Gout!!!

Well, i’ve been lay awake since around 3am with that familiar throbbing toe that i have become accustomed to. I’ve had 3 attacks in 3 months and have never had pain like it!

I’m not your ‘typical’ gout candidate either so feel a bit cheated that i’ve not the had pleasures of a port and cheese orgy!! :)

I’m pretty much tee total, enjoy exercise, fit (well was, but have had any training seriously curtailed), not overweight and have cut out the purine rich foods. I’m totally lost as to why this is happening so often.

Are there any other sufferers on here? Any magic cures other than hobbling to the doctors? I need something longterm…

Was always told gout was a rich persons disease**, there is your problem.😉
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** obviously that is bollox but still

@bruneep …..i’m not that rich, the kids have to share a jet ski! :D

Dehydration can be a trigger (even if just for a short time). Drink water throughout the day to stay topped up.

Worth getting the doc to check your blood pressure to see if that’s a contributing factor.

Worth considering if any meds you’re on might be partly to blame as well.

Doc may want to put you on allopurinol due to the frequency of attacks.

Save yourself the agony and go and get your allopurinol from the doctor and take it like a good little boy.

Mate of mine did that. Gout free.

Another mate raged against “tablets” and “doctors” and spent three years in absolute crippling agony before taking his allopurinol like a good little boy and is now gout free.

I would usually say don’t bother with tablets – paracetamol and ibuprofen at the top of my list for wastes of time that do a fair bit of harm for not very much good. But for gout? Stop messing about with lifestyle changes for something we have a medical fix for that is very safe in the long term would be my advice.

For me dehydration is the big thing. Keep drinking lots of water and it seems to ward it off.
Also if I feel the starts of something going on in my big toe, Ibuprofen seems to stop it developing. It won’t touch the pain of an attack when it’s established but seems to work to stop it getting started.

Tablets are great but you need to find the trigger.

Mine is too much pork products. Luckily found out as most people don’t have a clue what’s causing it.

Only have a bacon butty once a month or more and have been gout free for over 3 years.

The tablets do work but I found they give you explosive poo conundrums if you take them over a couple of days.

A friend had gout and it was shellfish for him. He loved the stuff and wouldn’t give it up. So he was popping tablets after his meal.

I get it in my big toe joint, Naproxen works for me .

Yes hydration and keeping the diet balanced for me has stopped it reoccurring. Realised on thinking what had changed and it was drinking v little water versus coffee abs developing a naughty savoury supper habit. Only had one attack but it v nearly kyboshed a skiing trip which would have been a disaster (putting boot on for first two days was some of the worst pain ever)

Gout is caused by the bodies failure to excrete uric acid appropriately and this builds up in joints in crystals causing the pain. Staying hydrated allows the kidney to continue to work but doesn’t always help as its not addressing the underlying cause. Allopurinol (beloved by Pedro Delgardo as it comes out on a chromatography scan just where steroids do) lowers the renal threshold of uric acid and you excrete a lot more thus preventing build up.
Take the pill!!

Interesting factoid: Dalmation dogs have white poo because they lack the enzyme Uricase and so their poo contains a large amount of the white crystal uric acid.

I am way too working class to get Gout…

I’m no doctor but are you certain it’s not arthritis? I went to GP after a flare up in the big toe joint certain it’s be gout. A blood test said no and it was arthritis. Since then I’ve used orthotics in my shoes to relieve pressure at the joint and touch wood no more flare ups. Could also be that I live off naproxen since breaking my back!

I get it occasionally, once a year around January – usually triggered by too much rich food and alcohol. Made worse by wearing some shoes that I’d ‘worn out’ with all the walking in lockdown – only 6 months old, but they’d worn badly. Not had any issues since.

If it’s not diet etc, and you’ve ruled out food types/triggers, then the meds option.

Same boat as you OP, although slightly less frequent flare ups. I’ve tried improving my diet, with some success, but after 3 or 4 incapacitating flare ups last year I have a box of naproxen in the cupboard and start using them as soon as I feel anything.

In January the doctor did a blood test and found very high uric acid levels so offered me long term tablets, but I don’t like un-necessary medicine so asked if I can get a retest after 6 months or so (to see if I could fix it with diet etc). Will go back soon for another test but suspect levels will still be high.

