GoutPal Support Services Update

Reply To: Allopurinol increase

nobody — Mon, 30 Jan 2023 12:54:40 +0000

Hi!
It would depend on your uric acid history as well as on the reason your doctor wants to increase the dose.
In any case you should ideally be on meds that prevent attacks when starting allopurinol. Your kidney injury might make some of these medications dangerous for you but there are several alternatives so hopefully at least one would be suitable. Failing that, you could perhaps take an effective painkiller (not acetaminophen/paracetamol).
I would recommend that you discuss this with your doctor ASAP. Don’t allow them to brush off your concern or to minimize attacks because they cause damage, not just pain. And if your doctor isn’t very knowledgeable about kidneys or about preventing and treating attacks, consider seeing another (perhaps a specialist).

Allopurinol increase

Karen C0x — Sun, 29 Jan 2023 22:30:13 +0000

Hi I’ve recently started this med as have had acute gout attacks following kidney injury. Doc wants me to increase when I’m pain free, will this trigger more gout attacks as it did when I first started. Just coming to end of an attack and becoming pain free but so scared to start the increase as the pain was so very intense

Reply To: Keto and gout

Richard G Paxton — Wed, 25 Jan 2023 15:34:07 +0000

Hi,

Yes, my uric acid was not controlled. But my theory is that the alcohol was dehydrating my body, thereby increasing Uric Acid levels. I was not drinking enough water either. I was drinking zero carb alcohol as well. Now that I have a uric acid test meter, I am going to start tracking this much better. All of the anecdotal evidence I have seen seems to show that people that are on a Keto or carnivore diet tend to see their gout symptoms go away.

I would encourage people to look at this video by Dr Ken Berry on gout. Its pretty good.

Read the comments as well, some pretty good anecdotal evidence from real gout sufferers. After reading them, I am convinced Gout can be controlled by diet.

More comments welcome.

-Rich

Reply To: Keto and gout

nobody — Mon, 23 Jan 2023 21:35:17 +0000

Hello Richard,
I have read people claiming that sustained ketosis was fine but that going in and out of ketosis was the problem. That sounds plausible. I never tried sustained ketosis but failing to eat enough carbs for a day or two certainly seems to be an inflammation trigger for me… perhaps if ate even fewer carbs for longer periods, my body would adapt to that. Do you think it’s possible that the energy contained in the alcohol you drank might have taken you out of ketosis briefly?
There’s one problem with your theory however: one does not go from controlled uric acid for years to an “attack in my right wrist and hand that took almost 2 months to resolve” overnight (or even over a few weeks). It sounds like your uric acid wasn’t controlled but that symptoms were in remission (that sometimes happens without an identifiable cause). There’s no way to know for sure (for one thing, we don’t know for a fact that this attack was gout). But if your diet contributed to this remission without lowering your uric acid, while it could be beneficial for gout sufferers, it should be used in addition to and not as a replacement for uric acid control. That’s because excess uric acid is going to get people prone to gout in trouble sooner or later (though later is sometimes as good as never and in any case better than sooner!).

Reply To: Keto and gout

Richard G Paxton — Sun, 22 Jan 2023 14:44:23 +0000

I have been on a carnivore diet for just over 2 years which helped my gout tremendously, although I stopped drinking at the same time (with a couple exceptions). I was on a keto diet for about 5 years before that. Because I stopped drinking, I am not sure if it was carnivore, drinking, or a combination of both. All I know is I went over a year without any serious gout flare ups. I did have a flare up back in June last year, when I introduced honey and berries back into my diet. Very painful attack in my right wrist and hand that took almost 2 months to resolve. I eliminated all carbs and had no issues until just a week ago. I had starting drinking again over the holidays. Just a few shots of cognac a night for about 4 weeks. Now I have a severe gout flare up in my left hand. My point of all these details is that I do believe the keto/carnivore diet is a very beneficial diet to help control gout, but there other factors that can contribute. My theory on this recent flare up is that alcohol was the main factor, that dehydrated me and made my uric acid go up. Unfortunately, I wasn’t monitoring my uric acid levels, so its just a theory.

