Gout relief

[Tony Berkeley]

I am 75year old, I have been on blood pressure and anti cholesterol tablets for over 20 years.
My doctor is happy these are under control on my 6monthly check.

Over the last three years I have had one or two annual gout flares. At first Doctor was able to rectify this with NUROBINDO (?) 500MG Tablets which usually cleared the pain in 3-4 days. but a sort of mild background feeling pain was there all the time. This year I had a flare which lasted ten days. After two weeks if came back.

I discussed with the doctor and he now gave me Colchicine 500Mg four times a day (max). I feel that this may take the inflammation but will not cure the problem.

My Doctor takes blood tests regularly and says he is monitoring my kidneys and is worried about any medication that may cause kidney damage. I like your suggestion of Allopurinol, and wonder if this will do the trick. Is is prudent to mention to the doctor that the ideal level is 5 to avoid tophi growth ?

My problem tends to start in my right leg, on the top of the middle food close to my ankle and then eventually move to my toes ….grateful for any comments.

Thanks in advance.
Tony Berkeley

[Keith Taylor]

Thanks Tony, sorry about the delay in responding.

I can’t find any reference to Nurobindo, so I can’t comment on it.

Colchicine stops inflammation spreading, but often needs the support of anti-inflammatories, and occasionally additional pain-blocking medicine.

The general consensus in the medical profession seems to be that allopurinol has more benefits than drawbacks for kidney health. However current kidney health is important, and this can only be assessed on an individual basis. If your kidney health is in doubt, I believe you would be better consulting a rheumatologist who has experience with gout treatment where kidney function is compromised.

Part of your treatment to lower uric acid should involve setting targets for months ahead. These targets must be set on an individual basis, and it is right to discuss 5. However, kidney function might mean that 6 is the lowest achievable. If kidney function is not an issue, I always recommend much lower than 5 for around 12 months, then review. At the review, you are looking for 2 things:
1. Uric acid has stayed consistently below 5mg/dL for 6 months.
2. No gout flares.
If both goals are achieved, then allopurinol dose can be reduced to bring it up to around 5mg/dL. If not, carry on with highest dose that is medically sensible until those goals are achieved.

I hope this makes sense Tony.

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