Thai docs treatment of gout

[tingtongtourist]

I read on English website there has been a rethink in the methods treating gout with colchine.

On attack ive always been told colchine: take 2 tabs at first and then 1 every three hours until getting the 'runs'.I read that the body can not properly utilise col. at this dosage and taking so many is counterproductive, so in many docs in west have changed methods of dosage.

This time i had a very bad attack (1st in 9 months) where my knee was causing immense pain 24/7.

After 3 days and no sign of swelling decreasing i went to a Thai doc to get the gunk drained.

It came out a bright yellow,the colour of the sponsor drink yuk.and doc couldnt believe how much came out.

He injected something else in the syringe and then padded up.

On leaving they gave me this prescription of meds; the amount & use of colchine quite different than i seen before.

For some reason Thai docs (and this one also) speak very good english to you while treating, but choose to take my gf aside and tell her about followup drugs in thai.

I could at least see the info on each bag.

I was wondering if anyone is familiar with the other 2 drugs and the reasoning behind dosages as they dont seem to be very affective at all

Even 2 days after drainage it is still quite painfull and hard to walk.

- 0.6 ml colchine-1 each morning

- .20ml tenoxican-1 each morn.

- 5ml serratiopedtidase 3 times a day.

any opinions or advice appreciated

[AyG]

Tenoxicam is an NSAID. It reduces swelling and pain.

Serratiopeptidase is claimed to be anti-inflammatory, with little or no scientific evidence to back that up. http://en.wikipedia.org/wiki/Serratiopeptidase gives a quick overview of it and the lack of evidence.

[WitawatWatawit]

Interesting, as I have just had a prolonged (and it's not over yet) bout of gout caused by Plavix. Did not know that there was a rethink on colchicine, so I'll look that up - but my cardio gave me some and said to take two then one an hour later when hit by a bad bout of gout.

PS: If your kidneys aren't in the greatest of shape, then NSAIDS are a no-no. So I'm restricted in what medication I can use.

[Sheryl]

This is an odd way to administer colchicine and I have not encountered that before.

First of all, it should not be taken on an ongoing basis, only during an attack. At which time the dosage is 1.2 mg (2 tabs) then an additional 1 tab 2 hours later. For a total of not more than 3 tabs, and this regimen should not be repeated more than every 3 days.

[AyG]

This is an odd way to administer colchicine and I have not encountered that before.

First of all, it should not be taken on an ongoing basis, only during an attack. At which time the dosage is 1.2 mg (2 tabs) then an additional 1 tab 2 hours later. For a total of not more than 3 tabs, and this regimen should not be repeated more than every 3 days.

I suspect the logic is along the following lines: gastrointestinal upset is the limiting factor in oral colchicine dose, though the higher the dose, the more effective it is. In the West doctors have limiting the upset as their priority, even though this results in a lower dose and is less effective at ending an acute attack. The OP's doctor is trying to maximise the dose to shorten the attack, despite the gastrointestinal effects.

Incidentally, low dose colchicine has been used in conjunction with other medicines which lower the body's level of uric acid or block its production on an ongoing basis. It's not, however, without its dangers.

Purely on a personal note, despite having gout I would never take colchicine. My Ph.D. involved the use of colchicine to block cell division. I wouldn't particularly want any of my (normal) cells blocked from dividing.

[Wrong Turn]

I used to be a chronic gout sufferer.

I have had 200+ gout attacks. Serious.

In the US, the common dosage for colchicine is .6 per dose, taken just prior and/or during an attack.

US and Thai doctors always put me on NSAID, pain killers, and colchicine. The bandaid, but not the prevention.

I solved my gout (or, keep it away) by:

*1/2 of a teaspoon of baking soda in 4 oz. water in the AM right after getting up, and right before bed - this alkalizes my blood as I think the acidity was causing it.

a couple of years ago, I replaced the 1/2 teaspoon in 4 oz. water with a whole, small, lime. cut it and squeeze the lime juice in 6-8 oz. of water in the AM. This also alkalized the blood.

