Treatments for Gout

I have had episodes of gout for more than 10 years now.  It wasn't too bad up until about three years ago when I started chemotherapy for cancer.  I also have Crohn's disease, and believe it and the gout mean I definitely have issues with auto-immune disorders.  In the past 6 months, my Allopurinol has been upped to 300 mg, then to 450 mg per day.  I also follow a low purine diet most of the time, but I admit, sometimes I gotta have a steak!  Anyway, the Allopurinol does not seem to be stopping the attacks.  I have had gout twice in my knee in the past two months, several times in my ankles, and now in my wrists.  I have Indocin for the inflammation, but all that seems to do is make my stomach upset.  I also have Prednisone, but long term use of it causes a whole other set of problems.  I'm looking for suggestions on anything else I might be able to do, or any other medication I can talk to my doctor about that might help.  I am currently doing acupuncture to help with the pain, but that hasn't helped much either.  I should also mention I am no longer on IV chemotherapy, but do take an estrogen-blocker, which can have an affect on bone strength/density.  Anyone have any ideas?  Also, has anyone else heard you shouldn't take Allopurinol during acute attacks?

Thanks,
Gail  

[txsilver]

You definitely have a complex set of challenges.  Have you tried any of the other gout meds?  Have you talked to your doctor regarding the increased pain, episodes and lack of relief from your current medication?

[tanglewood]

I'm sorry you are having so much pain. I have had gout a couple of times and took allopurinol. I remember my doctor telling me that allopurinol would not help an acute attack - that it is more of a "preventative". I've never heard that you "shouldn't" take it during an acute attack, though. Maybe someone who's had more experience can talk to that issue. I hope you find relief.

[gah_70]

Thanks for your replies.  I posted several months back about drinking Fresca for gout...a remedy one of my Oncologists told me about.  Not sure there is actual research on this, but perhaps it's time I take his advice.  Couldn't hurt anything.  

I did talk to my PCP about the increased pain, and he increased my Allopurinol and prescribed 20 mg Prednisone.  But, the was just last week, so I haven't had a chance to really see if it is going to work as I am still having a bit of pain left over from last weeks' attack.  If this continues, I think I will seek out a Rhumy and see if I can find any answers there.  There are none in my town, so I will have to travel at least two hours.  But, if it will help, the trip will have been well worth it.  

Thanks again!
Gail

[txsilver]

I remember the post about Fresca!  Speaking of food, I hear cherries are great for inflammation.  They seem to be helping me, too.
I am glad you talked to your doc and hope you get relief soon.  I hope you will not have to go to a rheumy since the nearest one is far away.  I know that, when we are suffering, we would drive to the moon to get relief if that is what would do it!  My rheumy has people who travel from all over to see him - sometimes it is just worth it.
Please keep us posted!

[Jay_from_Beantown]

I used to get a 2-3 wk debilitating gout attack  2-3 times a year for 10 years, either in the heel, top of foot, and under knee cap. I had an aspiration which showed the crystals to confirm the diagnosis. But now I am in pretty good shape - it has been only one short lived attack in 3 years. Knock on wood!  My solution has been one tiny .6mg colchicine every night and a big glass of water. I also stay away from beer but have a glass of wine a couple times a week - no problem. Colchicine stops the body from attacking the crystals but does not lower uric acid very effectively.  However I have noticed that crunchy deposits in my knees have gone away.  Many Docs prescribe colchicine to go with allopurinol.  I wonder if it is the colchicine that is actually doing the work. My blood tests are great after taking colchicine for a few years and in fact my chronic slightly elevated sgpt has become normal??  My uric acid level was never extremely high - only 7.6 or so, and it stays in that range today.  Basically I think people with gout have an immune system that reacts to crystals rather violently.  Many people have higher uric acid and gout crystals in fact - but the body doesnt go after them like mine does - my theory.  I suppose I could take allopurinol to get my uric acid level below 6 but not sure of the value given the potential side effects.  High uric acid is associated with development of heart and kidney problems - so it may be good to have a good diet.  I try on that score with more veggies and fruit- and to drink a lot of fluids - but colchicine has allowed me to eat a burger or have clam chowder without fear of an attack.  I suggest anyone out there to try the little pill and water every night. No need to start after the attack subsides.  While your waiting for the pain to go away get on a veggie/fruit diet with lots of water.  Hope it works for you too!  

*Warning: Colchicine (used since the 1800's) just went up in price 10X - which is because of an FDA created monopoly for Colcyrs - so I hope you have insurance - there are vouchers available or you can get old colchicine from outside U.S.. Also write a letter to the FDA to stop the corruption.

*BTW when I had my one attack, I went to 2 pills/day, after 3 days I went back to one:-)