I just came across this forum yesterday and have spent several hours reading a lot of information. As a 20 year gout sufferer, I wish I had found this forum 10 years ago. My gout started in my big toes 20 years ago, but was fairly mild and I just suffered through it. I was a heavy drinker during that time period up until 2 years ago, I think a lot of my issues where alcohol leaving me in a constant state of dehydration. My gout was manageable/tolerable until about 6 years ago. it started moving to my knees and then my wrists/hands. I am assuming due to years of crystal build up.

Based on my experiences with gout, I am a firm believer that it can be controlled through diet/nutrition and exercise. But, monitoring and controlling Uric Acid levels makes a lot of sense. I just ordered a home test kit so I can start testing monthly. For now, I plan to go back to carnivore, no alcohol, and ensure I drink a gallon of water a day. My goal is to stabilize and get my uric acid to 5 mg/DL and see if this regimen will eliminate the gout permanently. I will post results on this forum for those interested.

Reply To: THIS STOPPED MY GOUT!

nobody — Sat, 14 Jan 2023 18:15:42 +0000

Hello,
Gout symptoms typically come and go for no apparent reason. This unfortunately leads people to get invested in a variety of magical cures which do not work and which are sometimes harmful when used for very long.
It takes a long time to know if your gout symptoms are actually gone, and even then they might come back occasionally (especially during the first couple of years after starting a successful treatment and/or when consuming very few carbs). Additionally, were your symptoms actually gone for good, very high amounts of uric acid in your blood would still be a problem you shouldn’t neglect.
A harmful amount of uric acid in one’s body is not caused by the consumption of reasonable amounts of beer, fats, carbs or proteins.

THIS STOPPED MY GOUT!

Spinello Plumbing, Heating, & Cooling — Fri, 13 Jan 2023 19:21:37 +0000

I suffered from gout for 30 years. Tried everything. Was put on a statin for cholesterol and it got worse. It got to a point where I was limping almost everyday.
My hair has been thinning lately and my wife purchased these jelly beans for hair, skin, and nails.
Within 2 days of taking, I have not had any pain or any sign of gout.
My guess is the high amount Biotin (B-7 or Vitamin H) has something to do with it. It has 6,000 mcg of Biotin which is 20,000% of RDA.
The only other ingredient in these jelly beans which I have not taken before is Keratin 50mg. So it could be that as well.
I am back to eating anything and drinking beer with no signs of flareups.
Turns out, B-7 helps the body metabolize fats, carbohydrates, and protein.
If it helps you, then it was worth it for me to share this. I have cried my last tears of pain from this horrible affliction. Hope it helps! Godspeed.

Reply To: Alcohol and uric acid excretion

Tue, 10 Jan 2023 18:05:10 +0000

Hi George,

I’m intrigued why you ask:

There seems to be a lack of research into how long ethanol affects your kidneys and inhibits uric acid excretion. I wondered if anybody here knows how long it takes, after drinking alcohol, that your body starts to excrete uric acid at a normal rate (as normal as someone who is gouty can be! Haha)

Because I can understand why people want to know, for example, how long after drinking does your blood alcohol level return to normal. But I can’t understand what you would do with the information you are seeking. I.e., how will knowing that fact, or a reasonable estimate of, change how you manage your gout?

Reply To: Alcohol and uric acid excretion

James Park — Tue, 10 Jan 2023 03:17:13 +0000

I thought i drank alot too, but when i talked to my RA doctor, she said, that’s not alot. I used to drink about 1/2 bottle whiskey, Friday/saturday. once a week.

I lifted weights all my life, since 18. Anyway, i was 40, worked out 4-5x week, did yoga, ate healthy, was in great shape. 210lb (6’3). but my body was making urate crystals. Then one day my ankle started hurting, went to osteo to get ankle reconstruction. couldn’t walk for 6month. gained weight. then gout attack constantly for a year. I can barely walk now. Now 48, realizing it was all gout, taking med and see’ing my RA doctor regularly.

