r/gout

For the last eight years, I get 2 to 4 severe gout attacks to the point I’m on crutches for up to two months sometimes until the flare is gone I’ve quit drinking beer and limited my red meat significantly mostly live off chicken and vegetables and have not had a severe attack in over a year. But the last few months I’ve been getting little mini attacks that last for about a week, but it’s not to the point that I can’t get my shoe on or walk but I kind of feel like a big one is coming and I’m planning on starting my 100 mg allopurinol. My question is, does it make you dizzy and drowsy all the time I’m a service technician and I would prefer to take it in the morning, I don’t like taking medicine in the first place and the dizziness and drowsiness is the biggest reason I have not ever started it. I’m just like your honest opinions about how it made you feel when you first started it thank you.

hi all. i got my uric acid 24 hour urine results back and well… is this even possible? also btw i didnt know anything about gout prior to the research ive done today. ive had kidney stones for 13 years but for the past two months they’ve been making my life a living hell. i guess im just wondering if anyone has heard of a case of uric acid being this high before?

For years I went to my doctor with all kinds of complaints: pain in my joints, shoulders, neck, back, knees, and feet. Every time I was basically told to take paracetamol and wait and see. Sometimes I went back, but I never got a real diagnosis. More often I ended up seeing a psychologist just to cope with everything, because I could not get the pain under control.

For more than 7 years I was taking hydrochlorothiazide and heart medication. Over time I started feeling worse and worse, with more pain and aches.

Last summer, during vacation, I had a bike accident. I badly hurt my left knee and broke a finger. Three days later, my right foot started hurting terribly. I thought maybe it was related to the accident, or maybe I only noticed it later because my my attention had been on my knee and finger.

When I got home, I went to my doctor and asked for a check-up. He sent me for an X-ray for my finger, which was indeed broken. But for my foot he did not really have an answer. He said it did not look like gout. So I left with the advice to take paracetamol.

The foot pain was actually worse than my broken finger. I could not even wear a shoe.

Then this April this year, after working in the garden for two days, I woke up with the exact same pain, this time in my left foot. It escalated very quickly into severe pain, swelling, and redness. I took paracetamol, 6 x 500 mg a day for three days, but it did not go away. I still had no idea what it could be.

I limped back into the doctor’s office and saw another doctor. She looked at my foot and said, “This might be gout. Let’s do bloodwork.” I said it probably was not gout, because it had been ruled out the previous summer, but she still wanted to test my uric acid. She gave me tramadol for the pain and sent me home.

A few days later I saw another doctor for something else. My blood results had come in. She said my uric acid was 0.59 mmol/L, which is about 9.8 mg/dL, and prescribed prednisone: 30 mg daily for 5 days. I took the prednisone, but I got stomach problems and a very unpleasant, uncomfortable feeling from it. I also stopped the tramadol because it gave me neurological pain flares.

I could not take NSAIDs, so I used paracetamol, but it only helped a little.

I went back to the doctor literally crying from the pain. I had looked up hydrochlorothiazide and saw that it can increase uric acid and possibly trigger gout. I asked if I could stop it. The doctor said not really, but eventually agreed.

She did not offer a referral at first, but said that if I had more episodes it might be a good idea to see a rheumatologist. That is when I started connecting the dots. I realized I may have had gout for years, and that the clues were probably already in my medical file.

I asked for a referral to a rheumatologist while still in terrible pain. My appointment was first planned for the end of May, but because I was about to travel and my uric acid was 0.59 mmol/L / 9.8 mg/dL, they found an earlier opening.

The rheumatologist diagnosed gout and a severe gout flare. He prescribed colchicine and allopurinol. He wanted me to take colchicine 0.5 mg three times a day. But the pharmacy warned me that colchicine can interact with diltiazem, which I also take, and that colchicine is not a harmless medication, so they wanted to be careful.

The rheumatologist lowered the colchicine dose to twice a day, but the pharmacy still preferred that I stop diltiazem first. Because I had to fly and everything was stressful, I ended up not starting the colchicine or allopurinol yet.

Because I was still in a lot of pain, I contacted another rheumatologist for advice. In consultation with that rheumatologist, I started taking 15 mg prednisone daily instead. This lower dose was more tolerable for me than the 30 mg dose, although I still do not feel great on it.

After 3.5 weeks I am still in pain, although I finally see some improvement.

Now I still need to find out safely whether I can stop or adjust diltiazem while using colchicine, and how to start proper long-term gout treatment with allopurinol.

But at least after all these years, I finally have a diagnosis.

