r/gout

Long post apologies…

I’m a 35yr/female, diagnosed with gout maybe 2.5yrs ago. I don’t drink alcohol or anything so confused how I got gout but nevertheless, first flare, I had no idea what it was and thought maybe my heels I wore that night triggered some inflammation. Didn’t have another flare for a good 6 months, then had one after eating fish and noticed it was happening more frequently after eating fish/seafood and any syrupy drinks so I stopped consuming. I had a really bad flare in my left hand last year where all my fingers were swollen and I couldn’t close them. Didn’t take anything and went away on its own within 3days. Hadn’t had another flare since but now a year later, I’ve had THE WORST flare I’ve ever had. I returned from Bali and caught ‘Bali belly’; symptoms lasted a week and during the time consumed lots of electrolytes (electrolytes are normally a trigger but I’d rather that, then become severely dehydrated). No gout flare during this time. 3 days after my symptoms subsided, my left knee starts hurting but as it was 1 day after Pilates, I thought I pulled a muscle. Had a massage and it got worse to the point I couldn’t even hobble with my other leg to move at all. The swelling came down on its own with no meds just rest and then my right arm flared. Currently I cannot move my right elbow, swollen, throbbing and then my left knee swelling/pain has returned full force after kneeling on it ONE TIME. I’ve tried colchicine with no luck and about to take prednisone.

How long do you think it will take to work? Allopurinol doesn’t agree with me so can’t take this long term. I feel like my body is falling apart and I’m still so young.

I’ve also tried tarte cherry juice which helped maybe 10% with the elbow but feel it may have worsened the knee.

So as the title says… I’ve just realized that over the years I haven’t been spraining my ankle rather, I’ve been having gout flareups. I never questioned it cause I walked a ton so I figured I just stepped off a curb wrong or something.

My last uric acid reading was 8.7 and am on allopurinol so hopefully it’ll get better.

Currently dealing with a flareup in my ankle… so I’ll be lying down for a bit.

Anyone else have similar situation where they didn’t realize it was gout for a long time? Did meds help reduce flareups long term?

I’m a pharmacist. I’ve dispensed colchicine hundreds of times. A few months ago I started actually researching the history of the drugs I dispense and colchicine stopped me cold.
The Ebers Papyrus, an Egyptian medical text from around 1550 BC, documents autumn crocus as a treatment for swollen joints. That manuscript was already copying older documents when it was written. We don’t know how much older.
Egyptian physicians knew three things about it: too little did nothing, the right amount reduced the swelling, and too much killed the patient. They figured out the correct dose the only way available to them. Some patients did not survive the figuring out.
Here is the part that got me. Nobody knew how colchicine actually worked until the 1970s. Not the Egyptians, not the Greeks, not the medieval Arab physicians who wrote detailed preparation guides for it, not the French chemists who isolated the molecule in 1820. Physicians prescribed it correctly for three thousand years based entirely on observation. No mechanism. No theory. Just the repeated confirmation that it worked and the repeated warning not to use too much.
The mechanism, when it was finally described, turned out to be strange. Colchicine doesn’t fight inflammation the way most drugs do. It binds to a structural protein inside your cells called tubulin and prevents it from forming the fibers cells use to move around. In gout specifically, it stops the white blood cells that rush to uric acid crystals in your joints from getting there. No migration, no inflammatory cascade, no pain.
That’s the same mechanism that makes it toxic in overdose, by the way. It’s not selective. At the right dose it disrupts neutrophil migration. At too high a dose it disrupts cell division everywhere, and the GI tract goes first. There is no antidote. The Egyptians understood the margin mattered 3,500 years before anyone could explain why.
The plant it comes from, Colchicum autumnale, is named after Colchis. The ancient Black Sea kingdom. The homeland of Medea. Greek mythology specifically assigned the plant’s poison properties to her, which means the Greeks understood its toxicity well enough to write it into their stories.
It flowers every autumn without any leaves, which is why botanists eventually named it naked ladies. The flowers appear alone from bare ground, months after the leaves have died back. For centuries people thought it was two different plants.
Anyway. I found it remarkable that something this old still works, that the mechanism took this long to understand, and that the correct dose was calibrated through observation across dozens of civilizations who couldn’t communicate with each other and all arrived at roughly the same answer.
If you’re on colchicine and have questions about how it works or how it interacts with other things you’re taking, happy to answer in the comments.

I’ve been on gout medication for around 4 months already and my uric acid is well acceptable now, but I still get actual flare symptoms if I push training/cardio/walking too hard.

I walk a lot daily and also train regularly, so I’m curious how other active people here manage balancing gout with gym/cardio long term.

Did it eventually calm down after longer on medication, or did you need to change your training/recovery a lot?

