2 hours ago, lopburi3 said:

What size allopurinol were you on?  Normal here is 100mg but 300mg or more is often the dose for our larger size bodies.  Also not a good mix with alcohol.  

yes ....   I think from memory I was taking 100mg a day,  and plenty of water ,  or as much as one can stand. And your correct, the alcohol brings it on. Also, if I had a hamburger or steak two days running it would hit me.  Once I was on the orange drink to lower uric acid I was fine.

Edited February 1, 20188 yr by steven100

I thought I had sprained my big toe. There was a red spot just behind the ball of the foot. I didn't even have time to get my sock off to show my GP before he had diagnosed gout. (He was a very good GP). Put me on Colchicine (I think) for a couple weeks to make it go away, then did a blood test, which showed high uric acid levels (I think around 9, when normal is 1). Put me on a 100mg dose of allopurinol, followed up after a month with another blood test (6.5), doubled the dose when the UA level was still high, eventually settled for UA levels around 4 with a 200mg/day dose. Eventually I switched doctors, and countries, and ended up on 300 mg/day because that's all that's available. I don't drink, btw, so my liver is not otherwise stressed.

 

So I think for most people, a good general practitioner can prescribe the medicine and the blood work and check your numbers, you don't need a rheumatologist. But especially if they put you on 300 mg/day to start you need to get the follow-up blood work to make sure you aren't destroying your liver. If you have time to see the doc several times, going through the paces to start with a small dose and see what happens seems worthwhile. You don't need to get your UA all the way back to normal, you just need to avoid forming the gout crystals.

 

The OP sounds like a more advanced case and maybe does need a specialist, and different meds.

 

Incidentally, my initial case was brought on by imported White Stilton cheese with apricots. Got a chunk at holidays and was having it on crackers and that tipped me over the top on the UA.

 

 

35 minutes ago, jerry921 said:

Eventually I switched doctors, and countries, and ended up on 300 mg/day because that's all that's available.

Obviously country is not Thailand as 100mg is very common here.  And at 1.5 baht each not very expensive.  

1 minute ago, lopburi3 said:

Obviously country is not Thailand as 100mg is very common here.  And at 1.5 baht each not very expensive.  

Yeah, I'm in Mexico, thinking about relocating to Thailand. I pay 60 pesos (about 100 Baht) for 30 pills - 3.3 baht/pill. So if I move to Thailand I can switch back to 2x100mg/day and save about 30 satang per day, and a little liver stress. Good to know.

Good GPs are very, very rare in Thailand and medical care here is highly specialized with the result that one often has to use specialists for many things that a GP would handle in the west.

I use 500mg  bit c with rosehips for last 3year it keeps uric acid at 5.0 no gout