[d q]

I got my blood test results back today and most liver and kidney markers are near enough the results I got on 30mgs, 20mgs and whilst not taking the drug. Urine results also came back clear. Going by those specific figures and results it seems that this could just be a side effect that ‘may’ eventually go or reduce over time. Or it may be just something I will have to live with if I want to remain on this dose. Digestion wise, I do get the occasional delay but I can’t be sure that has anything to do with all of this, well at least I hope not.

Whilst we are talking about UA levels, my UA levels came back still surprisingly high after increasing from 30mgs to 40mgs. My results on 30mgs were 491 ummol and the increase to 40mgs only took it down to 487 ummol! Only 4 ummol difference?

I am assuming this could be because old crystals are dissolving and keeping the levels high? I cant think of anything else apart from trying to increase the dose and to see what happens. My results on 300mgs of Allopurinol was around 350ummol. What are your thoughts on this @nobody?

[d q]

Hi Mickey,

This is EXACTLY what I am experiencing but on the lower ‘left’ last rib or so. I noticed the pain when I went up from 30mgs to 40mgs (started Febuxostat mid November and have been going up very slowly) and went to see the doctor about it. My heamatologst did an abdominal scan and according to the radiographer she didn’t really find anything however I am still waiting for the formal report as sometimes the radiographers don’t like to give results in their entirety directly to patients.

Whilst waiting for the above results I went to see my GP about this and she explained that this is a side effect of Febuxostat (along with joint pains and muscle pains) and I can either a) try going back down to 20mgs to see if it goes or b) I can ride it out and just keep an eye out with regular blood tests. She mentioned that with time the side effects should ‘reduce or go away’.

I did a blood test yesterday and am waiting for the results. Based on these results I’ll be in a better position to decide what to do next (push for scans, attempt dose reductions, etc.).

I too have been worried if this is doing damage.

How long have you had the pain for and at what dose did it start/reduce?

Cheers mate.

[d q]

Hello Stephanie,

Whilst what you describe sounds like gout, I am little unsure about getting a diagnosis from a podiatrist. My podiatrist is fantastic and extremely talented but I would still probably get checked by a rheumatologist first. I think the best way to approach this would be to;

Visit your GP and get a proper blood test done. Based on those results seek their opinion and ask to be referred to a rheumatologist. They will further assess to see if gout could be the cause and then either a) Ask you to make a few lifestyle changes to see if they can lower your uric acid levels (if they can be controlled in this way) or b) they will put you onto medication.

Now in answer to your questions;

Now other joints seem to be affected, my right thumb, and right hip. My hands sometimes get real stiff in the morning.

Generally gout starts in one place and spreads over time to other places as the condition progresses. Attacking multiple places at once normally occurs later when nothing is done to control UA levels earlier.

Gout Without High Uric Acid – Maybe Pseudogout

Is it possible to have gout without the hyperuricemia?

Hyperuricemia causes gout over time. The most similar pain condition to gout without high uric acid levels is pseudogout which is a build up of calcium instead. However, I would not trust a prick test to give you an indication of your UA levels. You should have a blood test followed by another blood test 2 weeks later or so to get an idea of your UA levels. It is not uncommon to find low UA levels whilst you are in this midst of an attack either.

Or are the crystals going straight to my joints for whatever reason.

I am not too sure I understand this question but crystals will accumulate in joints over time. It is when these crystals break away from joints that the immune system reacts and causes you the pain you feel.

Get seen and tested properly first (preferably by a rheumatologist).
You’ll be in a better position to make choices and we will be in a better position to help too.

Take care 🙂

[d q]

@anybody, I wanted to update you on a few key pointers when starting 40mgs;

I got an ultrasound down around the abdominal area which returned an OK for all organs size wise and health wise. So it seems it might be musclier. I’m going to watch it for a further week or so as the pain is still present

Water intake has increased by a further litre so I am now on about 3 litres a day. May I ask if you saw an increase of water intake whilst increasing your dose of Febuxostat?

Are you still taking Febuxostat or have you tried the divorce with drug approach that Keith has adopted every so often?

Hope your well

[d q]

Interesting you say that, I was on Allopurinol for about 6 months and although I am not certain, it caused me bad haematological side effects (doctors are not convinced of this however) They believe it could have been because of the inflammation I had at the time. What about yours?

In any case I am on Febuxostat (Uloric) now and things seem to be stable. I’ve been on the drug since the middle of November and going up slowly (breaking pills into half and further into half, etc.).

It would be great to see what your latest UA blood test will show and if the Alkaline approach works.

p.s. How are you achieving your alkaline approach..?

[d q]

Well, if its any consonance and your counting low grade daily pain as a flare up then 9 months and counting. Recently started medication however and am hoping this will soon become a thing of the past.

Anyway, what is your current situation Kenny? Uric Acid levels?
We can then help further from there.

[d q]

@jean – this is exactly what I am thinking of trying but on an intense scale.
More out of curiosity and interest rather then treatment to start with.