Moral of the story, you could be in great shape, but your body is warning you. Go see RA doctor and make sure you take care of uric acid problem. You dont want your body to start making crystals in the muscles. I had all the signs but since I was noob to Gout, didn’t realize i should’ve took steps earlier on. My RA said, if I had came 10 years sooner, I might not need a ankle reconstruction surgery.

Food to eat with gout

anum amir — Tue, 27 Dec 2022 12:56:48 +0000

All vegetables and fruits are okay to eat if you have gout. Cherries might even help with gout by lowering uric acid levels. In case of continuous uneasiness rest a bit. Maybe buy your food online. Many platforms do home delivery of quality fruits and vegetables.

Reply To: What is the best Vegan Diet for Gout?

Wed, 07 Dec 2022 11:12:17 +0000

Gout & Plant-based Diet

I’ve recently added more reviews of vegetarian and vegan diets at Gout & Plant-based Diet Research.

Please let me know if you want me to do a more in-depth review of these. Or if you know other relevant studies about plant-based diets for gout sufferers.

Reply To: Alcohol and uric acid excretion

nobody — Sat, 05 Nov 2022 23:21:40 +0000

Hi!
I don’t consume alcohol and don’t know how long the effect lasts, sorry.
I wouldn’t assume that you can solve your problem by quitting alcohol and improving your diet anyway. Symptoms are a poor guide to what’s happening to your uric acid, except over many months (if not years). I would certainly encourage you to quit alcohol, but not by misleading you so I want you to know drugs work much better to control uric acid and more importantly to prevent future gout symptoms at this delicate stage of the evolution of the disease.
Animal products in general aren’t the problem by the way. Small cells are (at least as far as purines in general are concerned but you should understand there are additional concerns with animal flesh) so while you certainly want to avoid animal flesh, you should also avoid some non-animal foods as well. Milk is fine however, as are eggs and some other animal products. Vegans have been known to have uric acid issues (though this is by no means unavoidable). Again, drugs work so much better than tweaking one’s diet that I don’t think it’s worth wasting your time with the details unless you know you can’t tolerate the best drugs (and even then, you should make sure you haven’t been misled in this regard by incompetent doctors, as I was for too many years).

Alcohol and uric acid excretion

George Talbot — Fri, 04 Nov 2022 00:27:25 +0000

Newly diagnosed with quite mild symptoms. I had a high uric acid count so I have cut drinking down alot and removed animal products from my diet which seems to be doing the trick for now.

I was just over 7mg/dl, but I hadn’t fasted etc for the blood test. The flare was in the correct point of the big toe and there was redness so fairly sure this wasn’t a misdiagnosis, however no joint fluid was taken.

I’m 31 and I do enjoy drinking with friends, I have done lots of research into uric acid levels and food / alcohol. From what I gather a pint of beer creates around 50mg of uric acid. Other alcohols such as wine and spirits create 0mg.

However the issue is that ethanol inhibits uric acid excretion.. causing gout attacks especially if you are then eating high purine foods at the same time / after you drink.

There seems to be a lack of research into how long ethanol affects your kidneys and inhibits uric acid excretion. I wondered if anybody here knows how long it takes, after drinking alcohol, that your body starts to excrete uric acid at a normal rate (as normal as someone who is gouty can be! Haha)

How Does Alcohol Change Uric Acid Excretion? (click for image details)

Krystexxa

Arthur Allen — Mon, 27 Jun 2022 14:54:25 +0000

I’m a Washington, DC-based health care journalist (khn.org) and I’m trying to learn a bit more about Krystexxa from patient perspectives. If interested, please contact me at arthura@kff.org