I am sharing this because I feel frustrated that it took so long. Has anyone else had gout missed for years, especially while taking hydrochlorothiazide or similar medication? And has anyone dealt with the colchicine/diltiazem interaction?

Had my first flare up back in January and haven’t touched beer since. I’m itching for a creamy Guinness but I’m scared. Will just 1 really ruin me for a week? Or should i test the waters?

Knee was a little swollen, made a poor decision to play volleyball that evening. Felt fine after, even like the movement had loosened up a tight joint. Knee ballooned up overnight and continued for days, was finally able to see an ortho doc and he removed 160cc’s of fluid day one, 70 more two days later. Talk about sweet relief. Got on the colcichine but certainly motivated for a diet and alcohol overhaul!

Ok so I am on Zepbound and Ive lost nearly 40lbs in about 3 months. I’ve read that rapid weight loss can cause gout (which is not to say that it is a side-effect of Zepbound).

Anyways my right big toe hurts. I’ve been doing a lot of hands and knees yardwork and I thought maybe I whacked it. But it went away, then came back in about a 72hr span.

I do drink. A lot.

Long story short my question is this- does gout feel superficial ie just below the skin (which is what I am experiencing) or is it deeper in the joint itself?

Most I see online​​​ are fructose in fruits don't affect gout, but I'm in my first attack and want to be a 100% sure, so looking for personal experience. ​​​​​​​​​​​​​​

I'm 59. In the last year, for the first time in my life I had 2-3 gout flare, very mild: swolen toe barely visible, light pain when walking but bearable.

My uric acid level was around 7/8 constantly in the last 3 years.

I was diagnosticated by the doctor, with some pain killer flares went away in few days.

Now the doctor prescribed Allopurinol for some months, but he was skeptical: he was more inclined to prescribe diet and lifestyle change

The thing is: I don't eat read meat, eat a lot of vegetable, I have 1 or 2 beer per week max, which I can cut, walk 7K steps per day, my BMI is 27, slightly overweight and don't exercise a lot. My cholesterol/try are also a little high.

So: yes I can change a little my lifestlye. don't know if it will help, but on top of all:

is it worth to take Allo?? for months?

As title says I recently started new medication since I’ve had terrible gout and my UA levels are at 12. Just yesterday I woke up to terrible pain in my hips up until then I was feeling great has anyone had extreme gout flare like pain in the hips when starting the medication? I can barely walk and it’s even uncomfortable to sit and lay down it’s awful

Going to see the doctors tomorrow. What should I do to help and ask for when I see the doctors. The pain isn’t bad but I got the sharp pain in the big toe joint. I haven’t done anything that could implicate that injury.

I woke up 10 days ago with the very early indications of a potential attack, in my toe. Being determined not to make the same mistakes of the past (this would have been my 7th flair up in 7 years) and lie there wondering if this was indeed a flair up or not (they always had been!) I hit it straight away. I took an omeprazole and then half an hour later I took the first of 4 colchicine tablets that day. I did the same the next day and managed to take one more on the third day before growing exhausted from diarrhoea related fatigue. By that point I felt confident that I had staved off the attack.

The next few days went okay, full mobility and only a slight sense that all wasn't still quite right in my toe. I assumed it was an attack that was on the way out, due to the early intervention, rather than it was a warning of worse to come.....after all, previous attacks had only lasted a week, at most.

So on day 9, I was very unpleasantly surprised to get the worst attack I've ever had!! I don't think I can handle any more colchicine., it wiped me out, and not sure if it would even be a good idea to, toxicity wise, so soon after the last course? Anyway, this flair up has been quite different to my previous experiences, and I was curious if others could relate and also if there was any useful tips to handling it better in the future. Perhaps I hit the colchicine too hard and made it harder to last out the course than if I had spaced them apart further?

I know, ultimately, I will probably have to go on allopurinol but I don't feel I'm physically ot mentally at that point yet. But feeling like I had got a grip on a flare up for the first time only to realise that I really hadn't, has left me confused and battered!

Just prescribed 100 mg allo and 2 colchicine A day for the next 3 months. Not in A gout flare at the moment but looking to lower my numbers. Any insight on best timing for pill taking? Morning for allo or evening? Better luck with food? Thanks for any info.