About 3-4 years after I did the baking soda in water method, I added 150 MG of Allopurinol per day just to be careful.

Now, I'm gout free and eat and drink anything I want.

Best of luck to fellow gout sufferers and whatever works for you, try it out.

Edited March 11, 2015 by Wrong Turn

[katana]

Glad to hear your gout cleared up since I've heard that can be really painful.

PS While baking soda is a base and therefore alkaline, limes would likely be acidic not alkaline since they contain citric acid.

[nzexpat]

Wrong Turn says "This also alkalized the blood."

That is amazing !

What blood PH is achieved with the bicarbonate and lime juice ? Above 7.41 which is the normal "alkaline" PH of the blood ?

Altering the normal blood PH is not easily achieved but success will guarantee a person would be seriously ill and in need of urgent hospital care.

[JonboyBKK]

Just as a suggestion I was struggling w gout but I know everyone is different.

I am taking allopurinol 300mg, colchicine 0.6mg and 2x black cherry 1400mg daily. That combo does the trick for me always.

A USA company called piping rock sells the black cherry cheap and I swear by it.

[BlackJack]

try tumeric

natural

also the PH adjustment to Alkaline is used in many therapies

with success

but get a pee pee tester to make sure of your levels

[TheKnave]

Gout should be treated as a chronic disease. It's not appropriate to leave it untreated until you have an acute attack. Collections of uric acid crystals called tophi can build up in places like earlobes, and in kidneys, etc.

You need a doc who understands the disease.

Basically, you either over-produce or under-excrete uric acid. Lab tests can determine which. If over-producing, diet is your first-line defense: cut down on purines (found mostly in meat). Allopurinal would come next, a cheap and effective drug which you would have to take daily forever.

If you under-excrete uric acid, you need to take something which limits your kidneys from re-uptaking uric acid. Probenicid used to be the standard, but there may be newer drugs now.

In any case, you need a doctor who can figure out which approach is appropriate for you, and prescribe the correct drug and dose FOR YOU. Never mind what others are taking.

Good luck. I am gout-free 30 years+, after misery when I was a younger man. You can do it too.

[finnomick]

For what it's worth, my doc in the UK prescribed me a tablet to take which was a combined pain killer and anti-inflammatory. I can't remember the name but when I came to Thailand a pharmacist who seemed to be bothered about giving me the same tablet came up with Arcoxia. This, according to the strip is etoricoxib, MSD 90 mg tablets. If I feel a twinge in the normal right toe, one Arcoxia seems to stop a full attack happening. Then it was mentioned whilst having an annual checkup at the hospital. They checked the uric acid content in my blood and prescribed one Prochic Colchicine 0.6 mg and one Allopurinol 100mg tablet every morning and I haven't had any gout attacks since. I still keep off alcohol in any quantity and make a half-hearted attempt to eat the right things.

[emanon]

Start by the cause.

Minimize your intake of protein by 90% and avoid meat at all.

Too much protein increase uric acid dramatic.

Your kidneys are for many years over loaded, and it cause gout and rheumatic diseases, and nearly no control of the bladder.

Normal is when people get older, that the function of the kidneys decreases by age, 30% function is point of no return……..

Drink at least 4/5 liter of water a day, to clean your kidneys!!!

[AyG]

Minimize your intake of protein by 90% and avoid meat at all.

Personally I'd prefer to live with gout than die from Kwashiorkor or Marasmus.

[Jaggg88]

Glad to hear your gout cleared up since I've heard that can be really painful.

PS While baking soda is a base and therefore alkaline, limes would likely be acidic not alkaline since they contain citric acid.

here's the Yahoo answer to limes

Limes, lemons, oranges are all acidic in taste but are actually very good for you and will leave behind an alkaline residue in your system ..... they are therefore considered alkalizing ........... limes and lemon juice will increase the production of hydrochloric acid in your tummy, thus smoothing the digestive process and getting everything running smoothly........ just ensure that you rinse your mouth thoroughly after drinking their juice or eating them to protect the enamel on your teeth.