Thanks

Arthur Allen
Senior Correspondent, Kaiser Health News

Reply To: Acute gout with low uric acid

nobody — Thu, 09 Jun 2022 15:18:03 +0000

Hi,
I didn’t see your question earlier because this forum has very little activity.
Many conditions can produce symptoms somewhat similar to gout. And gout isn’t usually something you get whenever you eat the wrong thing as some people imagine.
Could you clarify what exact uric acid values you got, and from what kind of test ? People who get tested at my lab and who get a uric acid value under their current range would be very unlikely to experience gout symptoms (unless they started treatment recently). But ranges are kind of arbitrary and change all the time. And you may have meant within the range (that’s what people usually call “normal”) as opposed to below the range…
Colchicine isn’t a good way to diagnose gout. People (including one of my doctors) do use it for diagnosis occasionally so I’m not saying you shouldn’t try it if you really have no other option but this is a dangerous drug and the results are likely to be ambiguous at best so you’re going to want to be working with a knowledgable doctor if that’s at all possible.

Acute gout with low uric acid

Michael J Nolan — Wed, 08 Jun 2022 15:42:06 +0000

I get an acute gout attack after eating sardines, liver or a few beers. When I go for tests my uric acid is actually below range. So I read this paper online, do I need to try colchicine to diagnose my gout?

Here is the conclusions: The diagnosis of acute gout attack should not be excluded in the presence of normal serum uric acid levels if the clinical manifestations or the positive response at colchicine are suggestive of gout. The low uric acid level is correlated with increased inflammatory factors and urinary excretion of uric acid.

https://pubmed.ncbi.nlm.nih.gov/25581951/

Thanks

Crocodile Oil

Ole Bo Larsen — Mon, 25 Apr 2022 11:32:20 +0000

Generally, I experience people around me wanting to try to help me with my Gout. A dear family member just returned from Zambia and brought be a container of Crocodile Oil. She had been informed that the oil can also help Gout (whatever that means, right).

Doing a bit of research I understand that Croc Oil has inflammatory properties and is primarily used extrovertly for various skin problems like Acne. Its properties are many but interesting Omega 3 and 7 and it helps increase the white blood cell count.

Now I am still not a Gout expert even fully understand Gout and all its biological mysteries but Omega and inflammation do ring a bell so to speak.

If you have any experience with Croc Oil or some other valuable advice that would be appreciated.

Personally, I think it’s in the potential preventative category possibly to fight a Gout attack and a bit whatever works for you.

In any case, it can simply be a health supplement.

What do you think?

P.s. Fingers crossed I seem to be controlling my Gout attacks with my diet and exercises. I do have Osteo Arthritis in the same joint though actually both first MP joints (where the big toe joins the foot – Metatarsi)

Reply To: Allopurinol questions

nobody — Sun, 17 Apr 2022 08:23:41 +0000

Hi,
I don’t take allopurinol but, in theory, there’s not much benefit to spreading the dose over the day since the drug is metabolized over more than a day anyway. There might be a tiny increase in effectiveness when taking half the dose in the morning and the other half in the evening but I guess it’s mostly a matter of convenience and perhaps of managing certain side effects (which probably aren’t affecting you).
I suggest you ask whoever reduced your dosage when you get an opportunity.
And whatever you do in the meantime, make sure the amount of uric acid in your blood is checked after you reduce your dose (ideally a month or two afterwards).

Allopurinol questions

Nick — Thu, 14 Apr 2022 10:47:18 +0000

Hi guys,

I’ve recently had my dosage reduced from 300mg to 200mg which of course needs to be taken by 2 x 100mg. When I had the 300mg tablets it was one tablet a day, nice and easy, but the box label for the new tablets just say ‘Two to be taken daily’. Has anybody received professional advice as to whether taking them both at the same time is ok rather than spreading them out ?

I’m also interested to hear of people’s experiences of taking allopurinol at different times of the day – any benefit in taking in the morning rather than the evening, for example ?

Thanks !

Reply To: GoutPal Notifications Service

Thu, 17 Feb 2022 04:37:34 +0000

Early feedback tells me that this is more complicated than it needs to be. So later today, I will announce an easier way to stay updated about gout.