Having read the above I think I might bite the bullet and go for tablets. A couple of the flare ups over Xmas were the most pain I’ve ever experienced, I really don’t want to go through that again.

Beetroot is supposed to be helpful, my dad claimed it was but as a functioning alcoholic the root cause was plain to see and the drugs and beetroot had a battle on their hands

You have my sympathy, @lamp
I had my first attack of gout about 10 years ago – the typical big toe agony.
Since then I had another 5 or 6 attacks, each lasting about 5 days. I tried to alleviate it by drinking loads of water and taking brufen and that helped a bit.
About 2 years ago my right knee locked and was agony to try and move it. I could hardly walk (hobble) and couldn’t sleep due to the pain. I have had arthroscopies on both knees and initially put it down to more cartilage damage. However, I went for tests and it turned out to be gout!
I had to wait for the symptoms to disappear and was then prescribed Allopurinol. It has done the trick and I haven’t had an attack since taking it.
Go to your Dr and get blood tests done is my advice.

Allopurinol is great for reducing the frequency of attacks – don’t take it during an attack as it can prolong!

Colchicine is good for reducing an attack (then see Allopurinol above)

Cherries have been shown to help with reducing attacks.

Hydration is key – try to take as much water to help with the excretion of the underlying high levels or uric acid.

Reducing the levels of uric acid prevents new crystals from forming. It also slowly dissolves the crystals that are already there. It can take up to 2 years of daily medications to completely clear the body of crystals, and then further attacks of gout and joint damage are unlikely.

So its possible the lack of an actual action plan of treatment means it keeps returning.
Far as im aware it can also lead to kidney stones if no action is taken, which by all accounts make gout look like a minor ailment. Best find and work upon a plan of treatment before it leads to something like that.

How do you guys actually get GPs to do blood tests, or even talk about gout? All I ever get from NHS is bounced from doctor to doctor with each one telling me the last one was completely wrong and I spend all my time on square zero not able to advance.

Or is NHS Scotland just a disaster zone of incompetence?

xora – I called my GP and explained that having put up with bouts for 3-4 years I could no longer bear the excruciating pain. He prescribed me Naproxen over the phone and told me to book in for a blood test a month after the bout subsided.

I’ve had it for 45 years! Diagnosed at 21. Allopurinol once daily stops all attacks for me.

Are there any other sufferers on here? Any magic cures other than hobbling to the doctors? I need something longterm…

Another vote for long term Allopourinol here. Long paternal family history of it Great Grandfather, Grandfather and my dad all had/have it.

Box of Naproxen in the cupboard if it starts to flare up but I try to use sparingly as they play havoc with ‘me innards’.

I did try cherry tablets but didn’t notice any real effect.

The drugs have improved dramatically over the years. I remember my Grandfather in his 50’s being absolutely incapacitated by it, and my dad when I was little having some nasty bouts.

My old man has been on Allopourinol for many years. When it first affected me at 45 (same age it got him..) he basically said don’t go for anything else, these just work.And they do.

He’s not had a flare up in a good number of years.

Drink plenty of water (I get through a good 3l a day at least) and especially if you know you’re gonna be having a boozy do. Plenty of hydration in the days before a session and plenty for the days after.

I developed Gout about 15 years ago, thanks to taking Beta blockers for a dodgy ticker. I also got kidney stones at about the same time. I stopped the Beta blockers and the stones stopped but the gout persisted. 10 years of food diaries and elimination – the cause was found to be lentils!
2 years gout free but I developed another trigger. Bit the bullet and took the Alopurinol offered, and haven’t had an attack since.

I had a run of it, had no idea what it was, I ended up in the OOH GP with a knee twice the size of the other and the worst pain, relentless, can’t do a thing to ease it pain.

My GP gave me a box of Colchicine and told me to take 1 a day for a month to try to completely remove the crystals from my system, apparently that’s enough for a lot of non-standard sufferers to be ‘cured’ of it. Anyway, I misunderstand what he said, wasn’t helped by the pharmacist questioning it over and over and ended up keeping them for when I needed them.

Anyway, mine is caused by dehydration and impacts on the joints apparently, sounds like the perfect condition for MTBers in Summer.

It’s really worth sorting it, not only is it incredibly painful, and for some reason or other something to be ashamed of (why?) it can apparently cause damage to your joints.

