.;)
 
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