GoutPal Notifications Service

Wed, 16 Feb 2022 11:09:17 +0000

Many of you who are reading this will have been notified by email. Specifically, via a Google service called FeedBurner. But I am replacing that service with GoutPal Notifications. NB: I have already switched this service for my main website – GoutPal.com. So if you used to be subscribed to that email update service, you will need to resubscribe to the new service.

The new notification service is integrated with the technical “back-end” for GoutPal.com. Where I do my writing and publishing. So when you go to subscribe, you will see a lot of features that are only relevant to programmers and technical authors. But just ignore everything except for Discussions and Issues.

Discussions are the nearest thing to most of this forum. Gradually, I will replace this forum with GoutPal Discussions. But for now, I will maintain both. Though, I hope you will post in Discussions rather than this forum.

Issues are the nearest thing to my posts where I encourage readers to help me improve GoutPal information. Furthermore, I log all new pages and revisions in GoutPal Issues. So you should subscribe to GoutPal Issues Notifications to be informed when I publish changes.

In the new service, you can get website notifications as well as emails. Also, for smartphone users, the mobile version can supply phone notifications. All of which is explained at GoutPal Notifications.

If you have any concerns about using new notification services, I hope you will tell me using the link at the end of that page. But if you have any problems accessing the new service, please let me know by replying here.

GoutPal Forum Becomes Issues and Discussions

Mon, 31 Jan 2022 10:17:43 +0000

I’m upgrading this GoutPal Forum to become GoutPal Issues and GoutPal Discussions. So you can choose between resolving your gout concerns. Or chatting about potential solutions and shared experiences.

Soon, I’ll close this forum. But I can’t yet define ‘soon’. Except to say, I would prefer you to start using GoutPal Discussions instead of this forum. Also, I will keep this forum open for as long as I can. So that anyone struggling to use the new platform can let me know.

At this stage, I don’t want to bore you with unwanted explanations. Beyond what I am saying in my GoutPal Discussions Welcome Post. But I am happy to answer any questions you might have. In fact, I’m hoping for some interesting ideas that I can respond to. Especially in GoutPal Issues.

Research & Act Or Chat & Think?

Reply To: Muscle pain/weakness with allopurinol?

nobody — Fri, 14 Jan 2022 18:38:06 +0000

Hi,
I certainly experienced strange pain and weakness, but hasn’t everybody else (or at least everybody who isn’t young anymore)? Maybe a more specific description might be useful but this is probably something you should talk about with a doctor who would perhaps run a few tests to see if anything unusual is happening with your muscles. There could be many causes even if you didn’t change anything other than your allopurinol dosage (which didn’t change much).
Without looking at older UA numbers, it’s impossible to guess if you might still be experiencing gout symptoms (though unexplained metatarsal pain that lasts a few days is suspicious indeed!). If you still have solid uric acid in your body doing damage, this might end up interfering with your training. Uric acid has been known to move around the body and cause symptoms at the strangest of places soon after people drop their SUA low enough but I would be surprised if this happened to someone after three years of allopurinol (even if the dose wasn’t quite high enough). Damage caused by gout in the past might also end up causing problems (mainly bone issues) but so far as I know, there’s nothing that can be done to prevent it once the damage is done. So I would want my UA lower than 350 in your situation. In case allopurinol turns out to be an issue (which seems unlikely at this point), there are alternatives.

Muscle pain/weakness with allopurinol?

T K — Fri, 14 Jan 2022 18:19:12 +0000

I’m 52, lean, and very athletic, with a good diet (mostly veggies) and no drinking. Have been dealing with gout for 6-7 years, and on allopurinol 150mg/day for ~3 years. I recently started having some mild pain that arises in the head of either metatarsal and lasts for days before fading. Recent UA was 350 (~5.9). I bumped my allopurinol up to 200mg/day and immediately found that I started having strange muscle pain and weakness, particularly in my quads. I cycle daily, 40-80km, and didn’t have an unusual bump in distance or intensity. The only new thing was the higher dose of allopurinol. I have a concern about this, particularly because daily training on the bike is my main means of keeping fit.

