Uric acid levels(acceptable)
Thought I'd pass this along..
After your very first gout attack..or even right now..monitor
your blood uric acid levels..with blood tests..every 6 months or
so.It is VERY important to establish a normal "baseline"..do what you
normally do..eating/drinking exercise..etc.Do not make changes prior
to the test.As a rule a fasting blood test of 12-16 hrs is ok.
From the doctors I see..including 3 specialists..and all the
research I have done..the acceptable/normal limits of uric acid are
different for people that have had 1 attack..and those that have
never had one.
1 attack and you are CLEARLY..almost guaranteed to have another
1..that is without drug treatment/daily..Allopurinol.Whether you
choose to deal with the uric acid issue with
diet/exercise/drugs/restricting certain foods..etc.is of course your
option.
The levels..and NOTE:these are the levels when you are NOT..or
have recently recoverred from an attack.These are your
normal/everyday levels.
1 of the reference ranges is a MAXIMUM of 400 umol/L((Litre of
blood))
Another interpretation of this used by other labs is: .60
mg/L..or 6.0 mg/dL..
These are NOT high levels of uric acid..not out of the
normal/reference range..and will not even get
highlighted/flagged..maybe not noticed..and may be
ignored/disbelieved by some in the medical community..but some savvy
doctors/rheumatologists..say that.. no they are not high..BUT they
are too high for someone with a history of gout..and have to be
reduced.
Going above these levels will pretty much guarantee the attack
(s) will happen sooner.Ande be more severe.
Keeping these levels below the above limits should
postpone/prevent attacks.
Everyone has a different threshold at which the uric acid will
be deposited around their joints..and also when/what causes the
crystalization..
Also worth noting is that there is a big difference between
reducing uric acid levels through diet etc. and Allopurinol..Not only
will Allopurinol work much,much faster..more effectively..but part of
it's makeup as an oxidase xanithane inhibitor..which stops the uric
acid form forming in the first place.It stands to reason that a much
greater reduction..plus a component that inhibits the uric acid
development..i/e anything that can cause the deposits to
migrate..when they're migrating..due to drug interference..they're
usually on their way out.True they can cause problems on the way
out.By reducing uric acid levels without drug interference..a fast
enough reduction can not normally be obtained to cause
migration..elimination of the uric acid deposits.What quite often
happens with a dietary reduction in uric acid levels..is that the
levels can be dropped to the point where the attack goes away..but
not the deposits.This leaves one on the threshold of more
attacks..easier to be triggered.
Great observations, Arnold. Three questions for the group, if I may:
1) Can/should allopurinol be continued during outbreaks or is it
contraindicated in times of episodes? I am 50, toward the end of one
of the longer (1-1/2 weeks) and painful outbreaks, probably about my
third or fourth in the past seven years. I have never been prescribed
or tried allopurinol, and I am eager to try anything to avoid tophi
surgery (of course, I haven't yet been diagnosed with tophi either, I
am just guessing from the length of this outbreak ...).
2) Has cortisone injection been tried by anyone in the group or will
rheumatologists generally administer these shots?
3) Is there any accupuncture or alternative (non-dietary) course of
treatment known? Seems like gout is known as "Ben Franklin's disease"
and associated with Western Civilization, but, my interninst once
mentioned an entire village in India that drank a certain type of tea
was found to be afflicted with episodic gout outbreaks ???
Thanks all,
Alex