First attack I ever had I had banged my big toe climbing into a bunk on the Ferry back from a trip to France. Didn’t think much of it at the time or the next day, during the night the pain woke me up.

In the morning I thought I must have broken a bone it was that painful and swollen. Could barely get a sock on never mind me trainer

Taxi to A&E and a series of xrays later had a few docs scratching their heads. Cue a senior arthritic consultant type just passing by and being called in.

She took one look at it and asked if there was any Gout in the family…

Allopurinol daily for me keeps it away. On the very rare occasion that I do get a flare-up, I take indometacin, which sorts it out in a couple of days. I don’t like to use it though as it has a delightful effect on my innards, and also makes me a little bit woozy

As many have said – Gout results largely from a genetic pre disposition. Had my first attack at 45 10 years later than my father & his father – blood tests should tell your GP whether there’s any scope to manage it through diet etc – if it’s borderline then there lifestyle changes you can make – anything else, then it’s Alopurinol. I’m boarderline and after a number of initial attacks have managed it – As others have said drinking a lot more fluid every day is a key defence and taking NSAIDs at the first sign of a problem is crucial – as is avoiding injury or persistent pressure to extremeties that usually start a flare up.

I’ve had 3 proper attacks over the last few years. On two occasions, dehydration seemed to trigger it and, on the other, it was Belgian beer and spicy food. I try to avoid NSAIDs like Ibuprofen and Naproxen as they have caused me respiratory problems. To avoid attacks, I drink plenty of water but I also wear socks in bed. I reckon that should keep the blood in my feet warmer and therefore reduce the risk of the crystals forming.

He prescribed me Naproxen over the phone and told me to book in for a blood test a month after the bout subsided.

@tonyd and thats where my case gets weird, this is what I was told at A&E, but when I tried to book bloodtest at GP they refused as there was apparently “no point after the attack had subsided, I have no idea why they told you that at A&E”.

Change in diet seems to have mostly conquered the gout anyway since the first few attacks.

there was apparently “no point after the attack had subsided, I have no idea why they told you that at A&E”.

I’m not a doctor, but I suspect they thought the blood test was to check if you were suffering from a bout. My GP told me to wait for a month after the flare up subsided so that my uric acid levels would be back to normal (whatever normal is for me), then depending on how high those “normal” levels were we would make a plan. Turns out my “normal” levels are high so he offered me medication (presume allopurinol) but I’m trying to manage it through diet for now. Will go for another blood test soon.

Brilliant info as usual!

Turns out it’s down to dehydration. I have underperforming kidneys. So I have to sort that out…

To the allopurinol users, does this mean that I can continue living life as normal? Ie, training, sweating etc?

Yes! I haven’t noticed ANY downsides to being on Alopurinol!

explosive poo conundrums

Olive Pope Sox

My GP gave me a box of Colchicine and told me to take 1 a day for a month to try to completely remove the crystals from my system, apparently that’s enough for a lot of non-standard sufferers to be ‘cured’ of it

Colchicine is anti-inflammatory (in a slightly weird way); doesn’t actively remove crystals at all AFAIK
(Yr pharmacist was obvz “a bit” old-school – ’til about 20yr ago it was used really short-term during flare-ups in quite high doses and with mighty entertaining warnings about nasty side effects (including explosive poo conundrums 💥💩😕 ) and a pretty rigidly enforced maximum total dose. Low dose maintenance has far fewer problems)

https://cks.nice.org.uk/topics/gout/

I’ve posted on this a couple years back. Essentially, mostly the big toe and the joint is hot, points to gout. For me it’s dehydration, whether that’s post a few days exercise on the bounce or lots of alcohol leaving me dehydrated and heading for an attack. I’ve only ever had Naproxen work for me. I tried Cherry juice a few times. If you want to limit attacks then always be drinking water. Long term regular sufferers should be looking for Alpurinol pers

One other question, does the pain in the toe ever truly disappear? The flare up has gone and my foot is back to normal more or less, but i do get a faint twinge in the toe every so often. Is this perfectly normal given it’s a form of Arthritis? Or do i need to be a pit more patient and wait for it to disappear completely?

TIA!

The pain should go eventually. The uric acid crystals may have dispersed, but they will leave damaged tissue behind. This will take time to heal. Be on the alert for another flare up for the next week or so. The sooner you start taking the anti-inflammatories, the less severe and shorter lived the attacks will be.