Anyone else experience this, and if so, was it transient or permanent?

Reply To: Aching Gouty Toe despite Allopurinol

Wed, 12 Jan 2022 04:23:34 +0000

Most new visitors reading this discussion have found it after asking Does Allopurinol Dissolve Tophi? Please follow that link for the latest facts.

Also, this is a heads-up that I’m replacing this forum soon with GoutPal Issues and GoutPal Discussions. At the same time, this forum will become read-only. After which, I will slowly absorb forum topic information into GoutPal.com.

GoutPal Discussions are the nearest thing to this forum. Because I intend them to be where gout sufferers can chat about common questions, experiences, and opinions. GoutPal Issues work alongside on the same platform. However, I intend them to be where gout sufferers can collaborate with me to improve information on GoutPal.com. Therefore, the focus with GoutPal Issues is to help people apply my information to their situation. That is similar to some topics in this forum that I have tagged with Using GoutPal.

For this topic, there is a live Issue about Tophi and Allopurinol. So that is where you can work with me to apply my facts to your situation.

You start by posting your details in that issue. Explaining why my information doesn’t apply to your situation. Or seeking clarification about how it applies. Then we work together to help you decide what you need from your doctor. Or other health advisers.

By doing that, I intend to help you with relevant information. After which, I can use our dialog to improve my pages for future readers.

Reply To: Can Tophi Grow After Starting Allopurinol?

Keith Taylor — Wed, 12 Jan 2022 04:09:08 +0000

Most new visitors reading this discussion have found it after asking Does Allopurinol Dissolve Tophi? Please follow that link for the latest facts.

For this topic, there is a live Issue about Tophi and Allopurinol. So that is where you can work with me to apply my facts to your situation. By doing that, I intend to help you with relevant information that you can discuss with your doctor. Or other health advisers. After which, I can use our dialog to improve my pages for future readers.

Reply To: Next Steps

nobody — Sat, 11 Dec 2021 11:31:01 +0000

Hi,
Regardless of the accuracy of your self-testing, 6.7 and especially 7.2 are high enough for gout. The normal range is irrelevant. And not everyone gets the worst-looking big toes (mine were never shiny). Obviously I can’t tell whether you have gout but I can tell you’ve had bad doctors (which is unfortunarely not unusual).
If you’ve had gout for 20 years, I would recommend finding a doctor with a clue and discuss blood tests and potentially a pharmalogical intervention (standard warning: beware of allopurinol if you have East Asian ancerstry). If you actually have gout, diet will probably not work wonders after allowing the disease to fester for so long. Don’t get me wrong: improving your diet would help in the long run if compared with not doing anything. Just don’t bet on that curing your gout at this point.
Yes, people have had gout triggered by weight loss and/or dieting and fasting probably does something similar. But lots of things trigger gout whereas the only way to prevent it is to get rid of the uric acid in your body so I wouldn’t give up fasting if it works well for you and you tolerate NSAIDs well (but you should get medical tests to make sure you are actually doing well when you’re fasting and that you actually tolerate this dangerous class of drugs as well as you think).
The NHS’s dietary advice is probably useless. Chicken is no good for gout sufferers for instance.

Next Steps

Peter Wilson — Sat, 11 Dec 2021 08:50:45 +0000

Hi
I’m new to the forum but I can see that there is a lot of good advise and knowledgeable people participating here.

This is a long post but hopefully I’m giving some context to the gout issues I’m experiencing.

I am a Male aged 60, weight 14 stone 2 pounds so not obese and reasonably fit.

I have had gout like symptoms on and off for about a 20 year period and in the early years gout attacks were about every 2 to 3 years with moderate pain which was relieved fairly easily by taking NSAIDs.

