r/gout

My worst flares I've had are in my big toes. I've had them in my Achilles tendons and ankles before. But now it seems like my big toes just constantly ache a little bit. It's making me feel like I'm always on the verge of an flare, but one doesn't come.

Has anyone else experienced this?

Side note: When I'm dehydrated it will hurt a little worse, and sometimes all my joints will ache. Anyone ever hAve the all over pain? Wondering if that's gout, too.

I've been very lucky that I've gone about 9 months without a big flare-up, I started to get one but I hit it with colchicine.

Studies show that warfarin has been linked to increased uric acid levels. I've been on warfarin for close to 10years after open heart surgery and 2 mechanical heart valves. I've been battling gout flareups for close to 8 years. Started at 1 or 2 times a year and now getting it close to monthly. Has anyone experienced gout related directly to blood thinners?

Hello everyone,

I got diagnosed with gout 2 years ago randomly at 25. It's Currently under control with 200mg allo.

However my gp everytime i get a check up tells me to cut down on offal meat, alcohol, seafood and fructose. I rarely have offal alcohol or seafood (maybe one every 2 to 3 weeks). And I don't really eat fructose either, but if I stop allo, I get a flare up within days.

I've tried all the gout diets and nothing changes when I'm off allo. I plan to stay on allo permanently, but is the diet the cause of gout? My gp keeps telling me it's because of my apparent eating habits

48M. UA at 5.4 after 6 months on Allo, titrated up to 300mg, started at 100mg. I hesitate to flair this as a Success Story, I’m about 8 weeks since my last gout flare, and still in the familiar grip of fear that I could tip over the edge. I have been through 7 doctors, 4 of them functional/integrative, and have been diagnosed with Psoriatic Arthritis, Lyme Disease, CIRS, and ‘mystery autoimmune,’ and of course Da Gout. I don’t think any of the diagnoses were accurate, until I surrendered in January and went back to a new rheumatologist, I flared so badly in my left elbow/wrist/knee I wound up in the ER, scared and desperate like I’ve been during every flare.

Been dealing with this for 17 years, it takes a lot to NOT say it’s ruined my life. I got sober in October 9 months ago, no brain pills, no alcohol, cold turkey. I’m an AA guy now. I got sober, then lost my job, then flared up so badly in January I thought I might end it all. I have much to be grateful for. I started working with a new rheumatologist (my second) in late January—he pulled fluid from my elbow and looked at all my joints with x-ray and ultrasound. He kept telling me it was just severe gout and I kept telling him it was something else, otherwise I’d be better by now, I’ve seen all these doctors and specialists and alternative types… I’ve done extreme treatments and conventional treatments (allo/colchicine years ago but not for long, tons of prednisone, methotrexate, extreme diets, biologics (Humira/enbrel), foot surgeries, water fasts, exotic supplements, psychics, shamans, expensive Western docs, all the tart cherry juice you can drink, celery juice fasts, stupid fad-of-the-day, you name it) I’ve been a mess. The overwhelming/demoralizing/immobilizing pain in all my extremities over time, one year I had 10 visits to urgent care. I have a huge photo album of exploded painful joints. And you’re telling me it’s JUST gout???

I gave up, I told him I would do anything he said. My UA was only at a 7.5 at my first labs with him, but I was in an acute flare. He started me on 100mg Allo and .6 Colchicine as prophylaxis with prednisone as backup for emergencies. I titrated up to 300mg Allopurinol in early May. He said it was gonna be a rocky 6 months or so, things can get worse before they get better…and he was right: I gutted the last 6 months and went through 4 severe flares (wanted to die), 3 rounds of prednisone taper, and a couple intermittent flares that were painful and annoying but not completely debilitating. I got approved for Ilaris but haven’t taken the shot yet, hopefully won’t have to.

Last week I started feeling a little better—the last 6 months have been hell, the last 17 years have been months of hell punctuated by some decent pain free moments. My UA came back at a 5.4, I wasn’t in an immediate flare, and I broke down sobbing. I still feel a little dodgy, it’ll be awhile before I work through the fear and trauma of it all, and I’m anticipating some more uric acid movement and some pain but hopefully not as bad as the past. I’ve watched my children grow up wondering if I’ll be able to be active with them tomorrow, or next week, or next month. I hiked 6 miles with my dog last week, and went to bed that night without the terror that I might wake up flaring because I overexerted myself—I’ve always been an active athletic person and this disease has kept me from doing the things I love, but I tuned up my bike the other day and I’m looking forward to putting my body back together after all this horror.

