Thanks...going to a specialist, like you did, will be in my future.
Right now, I thing my PCP will move me up to 600 mg/day.
But I'm now searching for something other than eggs for breakfast & meat later in the day as an alternative.
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I just bought a Husqvarna TE-511 3 mo.s ago - it's sitting in my den with 156 miles and never off the street.
I hope that my left foot doesn't get so mangled by gout that my moto riding is dead & gone for life. Presently, my left foot looks like a knobby tire.

you have the bumps under your skin? my rhuem doc said, once the bumps show (or leak out) it is time to go immediately to 600mg of allupurinol.

my liver cant handle 600. good luck.

oh, my doc said diet makes little diff in uric levels. he said he had a few patients avoid the meds. they went essentially vegetarian..really behaved at the dinner table. he said uric levels went from 9 to 8. with meds..he drops them easily to 4.

again good luck. oh, more. my doc also said plant products that are on the list with high purines..mushrooms, lentils, asparagus do not affect uric levels that much like meat does. maybe you are eating too much meat?

I take my 300mg of Allopurinol in the AM and another 300mg in the evening and since I've been doing that (over a year now) I haven't had any gout flare-ups at all. The arthritis that was left behind by the damage done to my joints is still there, but it's nowhere near as bad as gout pain, so I can live with it. My SUA is 3.2 and my liver enzymes are normal, so I'm thankful and happy!

No bumps, really...just abnormal-looking/knobby joints where the gout & my feet have battled it out over the past few years.
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I do think I need to cut down on meat, yes.
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:(

you are scheissing me

Tart cherry juice is supposed to be the bomb, talked to a urologist the other day and he said lemonade, lots of lemonade. The citrate does something, he told me, but I forgot.

Tophaceous gout is nasty, you get pockets of uric acid crystals in the tissue. If you cut into it, it looks bright white, like old school toothpaste.

I was fortunate in the game of genetic roulette, not a lot of health problems in the family.

Those of you on the 600 mg of Allopurinol, be careful. I was put on it by my own doc when the single pill regimen still led to occasional flares. That did the trick. Attacks stopped and my UA dropped. But my dad, an internist, was **really** not thrilled with that higher dosing regimen due to potential liver toxicity issues. So I've cut back to 300 mg and been fortunate that the attacks have stayed away (other than the odd twinge here or there) despite the fact that I've otherwise made no changes in my lifestyle or diet.

I have gotten pain in my right foot large toe.
This is almost weekly.
It concentrates under the big toe. The first joint from the front.
It hurts. Not so much though that putting on a shoe is an experience I wish to avoid.
At times I will favor the foot and limp.

It is no-where excruciating pain like others have described.
Pain is felt though when the toe is pushed or pulled.
wth?

this^^..i am on 300, and one thing i questioned:

is it more liver friendly to split the pills and take half in the morning half at dinner? doc said it made no difference.. not so sure about that..but i am no doc.

i am not ambitious enough to try it. splitting pills is just that tiny extra step that makes it feel like a chore.

600 mg, jacked up my ALT levels. my liver sent out a SOS right away.

you're cool. i bet you sprain that 1st metatarsal joint. it happens..gout, you can barely tolerate a cotton bed sheet draped over your foot.

You may want to ask your doctor about Uloric (febuxostat). I plan to do so, if my SUA is not <6 by year-end.

Summary of clinical trial comparing febuxostat to allopurinol is here. As best I can tell - but I am NOT a medical professional - the summary says that febuxostat 80 mg/day is more effective than allopurinol 300 mg/day, in terms of % of patients reaching SUA <6, and equivalent in safety, including liver enzyme signals. I don't know of any trials comparing febuxostat to 600 mg/day allopurinol.

Arthritis Research & Therapy | Full text | The urate-lowering efficacy and safety of febuxostat in the treatment of the hyperuricemia of gout: the CONFIRMS trial

IIRC..600mg dropped my Uric to 3.1 or so.

but ALT..wow. my primary doc...seesh.

Your diet has not that much to do with gout, at least not directly.

Weight is a significant factor. E.g. 47,000 middle aged men were tracked for 12 years, the more weight they gained, the higher their odds of having gout, and those who lost weight had lower odds of gout. Specifically, BMI > 25 or gaining > 30 lb since age 21 each doubled the odds of gout. High blood pressure and using diuretics also correlate with higher odds of gout.

And heredity matters. Look at Art - does everything right, but still gouty.

For me, my odds of suffering gout flares is definitely related to my weight, but my SUA doesn't seem to be, at least not that I can tell.

Thought I'd pass this along.
I've been off Allopurinol now for 3 months...slowly weaned myself down.
I dislike taking chemicals.
I finally had a talk w/myself and stopped eating the foods which caused this wicked ailment.
Haven't had a bout in 5 months.
Also, I've lost 25 lbs.
Good health to my fellow sufferers.
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SmileWavy

don, what did you cut out of your diet? i've only had three flares, and i can feel the arthritis in the joints that were affected. i live in constant fear of another flare up. the last one was so painful and lasted so long, amputating my feet seemed like a reasonable solution.

Get doctor to Rx some colchicine. At first sign of a flare, take it. Helps a lot, in my experience.

I stopped my 600 mg/day allopurinol, as a experiment. Everything was fine for a few months. Then I started to feel gouty again - stiffness, twinges, hints of flares. So I started on allopurinol again. It is possible that maintaining my weight at the current level could, by itself, keep my flares to a tolerable level. But I wanted zero flares, so back on the med.

i was prescribed some colchicine. i got home, read about what it is and flushed it down the toilet. no way is that stuff entering my body. just saying.

I stopped eating any processed meat like sausages, drinking alcohol, etc., and began to workout and only eat when I felt hungry. Also, I cut way back on red meats - that was a pain to do. I think that losing the weight has helped. Now, my PCP gave me a Rx for two packs of Methylprednisolone 4mg Dospak last year and only once did I take a few. That med kicks ass!
Since then, no flares. I know what you mean by wanting to amputate your feet - worst pain I have ever experienced is gout.
I also stopped taking colchicine after I read online about it.
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Best,

I'm at 900mg of Allopurinol a day and since this dosage was started, I haven't had an attack or even a twinge from my gout. The Allopurinol didn't raise my liver enzymes and I have had no side effects at all. I do not eat a single thing that is on the list of gout trigger foods and my liver specialist and rheumatologist both insist (as I do) that diet doesn't have much, if any effect on gout as some people creat uric acid in excess amounts and they cannot excrete it. Managing your gout with diet alone is ineffective, at least it has been for me.

I drink 1 gallon of water (as PowerAde) a day, no alcohol, no red meat, no HFCS, no fatty or fried foods...

Thanks!
 

Thanks for remembering me!! My brother and I both have gout and we're both at our ideal weight and eat a very healthy diet. Heck, I don't eat red meat or drink any alcohol...

For most people, this is simply not true. Genetics has a lot to do with it, but diet matters, a lot.

Art, stay away from tylenol and stuff with tylenol in it if you are taking that much Allopurinol.

A few years ago some big pharma company did some bureaucratic gymnastics and got the sole rights to clochicine. It was a pre FDA drug, so this company did a bunch of crap that resulted in their have sole rights to their version of colchicine, colcris, or however you spell it, and prohibitied other colchicine from being sold. Went from a dime for a pill to five dollars.