I really want to maintain a healthy active lifestyle, so being forced constantly to cut back honestly sucks.

I had a reaction to allopurinol and was told by my rheumatologist to stop taking them, I’ll have to wait a few weeks for my next appointment but I’m afraid of having another flair up because I have to stop taking them, it’s affecting my mental health waiting for an attack. Any experience on coming off allopurinol? I was only taking 100mg a day for about a month.

She says it's not very high and she wants to wait and see what happens, however I've told her I've gotten flare ups over the course of many years, and my most recent was in March and April for about a month straight in both feet.

I'm a new patient of hers since I was recommended by a friend. Her visits cost about $100 per. I'm working on getting a good job so I can get insurance.

Should I find a new doctor or should I insist that I be prescribed allo? Seriously, I could lose my job if I get a flare up again. I just started working there and if I get a flareup then I'm unemployed again. It's really important to me that the doctor acknowledges what a flareup could mean for me and my life.

My gout flare ups have typically been isolated to my big toes, and ankle - but I'm going thru my first knee flare up after a busy weekend doing yard work, and I have to say the knee pain is so much worse than I imagined. Any tips on coping with the constant throbbing? Currently on a dose of colchicine to help take the edge off, and Mortin

Edit: Thanks everyone. I’m at urgent care now waiting for a dexamethasone shot and uric acid lab to be drawn

For the last 4-5 years, I’ve gotten random flares of pain in my big toe joint. I’d always assumed it was either a slight bunion, or just pain from the gym. It usually lasted 3 or 4 days. About 3 weeks ago, the pain flared up again. This time, the joint is red, warm, swollen, and about an 8/10 pain when walking. It has not gotten better since it started. Most of the people I’ve talked to say it sounds like gout, and I think it sounds like gout as well. I’ve cut out alcohol (wasn’t a huge drinker, but I was having a few old fashioneds on the weekend), cut my meat consumption in half, and gone through 4 bottles of tart cherry juice with zero change.

I set up an appointment with my PCP, but the earliest available time is 5 weeks out. I’ve never had a uric acid blood test. Would you wait for the PCP appointment, or go to urgent care? Is that even something they would be able to address? I’m on my feet most of the day at work, so it’s miserable.

Hi everyone,

I've been in the midst of my worst gout flare up imaginable. For 3 weeks now my foot has been swollen, from multiple joints.

Usually colchicine plus indomethacin will have a flare up handled within days. This time however, nothing. For extremely had flare ups, Ill get a steroid shot. Once again, nothing came of it.

Doctor told me to quit the colchicine and indomethacin, prescribed prednisone. Ive now been on prednisone for over a week, and still, no progress.

My podiatrist and rheumatologist aren't being particularly helpful on when I can see a solve on this. All I get from either of them is to continue with rest and medication. It has improved, but not enough to have me walking. Ill be starting on allopurinol after the inflammation clears, but at this rate who knows when that will be.

I understand I have to be patient, but Ive been literally crippled with gout for 3 weeks. Its affecting everything in my life Does anyone have any experience with a similar situation?

Im at like 16 day now and the last two nights the pain has returned almost as bad as the first week. Is this normal? I got medication on day like 6 or 7 and research says it shouldnt last more then 5 days with medicine or 2 weeks without . I got a life to try to get back too

I just don’t seem to understand…. A couple weeks ago I go out with the boy to play golf. We have some drinks (beer, shots, seltzers) maybe a dog at the turn and then we went to a steakhouse after the round. All bad I know, not the smartest idea. I got a flare up obviously, But ever since then, I haven’t been able to shake this flare up. It’s in my right ankle, feels like a really bad ankle sprain. I immediately changed my diet, started fasting and drinking as much liquids as I can, tart cherry juice, celery juice, but mostly water but I’m in this vicious cycle. I’ll wake up and be in pain, so I drink drink drink and I’ll feel fine by the time I get to work, but I’m a bartender and on my feet for 6-8. I’ll feel fine, but being on it so much by the 6th hour I feel the pain creeping back. By the time I get home, foot is hella swollen and I start limping. Once I’m in bed there’s not comfortable way to sleep and I’m pumping ibuprofen all night. Do I need to take time off work to not agitate it, rest until I get better? I’m over this shit. I’m 39 and in good shape, i always watch what I eat but I can’t live like this anymore. I don’t have my medicine cause I just recently moved from SF to Vegas. Anyone got something for me?

Hi all,

I went to urgent care on Friday because I couldn’t walk on my foot - he diagnosed it as gout within 10 seconds without running any tests - 50 mg of Prednisone for 5 days.

I’m on day 4 and not really feeling much of a difference. Although it seems like I probably have gout, there was one difference in presentation of pain that I noticed when reading up on it. Gout seems to happen out of nowhere whereas I felt soreness in my toe that built up over a few days (that I walked on a lot).