Hello I’m new here but certainly not new to big toe pain. I was hoping to confide in some other members of the gout community in hopes I can could get a self diagnosis. About 5 or 6 years ago in the winter months I experienced an intense flare up in the joint located just before my big toe on my left foot. Over the course of a few days it got so bad I could barely walk on it. I went to the doctor and was diagnosed with gout purely based on location and pain level. Over the next several years I would have flare ups maybe 2 or 3 times a year. The thing is that it only ever happens in my left foot. I’ve never had any other symptoms or pain in any of my other joints. That had me curious so I started digging into other options. I came across a condition called Turf Toe. Basically a sprain located in the same spot one might have a gout flare up in.

Allow me to give you some back story which might point to the possibility of it being a sprain related flare up and not gout. I’ve been in construction for over a decade now. For 7 years of that time I worked as a trim carpenter which involved me crawling around on my knees installing base. I quickly discovered that squatting on my toes or even getting on my knees with my toes bent while sitting back on my heels was the most comfortable position to be in to allow for speed. I did this for years and would always favor my left knee over my right when doing so. From what I’ve gathered turf toe happens when the toes are bent and pressure is applied to the joint either forcefully or with repeated use. That could explain why I have only ever experienced my flare ups in my left foot.

What baffles me is that the flare ups can be caused by something simple like wearing the wrong shoes or by bending my toes too much while working. Have I destroyed the joint in my left foot causing flare ups seemingly randomly or is it possible I do have gout and it’s only located in my left foot? I can go months and months eating red meat and drinking beers and have no issues. Just last weekend I decided to wear a pair of shoes that I don’t wear often that are a size too big for me. I had them on for maybe 5 or 6 hours and in that time I noticed a slight pain in my big toe that I ignored. The pain intensified over the work week and I continued to work on it and just the other day it got so bad I couldn’t bend my toes or really put any pressure on my foot. I’ve got it splinted and wore a boot yesterday and it’s already feeling much better.

Anyways if any one could give me some insight on what I’m experiencing I would appreciate it.

Yesterday I've started taking Allopurinol after so long hesitating because of concerns related to side effects. I do want to know what the gout flares are like and how many to expect as well as when they'll begin to settle down. I know everyone's experience will be different, but I would just like some stories about your Allopurinol journey.

A couple weeks ago I woke up to a flare in my elbow. The pain was intense and it wouldn’t bend and I hated it, but at least I was mobile.

Surely some heavy prednisone, drowning in water with no meats or sugars for a couple weeks will flush it out and I’ll be okay.

Nope.

The exertion that first morning after tophi formed in the joint ruptured the tendon on the back of my elbow.

It then caused urid acid crystals to form in the sheath of the tendon itself which has caused more damage and rendered outward motion of forearm obsolete (think like chopping force or holding yourself up with your forearm)

Doc is having me wait 4 weeks after seeing what the MRI showed. And if it doesn’t go back to normal, I might need surgery.

All this to say, TAKE YOUR ALLO PEOPLE DONT FORGET

What do you folk use for extended chronic (smoldering) pain management? I don't like NSAIDs but I'm not finding anything to work as well. I tried Naproxen (alleve) and I really don't like it's impact on gut motility, so I've been using Ibuprofen judiciously, trying to limit it to 2 or no more than 3 tablets daily. I don't have kidney or heart issues (at least not yet) but do worry about impacts on gut health. The half life of Naproxen is like 17 hours, whereas Ibuprofen is something like 3, so at two tablets a day pain control isnt perfect but hopefully minimizes known deleterious impacts on heart, kidney and bowel.

Just curious what other have done when there's a need to manage chronic pain longer term?

I started .5 Alo in February. Ive been having a major attack for the last 3 weeks now. I actually had pain in both feet for the first time for about 5 days. I thought I was getting better, walked around a little and boom, immense pain. My uncle said he went through something similar until a Dr. in the ER put him on Uloric. He swears by it now. I told my Dr. but he told me it wont change anything. Any thoughts or similar experience?

As if a flare up isn’t bad enough during my daily life I was lucky enough to have an attack a week before flying to Hawaii for a vacation. I’m currently here and it has been agonizing to say the least. Have not had an attack for over 2 years— take daily 100 mg of allo.

This is my 3rd week with pain. Prednisone usually kills it within 24 hours, but I have been on a tapering dose for 2 weeks & barely any sign of relief. Yesterday I felt like I could finally put pressure on my right foot, but now it’s just as bad as day one. I went to urgent care in Hawaii, but they couldn’t do a cortisone shot. I refuse to take the colchine/indomethacin because of how it affects my stomach. I’d rather limp during my vacation than be bedridden.

I leave in a few days, and have a podiatry appointment the day after I land to see if they can give me a cortisone shot. Should I be off prednisone by then to ensure they’ll give me the shot?