Life is hard enough, we’ve all been through so much. If you suspect you have gout or bouts of mystery pain that drives you to suicidal ideation, don’t be like me, go see your rheumatologist and get on Allopurinol if they recommend it. THANK YOU FOR LETTING ME LURK HERE AND GET SUPPORT AND ADVICE. Love, health, and healing to everyone.

For reference I’ve never been diagnosed before, but over the last 36+ hours having been on my couch in the worst pain of my life and reading everything I can, I’m 99% convinced I have it.

My questions for the group since I’m new here are:

Will an urgent care prescribe me anything to make this go away??

I can’t even walk, bend my toes, literally do anything without feeling like my ankle was ran over with a semi it’s unbearable. Can you die or your body go into shock from the flare up pain??

I’m a 34 year old grown man and I’ve cried 3X due to the pain and have never experienced anything this awful

EDIT:

Thanks to everyone that has shared opinions and given advice. I can’t thank you all enough and am relieved to know I’m not the only one. I’m currently waiting at the pharmacy for prednisone, colchicine, and indomethacin.

Currently have my first ever gout flare up. I have had it for just over 6 days now and on on my last day of colchicine. It is still a bit sore but I am managing to walk around a bit a lot better than before. I was thinking is it worth going for a short walk just to get out. Am I going to regret it could I make it worse or is it better to leave it till almost completely pain free

A month ago I had the worst pain of my life in my right knee.

7 hours in A&E, all clear and go home. Here’s a single ibuprofen.

Went to the docs the next weekday, I mention gout runs in the family and get given colchicine.
A week of being unable to walk followed by a long couple of weeks recovery and I’m back to being mobile with minimal pain.

Had a blood test and confirmed gout.
Offered Allupuinol and a change to lifestyle choices.
I declined allupurinol to begin with as wanted to see if I could get by with just changes to diet.

Ate modest, cut out any alchohol, low purine diet choices. Gradually feel 100%.

Until this morning. Out of the blue, unable to straighten other knee without pain.

Now it’s 1:00am the next morning and I cannot escape the pain. Ibuprofen and paracetamol aren’t touching the sides.
It’s feels like hot lava is building up in my knee.
It feels like someone’s driving a red hot poker through the front of my kneecap and out the back.

There’s no escape. And I’m quickly running out of options.
No ice left. Maxed dosage of painkillers for the next 4 hours and I’m so fucking angry at this!

Writing this helps take my mind off the searing pain.
I hope this is over quicker than the last one. I can’t deal with the weeks of immobility again.

Hey guys, so today will be the day I start taking Allo. I’m a bit nervous because I’ve seen a lot of posts in this community saying that it usually gives flairs initially. Is there anything I should look out for and my doctor said if I get a flair I should have some Tylenol or advil. So any advice would be appreciated. Thanks in advance!

My whole story with Gout basically started at 17ish. It was exactly like you expect it to go, extremely painful, staying in bed the entire day, and having no idea what was happening, i went to a doctor, he prescribed me Seractil for the pain, and that was kindof it for the first time.

To the surprise of no-one, the gout flares came and went at completely random intervals, i'd guess around once a quarter?

I think over the course of the next few years i had two MRIs and one xRay, and the only thing they found out was "fluid in the joint". That's it. At some point i thought about giving up, i had multiple gout flares where i didn't even bother going to a doctor anymore, i just took my 1200 to (rarely 1600) mg of Seractil a day and try to survive until it's over.

I got sent to all kinds of foot experts, at least two differnet physiotherapists, from foot exercises to shockwave therapy and whatever else you can imagine, obviously nothing helped.

Then, at 23 years old, i had one yet again, my right knee, it wasn't a super-bad one, so i got to my office-job with crutches and painkillers, and tried to work as good as i could, and something just snapped in me at that day, i'd say i'd get this fixed now no matter how many doctors and nurses i had to piss off.

So, after work i drove to the next hospital, told them my issue. They went to work, first an ultrasonic of my knee, nothing, they took me in (for the first time ever), 1-2 days later, MRI, nothing (at least nothing worth remembering). They told me they're thinking about a knee reflection, and said they are planning on doing it. On the day where it was supposed to happen, they say they'd cancel it, don't wanna do it. Nurse handed me my discharge papers, and i called my dad to come pick me up.

After i had called my dad, discharge papers in hand, doctor came back in and said they changed their mind, they're gonna do the knee reflection. That was the day my life changed. They took me into surgery, and besides the pain in my knee, it was just an amazing experience, people were friendly, i was brought to the operating room, i was doing smalltalk to the anaesthetist (super nice lady), last thing i remember after waking up was talking about my Motorcycle.