The other thing is that gout hurts at rest? My foot does not hurt at rest - only when applying pressure or walking, then it absolutely throbs.

Could the doctor have jumped the gun on gout? Context: the last 4 weeks I’ve been walking 20k steps a day, so a LOT of pressure on my foot. I don’t drink alcohol or really eat the trigger foods, but genetically not so lucky. I’m still treating this like a gout flare up - anyone here at first diagnosed but then it turned out to be something else?

I got my blood work done 4 weeks ago because I had a bad ankle flare up. My uric acid showed up 444umol/L. This was within normal range since normal range was 210-540. Doctor ruled out gout and had me referred to sports medicine. Fast forward to 3 days ago, bad toe flare started and now in immense pain.

Reading more on gout apparently I am in gout territory for uric acid, converted I was at 7.4mg/dL. With normal ranges with meds being targetted at 6 based on my reading. My question is how are the ranges in blood work so far from gout range, doctors then often say things are normal when they are clearly not? Or am I understanding this wrong, if so please enlighten me since two doctors have already ruled out gout for me based off the blood readings but it's almost 99% gout.

Just found this group. Last Monday I woke up with a swollen big toe and intense pain in my toe from even the slightest physical contact. I could sort of bend it back and forth so didn’t think I broke it. Had to travel so painfully shoved it in a shoe and dealt with it. Ice and ibuprofen didn’t seem to do much. Went to urgent care on Saturday and they suspected gout. Xray revealed no breaks so they prescribed me Colchicine. I’ve been taking it for 48 hours and the things have gotten much better but still not back to normal. Since this is my first time through what should I expect over the next few days?

I was diagnosed with gout about a month ago I am a 22m, and recently was given allo to lower my uric acid levels. I’ve been excersing and eating in a calorie deficit for since January anyway so my lifestyle is fine.

Question is I have a few festivals coming up towards the end of June and I like having a drink and will probably be getting drunk. Will I likely get a flair up after this? Or will the medication be set in and doing its thing, my ua level is currently 6.1

This is my first flare. Big toe. A bit over 3 weeks now. Took. a tapering dose of Prednisone for the first week. ​​​​​​​​​​​​

Pain has been gradually decreasing to the point where I don't feel any pain at rest but feel a slight pain when I try to walk normally ​​​​​​​​​​​​​​​​​​​​​​​, so have to limp still, have to wear loose shoes/clogs.

Is this normal? A bit scared as Google and ChatGPT say that first flare lasting this long is atypical. Have PCP appointment in 3 weeks. ​​​​​​​​​​​​​​​

Hello fellas, I am on the brim of going insane😂

25m here, managed to get my uric acid levels from 10.2 to 8.7 dropped 9 kilograms, and while dieting and all of that I had this strong unexpected most gruesome pain I’ve ever felt, had been taking colchicine for 5 days intervals.

Note I am a teacher and mostly on my feet will that affect it?. Im also on allopurinol 100 mg.

Why im posting is because I feel hopeless and I cant wrap my head around what is happening please if u have similar experiences, benefit me with what I should do next, thinking of MRI because im afraid my joints are damaged.

Im just at a loss. Im so upset and in so much pain I was crying just trying to walk to the bathroom. The urgent care couldn't diagnose me but said its probably gout, and I cant get in with my doctor for over a month.

I just dont understand how this could have happend you know? They told me to look up what causes it so I did that while resting and it says things like alcohol, seafood, fatty meats, and organs, all of which I dont like anyway so I sont eat them. I dont think I eat enough sugar to cause this, I see a nutritionist and follow her advice. I eat well and am dropping weight yet still this happend. Im just so frustrated

Woke up Saturday took my allo after breakfast. Cleaned the house then went to the mall and walked around a bit before heading to the beach for fried chicken, chips and a swim with my son. 3 hours later we finish up, get some shaved ice then stop at the market for some wagyu beef and had bbq and a beer for dinner.

Sunday morning, breakfast again with allo. Scrubbed the balcony, went for a 2 hour bike ride with my son then pasta and meatballs lunch. This afternoon I washed both cars, mowed the lawn and did some more outside work that I had been putting off. Planning to cook hamburgers in a bit.

This is how most of my weekends go. Take your allo and live a normal life.

Did blood work on Tuesday and got results Thursday stating my UA was at a 5.4....results also said my iron (ferritin) was low... Yesterday I go to Texas Roadhouse and eat a Steak salad around 4pm to see if that would help with the iron....fast forward to 1030pm last night and I have a flare up in my left knee, smh... Took Colchicine last night and first thing this morning.

Been taking Febuxostat daily and haven't had a flare in about 6 months, smh