Over the last five years things have gotten a lot worse as I’m now seeing gout attacks most months. Again, I’m only getting moderate symptoms which means that I can take NSAIDs to relieve the pain but I would like to understand what’s going on.

Over the last 20 years I have consulted with my doctor a few times regarding gout but no diagnosis for gout was ever made. During gout attacks I tend to get moderate to low pain and not the classic big red shiny toe symptoms you often see in photographs which has led my doctors to be hesitant about diagnosing gout and blood tests have indicated that my uric acid levels are within the normal range ( < 7.2 mg/dL). Doctors have just prescribed NSAIDs and advised rest and stated that they do not know what is wrong but were not convinced that I was presenting with gout.

However, I am convinced that I do suffer from gout and that things are getting worse.

I have recently been looking at my historic medical records from the NHS website and blood tests show 2 UA tests in the past with readings of 6.7 and 7.2 mg/dL, these were about 10-15 years ago and I haven’t had any recent tests via Doctor’s clinics.

I have started monitoring my uric acid levels using a finger prick monitor on a weekly basis over the last few months and my uric acid reading is averaging about 7.4 mg/dL which I know is quite high.

I generally get attacks which affects my big right toe and more recently I’ve been getting nighttime attacks which affect my ankle. This often feels like tendinitis but I suspect that it is gout, or gout induced tendenitis. Both big toes can become inflamed with slightly reddish appearance.

I’ve also started looking at my urine pH levels and found that they are slightly acidic which I believe is quite common. This was done using test strips not meters. I would ofcourse like to see a more alkaline reading which would be better for gout management.

Looking at the NHS Gout advice website I noticed that my food sources generally fall within the moderate and low purine categories so I think my purine levels are likely to be moderate as I am not a big eater.
I generally can cope with a low calorie intake and my body feels happier when I’m on a low calorie intake so I don’t really have a problem with this but I was wondering if fasting is known to cause any problems in relation to gout.

I know that dietary changes can be an important part of gout management. Therefore, I have cut out alcohol completely and cut down on red meat and moved more to chicken as my primary source of meat. I have started drinking more green tea and water which hopefully should be beneficial and I feel that I’m getting plenty of hydration, probably drinking at least 2-3 L of fluids a day.

It’s almost as if making these dietary changes has been to no avail and if anything has made my gout attacks more frequent.

One thing I have picked up from this forum is that there may be something which has been called “gout hell” which seems to be where historic UA crystals dissolve and UA is reintroduced back in into the blood and the auto-immune systems reacts to this higher level of uric acid and I was wondering if this could be something I’m experiencing.

if I am going through “gout hell” then at least there is some hope that this may be short term pain for long term gain.

I just do not know where to go from here as I was hoping that diary changes would show less frequent attacks and improvement in my situation.

I’m wondering if only medical intervention can improve this situation.

Reply To: Fractured Sesamoid presenting as gout?

nobody — Sun, 21 Nov 2021 01:54:08 +0000

If you actually have gout, depending on what your uric acid used to be, going on a gout prevention diet could actually prolong your symptoms. It would help in the long run and allopurinol can do the same thing depending on the dose so it’s not that such diets aren’t helpful, only that they’re rarely a quick fix. To simplify things a bit, it’s mainly what you ate last year that’s the issue rather than what you ate yesterday.

Reply To: Fractured Sesamoid presenting as gout?

Subaru Pilot — Sat, 20 Nov 2021 20:59:09 +0000

Thanks. I agree, internet is not a doctor, but it is nice to put things out there on a virtual “round table” for discussion.

I made another appointment with my podiatrist for this week and I am going to discuss an MRI or other imaging.

I suppose what I was thinking was that if it was true gout, and it’s been over 3 weeks, and after the initial consult at Urgent Care suggesting it was gout, I have been very particular with my diet, including no alcohol, no red meat, and watching typical consumption triggers. And, I don’t indulge in sweets. It seemed like I was already following the gout prevention diet, which is frustrating because that means I have no other options aside from taking the medicine should it come down to it.