Possible gout advice pls

chatfir

Hi all,

Unfortunate new member - currently believe I'm suffering with an acute Gout attack at the moment

I had similar attack 5 years ago which I didn't take seriously and just used over the counter meds. Big mistake and was in agony for easily over week. Bloods got taken back then - uric was up slightly, but not enough for them to say yes, definitely gout.

I have since been given Naproxen 500 or Etorixib to use if and when it happens again. Since then, I've had around 5-6 occasions where Ive felt something start up during the night - stiffness in toe, bit of pain in that joint and quickly taken one of the above tablets just in case - it's worked and I've been managing it well this way.

Annoyingly during holiday last week I had this happen to me. I quickly took Etorixib but it didn't really help. Maybe I messed up by taking only 60mg (which has helped in the past) when 90/120mg is recommended for day 1 to settle it. The pain was more about the big toe joint itself (and stiff) nothing on the outside edge of my toe. Over the next few days I took more Etorixib but also some 500 Naproxen and it got bit better then bit worse then slightly better but wasn't go away.

Then on Monday when back in the UK, it got worse and the pain had moved from the joint to the outside edge. I'm thinking that walking on it a bit and the heat on holiday didn't help things.

I've spoken with my doc and I'm now also on Colchesine alongside the usual drugs. 2nd day of it and hoping things get a bit better soon.

Not sure what caused it as didn't drink that much and was eating ok(ish), maybe the heat was a factor. Also confused as to why the drugs didn't work the way they normally do for me.

Anyway sorry to ramble on but I'm here hoping for some advice. I have a blood test next month. I don't fancy the idea of Allopurinol daily but will do if needed. Hoped I could continue as I have been but really don't want to go through this again as I'm on day 9 and still painful

Poppyjane

Welcome @chatfir to the online community

What a disappointment to have your holiday disrupted by a flare of gout. You sound as if you have followed all your guidelines so it is confusing and somewhat of a mystery.

Some of our members have experience of gout so I hope they will be able to offer you some tips . Meanwhile I attach some information which I hope you will find useful.

https://www.versusarthritis.org/news/2022/january/what-are-the-best-ways-to-manage-gout/

https://community.versusarthritis.org/discussion/60862/gout-spike

Do let us know how you get on.

Take care

Poppyjane

PaulS

Hi, I suffered gout on a regular basis for years and was of the same opinion that I didn't want to take meds daily for it. I tried changing diets and I exercised regularly but I got to the point where I was suffering with it every few months and had to give in. I started taking allopurinol tablets daily about 3 years ago and have had no issues with gout since. I also have had no side effects from the medication. Best of luck.

Paul

chatfir

Yeah lots recommending Allupurinol - which I completely get - although my attacks have been very infrequent and that's alongside a diet that has contained a fair bit of purines as well as a LOT of exercise as I race in triathlons, so the question I would love to get answered is why the normal meds I take when a flare up begins, didn't fix it this time.

From what I can gather - I must have under dosed on the Etoricoxib. I took 60mg immediately, but recommendations for acute gout are to hit it with 120mg first day. Maybe I've been very lucky in the past and 60mg was enough, or maybe this has a lot to with the weather (was in Greece when it happened and air-con at night).

I'm also reading a lot of conflicting info about recovery. Ice and elevation is mention almost everywhere but then ice can cause the uric acid acid to crystalize even further, and I think in my case, it did. I've been cooling my foot/toe down every single evening (up until yesterday, it's been getting warm from around 6pm) and wonder is this has contributed to a long recovery.

I'm 3 1/2 weeks in and it seems to finally be going now, touch wood. The past week has been mostly OK-ish only pain when walking on it, which I've been trying to avoid, and my brain still wants to use to outside of my foot only.

I have a blood test in 3 days, which I hope is not too soon after an attack, so will see what the levels looks like and decide on future plans. I'm also concerned about the lump that has formed on the outside of my big toe and really hope it reduces

chatfir

quick update - bloods were taking towards end of flare up which isn't ideal as should be a few weeks after all symptoms have gone. Anyway, it was 406 micromol/L which is a good indicator. The lump on the side of big toe has also not gone away and could be Tophi. Had x-ray to confirm a few other things and rule out fracture

Thankfully the main symptoms have now gone. I have been given Allopurinol to take (if I want to start) but going to wait on x-ray results in a few days as would be good to get a nod from doc saying it's definitely gout

I'm reading that Allopurinol will also help dissolve the tophi lump, if it is that.

My only concern is what damage Allopurinol can do. I'm very much into heath and fitness, so it's a concern, should I be taking it for the rest of my life

Also if I start taking it just t get rid of the tophi, then stop, could that cause a problem?

claudsl

Hi @chatfir

Unfortunately I have no knowledge in this topic, however I did find this article on Allopurinol which may contain some helpful info for you.

Allopurinol | Side-effects, uses, time to work

Hope this helps

Claudia x