Is this the right way to start Allopurinol?

[Thomas Placanica]

Hello so my first gout attack was 2 weeks ago the pain was in my right arm, wrist, and left foot top of foot all the way to the ankle and it charlie horsed the calf muscle in my leg. My doctor thought it could be a clot or a fracture. But he could not test me there.

I was sent to the emergency room where they took blood and determined it was an attack of gout. I was given a steroid for 5 days and some pain meds for 3 days. Then 5 days later put on Allupurinol 100 mg a day. Blood level a 13 at the time.

It took 6 days to feel good enough to walk on. Then yesterday I feel it coming the same way on my right foot top and ankle again pain unbearable. Back to the doctor and get a steroid shot, and they do a blood test level is now 9. So they increase my Allupurinol to 300 mg a day.

Is this a proper procedure or should I have been given the Mitigare (colchicine) and should I call my doctor and ask still in severe pain 2 days later. I have changed my diet eating raw garlic, drinking apple cider vinegar eating apples 1 a day only chicken and veggies. Help its killing me.
Thanks Tom

---

Allupurinol = Allopurinol

[nobody]

Hi!
It’s not the proper procedure but you should nevertheless stick with it.
It’s important that you get monitored for side-effects since you have been put on 300mg allopurinol. So yeah, call your doctor to get another blood test (maybe not right now but soon)! You’ll also want to get tested several times to know if the allopurinol is working well enough.
But allopurinol will not get rid of your pain. It takes long time to work. People often take Mitigare as well for a few months when starting allopurinol but that isn’t likely to prevent pain entierly. Certainly taking a little Mitigare wouldn’t provide quick relief. So you probably should have yet another drug on hand and you probably don’t want to be on steroids for very long. So ask your doctor about that (anti-inflammatories have side effects as well)!
If you want advice about meds, you should start by being clearer about what you’re currently taking and what you’ve already tried. For instance, what is “some pain meds”?
Chicken isn’t going to help with gout by the way. The meds are in most cases more important than diet but if you want to improve your diet, you’re going to have to look at everything you’re eating and not only a few things. I’m having trouble making sense of what you wrote but eating only apples, chicken and veggies is of course not a great diet.
Oh, and do make sure you’re staying well-hydrated!

[Dave]

I know exactly how you feel! 4 years ago, I started suffering from gout attacks that incapacitated me for weeks. I told people id rather cut my foot off then have to endure another gout attack. Hopefully my experience to controlling my gout will provide you with some help/hope.

My physician initially prescribed 100mg allopurinol and steroids for acute flair ups. I was under the impression that taking meds was all I needed, and my gout would just go away. Wrong! While traveling for work I woke up on a travel day with the most severe attack I ever had. I was in my hotel room not able to get out of bed because of the pain. I did travel that day and how I did is for another time.

When I returned home, I visited my physician again and he increased the allopurinol dosage to 300mg. I also knew that I had to take control of this gout and educate myself on causes, monitoring and treatment. The first step was to identify those foods and beverages with a higher purine content and remove them from my diet. Second was to begin to monitor my UA levels from a home monitoring device. Initially I was taking samples every three to four days for the first month. All the results were placed in a spreadsheet and graphed over time.

After two months I was encouraged to see my UA reading decline from the danger zone (7 mg/dl) into the good (5mg/dl – 6mg/dl). It should be noted that when I was initially prescribed the 100 mg of allopurinol, my Ua was 9.1 mg/dl. All was going well until one morning I woke with another attack. This one was not as severe as the previous, nevertheless discouraging that it happened. I questioned the accuracy of my testing device and set up an appointment that day to get lab values. I brough my monitor with me into the lab and had the tech use the same sample of blood for their draw to use on my device. When I received the results, I found my device was off by only .2 mg/dl.

With the knowledge knowing my monitor was within an acceptable accuracy range, it was back to trying to understand why the recent attack happened. Could this be the crystals beginning to dissolve and getting flushed from the joints? I’ve read that this is common and is a sign you are on the way to controlling gout. I ran with that conclusion and continued on.

Over the months I watched my UA levels decrease remarkably to at one point my UA was hovering in the 3’s. Additional lab values were taken, liver function good and my monitor still providing accurate readings. My allopurinol was reduced to 150 mgs with no remarkable increase in UA. Slowly my diet began to include some of the foods I enjoyed that had higher purine levels. Most notably was beer. The only change there was switching over to light instead of the regular lagers I enjoyed.
There was a noticeable uptick in my UA readings after the new change in diet, although I maintained average levels in the 4’s mg/dl. At times there were spikes that increased by 1 mg/ml and I attributed that to testing of some foods that I really missed eating.

With my UA levels safe for close to a year, I asked my Physicians’ advise on decreasing my allopurinol to 75mg. He was good with it and I’ve been dosing at 75mg for the past nine months, attack free.

Today my UA levels are still in the safe range and although my diet has somewhat swung back to the pre attack days, it’s still just a fraction of what I used to consume. My goal is for one day to be off allopurinol but to still monitor my UA and control diet. I certainly hope my experience can be helpful and know too that all cases are not the same.

I purchased my monitor from Amazon which they source from Canada. These are not sold in the US from my understanding. https://www.amazon.com/UASure-Uric-Acid-Meter-Sure/dp/B01LN44MKA

Best,

David

[Author]

Posts