My wife's uncle drinks tea made from Bai-yanang and claims it controls his gout. This herb is cheap in Thailand so worth a try, but he drinks 4/5 cups a day.

Edited March 12, 2015 by Jaggg88

[Issangeorge]

Start by the cause.

Minimize your intake of protein by 90% and avoid meat at all.

Too much protein increase uric acid dramatic.

Your kidneys are for many years over loaded, and it cause gout and rheumatic diseases, and nearly no control of the bladder.

Normal is when people get older, that the function of the kidneys decreases by age, 30% function is point of no return……..

Drink at least 4/5 liter of water a day, to clean your kidneys!!!

Do you have any idea how hard it would be to drink that much water? I have a hard enough time drinking 1 to 2 litres, unless it's a very hot day, but even then I only drink around two max, just a little easier doing it.

[Don Aleman]

Tried all the gook you listed and then, raw,unprocessed,unpasturized apple cider vinegar, ( 2 tablespoonsw/water ) 3 times a day and gout never, after 3 years, returned !,

[Nomad56]

Glad to hear your gout cleared up since I've heard that can be really painful.

PS While baking soda is a base and therefore alkaline, limes would likely be acidic not alkaline since they contain citric acid.

Although limes and lemons are acidic, their affect on your body is alkaline, it is the most perfect way to start your day with lemon or lime juice squeezed into warm water.

[khomlong1]

Hi Guys, having suffered from very painful gout myself. I was given allopurinol and colchicine. You just have to be patient and take one of each every morning until the symptoms subside. Cut down on alcohol and have non-drinking days. You can buy these drugs at most pharmacies to keep at home in case of further attacks.

[emanon]

Issangeorge,

Do what you want to believe Issangeorge, I only try to be helpfull on this forum, you can see that my reaction is very rare, because the reason is, I don't need to be pissed off.

If you want to poison your body with medicines while you don't have experience with this subject, give other people the possibilety to make their choise.

I'm talking about My experience.

Lucky, I like this forum, some people give usefull info.

[Thunderbirds20]

I have been going to see the doctor at Memorial Hospital every month or two since last October because I too have Gout. He told me not to drink beer, ( I have not had a beer in more than a year on my first visit) or eat chicken, ( I only eat chicken a few times a month) He then prescribed 100 mg tablet once a day of Allopurinol because my Uric Acid was high!

I stopped eating chicken and took the medicine as prescribed, but still had high Uric Acid. He gave me the same prescription for two more months and told me not to eat broccoli either. I was just there on the 2nd of March, ..... he trebled my prescription for Allopurinol to 300 mgs a day, ... once a day in the moring after eating.

I also have high blood pressure and was taking a diuretic every morning as well. I read online that they can cause a build up of Uric Acid too. I stopped taking those. I have not had an attack the entire time, but the Uric Acid is elevated.

Is there really a cure ... who knows??

Here i a little side tip if you go to a private hospital and need medication. Get a prescription and buy it at a pharmacy. It will be a lot cheaper!

[AyG]

Here i a little side tip if you go to a private hospital and need medication. Get a prescription and buy it at a pharmacy. It will be a lot cheaper!

Allopurinol doesn't require a prescription to buy.

[mxyzptlk]

I was prescribed Allopurinol 300mg by my doctor in the UK. Prior to this, I suffered some quite severe gout attacks affecting mainly the ball of my foot & big toe which made walking painful. Once the allopurinol (1 tab per day) got into my system (which takes a while), I never had another attack. Since I moved to Thailand in 2009, I've stopped talking the allopurinol, mainly because my alcohol consumption is now approx half of what it was when I was working in the UK. I would recommend allopurinol to anyone who is unlucky enough to suffer from gout....