Do you have your uric acid blood levels before you started your trial..?

cheers

[d q]

@anybody – have you tried replacing water with alkaline water and pressing on with it for a period of time?

[d q]

Hi Tim,

Back to the basics for a second. You know you have gout and you haven’t had an attack in years because your taking medication for it or because luck has been on your side?

[d q]

Whilst not Homeopathy in the respect of the required components, he is suggesting not to use pharmaceuticals and instead buy this “Calkaline” alternative.

Yes, my gout is due to an increased rate of red cell production. The technicalities are out of the scope of this thread.

I have no particular reason to trust this site neither do I suggest trusting these sites especially since it promotes the selling of a product (or an e.book on other sites) but it seems one can Alkalise their diet at home eliminating the need to purchase he’s product. I too question some of the information on the site and even emailed him but the interest (more so the curiosity) was to know if anyone has actually tried substituting water with alkalised water on a long term basis and seen progress in a way that can be a substitute to common UA lowering drugs.

The very reason I raised this post here was for us to question the possibility.
Has anyone got research articles or documentation as to whenever its been tried?
Is the replacement Alkaline water approach (not baking soda) safe / feasible?

[d q]

Thanks mate – pretty much what I wanted/needed to know.

[d q]

Slightly interesting website – opinions anybody?

@nobody, @keith – just a little read for us;

I’m generally not a believer of all the homeopathy treatments when it comes to gout except the benefits of cherries however I stumbled on this and this. Both sites seem pretty new on the internet. Interesting information up there but not exceptionally new to us.

Now most of the information on those sites we already know however my emphasis is more on the second link here. Aside of he’s attempt to convince us to purchase etc. and I’m not actually sure it will work in my case since I believe I have secondary gout (rapid red cell turnover releasing UA into the blood) so purines don’t really count but have any of you tried to heavily alkalise your diet to see if much lower UA can be achieved? Is this actually feasible?

Another thing I wanted to discuss was he’s opinion on how Febuxostat and Allopurinol work. He makes it clear that these are very damaging, @keith I was wondering if you had any information from your library about long term use of these drugs (Febuxostat being relatively new)?

p.s. He’s statement about Lemon and Vinegar being acidic and dangerous however seems wrong as I understand these turn Alkaline upon entering and metabolising in the body? I have emailed him about this and am still waiting for he’s response.

And… On a more social note, Happy New Year 🙂

[d q]

Believe me buddy, the best way to approach this is to keep it simple.
Increase healthy foods and decrease unhealthy foods is all you need to do.

Over complicating your food habits will only cause you to end up with all sorts of obsessive issues in the long run for e.g. when you have; Holidays, Stressful Days, Barbecue Days, Parties, Ice cream family days, etc.

In the 1950’s Gertrude Elion had pretty much cured gout with the invention of Allopurinol. If you couldn’t tolerate that, the Japanese came along in the late 1990’s and pretty much polished Gertrude’s work with the invention of Febuxostat.

In short, take the pill for now, eat everything in moderation and live your life knowing gout didn’t dictate it 🙂

[d q]

Hello Sian, being in similar situation I would also like to back a few of nobody’s comments in a concise fashion.

1. Febuxostat is a powerful drug. I took 20mgs and my UA dropped almost 100ummol. Make sure you closely watch the results on UA levels.

2. Check your liver markers (Albumin, Alanine Transaminase, Alkaline Phosphatase, Bilirubin). These are important numbers for Febuxostat as it is metabolised in the liver and not the kidney. These should be checked with every dosage change.

3. Make sure you have a blood test called FBC (Full Blood Count) after starting and increasing dosages of Febuxostat to make sure cell counts are not affected.

4. Ask about a 24hour uric acid excretion test. This should help to get an idea of just how much he’s body is eliminating.

5. Although an MRI will give you a fantastic picture of what is going on try and also get an Ultrasound scan / X-Ray to see if any joint erosion has already taken place.

Take care!

[d q]

Have you medically been diagnosed with gout or do you have “gout like symptoms”?

[d q]

Hello Colin, good news about the blood situation. Keep an eye out on your platelet counts too. It also helps to take Vitamin E as this acts as a mild blood thinner and will help with blood flow. Consult your haematologist about this first though.

Out of curiosity have you ever had gout attacks in your toes?

[d q]

No worries mate – your welcome.

Having a positive diagnosis for gout normally means taking action asap. I know you have taken positive measures to avoid certain foods and beverages however by not knowing how much you have actually reduced your uric acid levels (if any) by will only expose you to further short term and long term risks.

Definitely get a baseline blood test done before starting any medications and make sure it includes Kidney and Liver function. You’ll be in a far better position to decide which treatment options are open to you once you have these results. If you are sure tophi is present then it may be that a diet change alone will be out of reach and drugs may well be the only option.
Anyhow, get those results and we can go from there.

Good luck.

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