I think it was the next day, the doctor came in the morning and told me what he found, he basically said "So, i tried moving your knee while you were out, and i could fully bend it, your inability to bend it is a psychological problem, not a mechanical one (or sth along those lines, he made it sounds like it's good news), the other, far more interesting information, is that they found uric acid crystals in my knee, and that he diagnosed me with Gout.

From there on out i got the right medication, Allopurinol to take daily, a few others incase of a gout flare, my life basically normalized from one day to another (besides the obviously still ongoing gout flare that drastically got better with the correct medication).

The only real times i get a gout flair now is if i REALLY exaggerate eating meat (god i love meat) and/or if i happened to forget to take Allopurinol for a day. But even then, they're usually very light ones, and i can "feel" them coming, taking 25mg of Prednisolone and 1mg of Colchicin is usually enough to take care of the issue within a few hours. I often feel it coming at the evening, take the meds before bed, and by the time i wake up it's almost gone. From personal experience i'd say it takes around 6 hours to have a big noticeable improvement, going from limping to walking normally again.

Since i had my knee reflection 2,5 years ago, i had 3 (or 4? Honestly don't quite remember) instances where i had to take Prednisolone (6 tablets total), last one was this week, why i wanted to make the post. My long-term Uric Acid levels have been steadily declining, over the past year going down from 6,4 to now below 5,2 (last check was in April).

I used to get severe constant flare ups every couple of months or at least every three months for years, my big toe, or the arch of my right foot, twice I got it in the centre of both my feet, it was the most agony I was in, my friend took me to the hospital in a wheel chair for pain meds, I never took it seriously and never took the doctor prescribed allo for my gout,

Fast forward to now I eat the same, have a carb rich diet, heavy red meat and yet I haven't had a flare up or even tenderness or joint ache in years .. what's happening to me ? Is this normal.. is this a calm before the storm as I've read in other posts ?

Has the crystals been flushed out of my system? I haven't done a uric blood test recently

So, had a flare. My second. I ignored the first like a fool and thought I'd be fine.

Went and had blood work done and the doctor put me on febuxostat, 40mg. Ultrasound showed no crystal formation around my ankle.

I understand I'm going to be on this medication for life or until they discover a cure.

But, I enjoy a drink. Usually whiskey or a few beers. I'm due to travel home in a week from abroad. Only go once a year to see friends and family. Drinking is a big part of the culture, so I'm wondering if one or two in a month's time is going to be dangerous?

Also, for anyone like myself that enjoys a drink, how long after starting on UA lowering medication did you feel comfortable having a drink or two every few months? Any major flareups after having a few?

Any advice would be appreciated because a few drinks at the end of the working week is important for socialising and stress-relief.

Currently suffering my first gout flare up. Medication aside, just wondering what the best things to eat during a flare up. I've read that cherries are good as is low fat milk and dairy as they apparently help to speed up the secretion of uric acid. I'm trying to drink lots of water too. Also I have some chicken legs in the fridge that was supposed to be for dinner but I've read in places that chicken should be avoided. Is it ok if I remove the skin

I've been on allo for 2 years now and it has basically saved my life. That said I occasionally still get flares (last was a month ago and last a few weeks because my guard was down so missed the colch window). And I am still getting just tiny foot discomfort on and off here and there.

I'm on 400mg Allo, and when we bumped from 300 to 400 my uric acid barely budged downwards (it's in the 4's I believe, my high was around 7). My doc agrees to go up to 500mg of I want but could tell he hesitated to offer it as I'm already so low.

Would like to know if I am in a 'just deal with it's phase of gout or if I should be more attentive to my triggers indefinitely. I was sort of under the impression I could be flare free if I got the right allo dose but maybe that is unrealistic given how others here seem to focus on trigger foods/drinks. I was very focused on them in the early days but less so now thanks to allo. Thx.

Here are my numbers: Uric acid trend (mg/dL): Mar 28, 2024: 6.7 May 31, 2024: 6.9 Aug 14, 2024: 5.3 Sep 30, 2024: 5.0 May 19, 2025: 4.9 Jul 25, 2025: 4.1 Dec 12, 2025: 4.1 Apr 6, 2026: 4.0

Reference range: approximately 3.3–8.0 mg/dL Overall trend: 6.7 → 4.0 mg/dL over about two years, with the largest drop occurring between May and August 2024, followed by a gradual decline and stabilization around 4.0–4.1 mg/dL.

Is there any advantage to see a rheumatologist for gout instead of my primary care physician (PCP)?

Rheum has higher copy than PCP. If both have to prescribe all allopurinol then any specific reason to visit Rheum?