Edited March 13, 2015 by mxyzptlk

[HerbalEd]

For many years I have prescribed celery seed tea or tincture to many people suffering from gout. Usually the results are good to very good. Unlike the usual drugs prescribed for gout, the celery seed is completely safe ... and very inexpensive.

Yeah, it sounds too good to be true, but it is a very old remedy and I know what I've seen.

You can make the tea by putting a full teaspoon of the seed in a cup of piping-hot water ... cover ... and let it steep for twenty minutes. Then strain and drink. Drink two cups per day.

You can make the tincture by adding one part of the seed to four parts of strong drinking alcohol in a jar with tight-fitting lid (e.g., 5 grams seed & 20 mL alcohol). Bacardi Rum 151 works very well. Let the seeds soak for ten days, shaking the mixture at least two times per day. Then filter through coffee filter. Twice per day mix half-a-teaspoon of the tincture in a cup of water and drink.

[sawadee1947]

http://en.wikipedia.org/wiki/Tenoxicam

http://en.wikipedia.org/wiki/Serratiopeptidase

it's a good medication, but probably you should take care of your weight? maybe over weight? Or obese?

Or eat to much proteins? Meat? Beef? Or too much BEER?

During my time as Doc I was successful with a diet plan for my patients (more than 80% could live without colchicine)

[Issangeorge]

Issangeorge,

Do what you want to believe Issangeorge, I only try to be helpfull on this forum, you can see that my reaction is very rare, because the reason is, I don't need to be pissed off.

If you want to poison your body with medicines while you don't have experience with this subject, give other people the possibilety to make their choise.

I'm talking about My experience.

Lucky, I like this forum, some people give usefull info.

I was not making a criticism, I was just remarking that it is not easy to drink 4 to 5 litres of water a day, at least for me.

[Wrong Turn]

Glad to hear your gout cleared up since I've heard that can be really painful.

PS While baking soda is a base and therefore alkaline, limes would likely be acidic not alkaline since they contain citric acid.

Many doctors actually belive limes are acidic.

No.

When limes and lemons are metabolized by the body - it is alkaline.

Limes and and lemons - when digested by humans - are ALKALINE.

[Wrong Turn]

Wrong Turn says "This also alkalized the blood."

That is amazing !

What blood PH is achieved with the bicarbonate and lime juice ? Above 7.41 which is the normal "alkaline" PH of the blood ?

Altering the normal blood PH is not easily achieved but success will guarantee a person would be seriously ill and in need of urgent hospital care.

The term "alkalize" is a generic term.

The body has a very narrow range of Ph.

Many things alkalize the blood; many things cause acidity - within a narrow range.

[Wrong Turn]

Just as a suggestion I was struggling w gout but I know everyone is different.

I am taking allopurinol 300mg, colchicine 0.6mg and 2x black cherry 1400mg daily. That combo does the trick for me always.

A USA company called piping rock sells the black cherry cheap and I swear by it.

Please review the health detriments of taking colchicine daily, every day.

[Wrong Turn]

Start by the cause.

Minimize your intake of protein by 90% and avoid meat at all.

Too much protein increase uric acid dramatic.

Your kidneys are for many years over loaded, and it cause gout and rheumatic diseases, and nearly no control of the bladder.

Normal is when people get older, that the function of the kidneys decreases by age, 30% function is point of no return……..

Drink at least 4/5 liter of water a day, to clean your kidneys!!!

Do you have any idea how hard it would be to drink that much water? I have a hard enough time drinking 1 to 2 litres, unless it's a very hot day, but even then I only drink around two max, just a little easier doing it.

Drinking 4 to 5 litres of water is very easy.

How many hours per day are you awake? Probably, about 15 to 16 hours.

I slowly sip 4-5 litres per day, easily and without any disruption of my daily routine. You have not tried doing it.