I had my first gout flare a few months after starting a morning exercise routine that included calf raises ( in which you briefly stand on just forefoot/toes to
Raise yourself then lower). Just prior to the flare I did these heavily, so do you think the pressure in my toes may have incited the flare(and I do have a bone spur above left big toe joint (Hallux Limitus) ) ?

Both of my elbows, but especially my right have huge build ups. I get flare ups pretty much biweekly. I can’t put my elbows on hard surfaces for the past year or so.

It’s so annoying because I cut out drinking and most meats, but I moved to Asia where prevention isn’t prevalent. At this point I’ll fly back to the US to get them cut out and get on Colchicine or similar to do anything.

I know how defeating this disease can be so I wanted to share my success story.

First flare around 8 years ago, 30yo. Had 1 bad flare/yr for a few years that I would just treat the symptoms with Colchicine and Indomethacin. Frequency of flares started to increase after a few years to more like once a quarter and I could no longer deal with hobbling around in pain for two weeks at a time.

About 1.5 years ago I started allopurinol and it has been such a game changer. I’ve had a few dull flares, but nothing to take me completely out of commission since I started, and nothing at all in the last 6 months. I tapered my dosage up thanks to advice from this sub, starting at 100mg and slowly increasing to 300. I also kept colchicine on hand, taking .3mg daily for the first month and then taking it any time I felt the slightest twinge for the next 6 months.

My unprofessional advice: Unless you’re going to the all you can eat and drink shrimp and beer buffet every day, lifestyle changes are unlikely to resolve your gout (you should still make them, though). Just start the allopurinol. I was resistant to starting a daily medication that I would have to take for presumably the rest of my life and I wish I had done it sooner. Probably something to do with confronting the reality of aging.

Good luck on your journey!

Hi folks, hoping you can share your thoughts on my experience.

I was diagnosed with gout about a month ago after being misdiagnosed for a year with a sports injury (I’m a rock climber and do HIIT).

The main symptom is persistent pain in the big toe. It has been a mild pain for the whole time - like a 5/10 on the pain scale - but it’s never been a flareup. My new podiatrist ran a uric acid test and it came back 8.2. She also did an x-ray and MRI scan of the big toe and saw some reduced cartilage in the joint. She was certain it was gout even though I’ve never had a flareup.

In this forum I seem to only see posts about people having flareups. Is it possible to have gout with no flares? This doctor seems to think so. She also says I will need to be on gout medication for the rest of my life, which feels extreme to me if I’ve never had a flareup. I have booked a separate appointment with a rheumatologist for a long-term plan, but in the meantime wanted to see if anyone else can relate.

It very well could be in my mind but sometimes I feel a slight relief in gout area when I am urinating. Is this actually possible because of crystals leaving or just in my mind?

Didn't know whether to tag this as "sucess" or "vent" (it's both)

I'm finally below 6mg/Dl UA and ready to start the (sometimes painful I hear) recovery journey.

28months ago, I went to the Dr saying I had gout.

Don't recall the number, but it was the upper-edge of 'green' on the chart in the app. I didn't get Allo until a year later after advocating and another test showing 9.5mg/Dl. My first one was likely lower because it was during athe tail end of an active flair. Neither me nor the doc knew at the time a flair would artificially lower that number.

I didn't know that UA should be re-tested (and he apparently didn't either).

A year later (on 100mg Allo) UA was 7.3 which was also within the 'green' on the app.

I didn't go up to 200mg until near tears in his office about the pain I dealt with the past year.

I then read up on gout: internet searches, r/Gout forum, scholarly articles.

My next test UA was 7. I said, well that's above 6,so we're moving to 300mg right? He resisted and said we needed an MRI and to look for other causes since it's 'probably not gout, since Allo isn't helping'

I told him we were supposed to up the dose and re-test until <6mg/Dl.

He doubled-down, and ordered an MRI.(that I never got)

I started myself on 300mg Allo that day.

A few days later I had a tele-med Dr say "I don't reccomend people getting the bulk of thier medical info from reddit, but in this case you are right"

I got a prescription for 300mg/day.

My follow-up 4weeks later (yesterday) UA test showed 5.5mg/Dl

28months after me walking into my PCP's office saying "I have gout" I finally got down to <6mg/Dl.

I finally got over it, but my PCP delayed my recovery by a year.

Over those two years I gained 50+lbs. I used to create large sculptures, build things, bike and run as main hobbies.(hobbies on my feet)

I transitioned to playing guitar/singing, drinking LOTS of beer and going to concerts. (mostly sedintary hobbies+booze)

In 2026, I'm down 35lbs so far through just dieting/calorie management.

I'm looking forward to being able to exercise again without the painful reminder.