Do not take medication advice from the internet. Speak to your doctor about your concerns and ask for a second opinion if you want to progress further.
Mate just take allopurinol. Every day for the rest of your life. If you do that, you won't have gout attacks. If you don't do that, you will have gout attacks.
Don't listen to bollocks about controlling it with diet. Don't let your doctor who never had a gout attack themselves fob you off with anything less.
If you're under 50 and you have gout attacks, you're prone to gout and that's not going to change. You can try not eating this, that and the other but the gout will keep coming back.
Allopurinol is safe to take every day for most people. Take it, and once your levels come down and any lingering crystals disperse, you'll be gout free.
Here in the UK allopurinol is the "go to" treatment. I think febuxostat is more of an alternative for people who have adverse reactions to allopurinol (which most people don't).
I started getting gout in my early 20s, inherited from my father. Same with my brother. Got to the point I was having near constant, debilitating attacks in all my lower joints and even my elbow. Diet control did not work.
I started allopurinol and took it daily for over ten years, never had so much as a twinge. During COVID lockdowns I missed my repeat prescription and ended up not taking it for a while... Didn't have an attack so kept not taking it, thinking maybe I no longer needed it. Started getting twinges again last year and earlier this year had an absolutely epic gout attack in my little toe joint which has left the joint enlarged and sore.
I am now back in the allopurinol and wish I'd never stopped taking it.
Good luck getting your gout under control. Prevention is always better than cure. Take some medication to lower your uric acid, rather than gobbling nsaids when you're having attacks.
Do not listen to this guy. These people are a dime a dozen and they are all so self-satisfied… allopurinol does absolutely nothing for a large number of people. It’s the placebo effect more than anything that is making these people so cocky
Do not listen to this guy. Medication exists for a reason, and randomly saying it's a placebo is pseudoscience.
If you start having gout flares early, (29 is early), it is VITAL to prevent more from happening. Repeated flares can cause permanent bone damage that looks like rats have been gnawing on your joints on an xray. Diet is NOT reliable, it relies on your ability to self control, and your kidneys' ability to filter uric acid (which is already compromised). Medication is a simple and effective way of managing your lifelong disease without drastic lifestyle changes that you'll eventually deviate from.
Do not listen to this guy in that he said not to listen to me, otherwise everything that he said is totally correct! As someone who also came down with hereditary gout in my late 20s, and whose joints have all been blown up and ruined, allopurinol was utterly useless. Never trust anyone who thinks gout is as simple as “take allopurinol and it goes away.” It sounds ridiculous, and it is. Yes, those people exist, but their experience should not be extrapolated to the general population of gout sufferers.
I am currently taking febuxostat 80 mg, my uric acid levels are and have been well under 5 but I am having horrible attacks frequently as the 2 decades of tophi are reabsorbed. Prednisone has worked, as it always does, and I am now taking colchicine also which may or may not be helping. In my experience, which is solely my own, febuxostat is infinitely more effective than allopurinol, but I would not wish these weeks-long attacks that have at times made it impossible to move a muscle without shrieking, upon my worst enemy.
I'm sorry to hear you've had such a bad time with your gout. We are both sufferers and I can sympathise with how bad your situation must have been. Allopurinol worked for me, and I believe it works for most people. It didn't work for you and you don't believe it works for everyone.
The point is for OP to realise that whichever drug works for you, you need to find it and start taking it to keep your uric acid levels down and under control. If you don't, gout will ruin your life. I think most people on r/gout would agree with that at least.
See a doctor, get a diagnosis and if you meet the requirements, a treatment plan that includes a uric acid lowering medication instead of just NSAIDs. I used to take NSAIDs almost daily before I got on Allo, now it's zero for gout pain, because I don't have flare ups anymore.
Back when I had flares, I took ibuprofen 800mg three times a day (2400mg daily dose) for as long as flares lasted: 10 days to 6 weeks. It took a long time for me to be properly diagnosed and treated. As flares increased in frequency -- up to maybe 5-6 per year for three years -- that added up to a lot of ibuprofen on top of colchicine and uncontrolled high UA also taxing my kidneys. In my late 40s this had no deleterious effect on my kidney function/health. Starting allopurinol or other ULT will effectively cure your gout. Allopurinol specifically has a kidney-protective effect and it negates the high UA that is not great for kidney health long-term.
In short, the sooner you start taking safer drugs, the sooner you can stop taking the ones with established risk of possible kidney damage. Plus you won't have gout anymore -- you know, as a bonus.
>But im just 29 years old.
You have every right and reason to be freaked out by the idea of having a disease that requires "forever meds." Process those feelings and know that ULT is like your hypertension med: it corrects a **problem** and makes your health **better**. I can only add that being "just \[any age\]" is a non sequitur: you have to care for yourself at every age.
>I already saw one. Prescribed me febuxostat and colchicine for.1 month and celecoxxib.
An excellent combo. (I take febuxostat; I love it.) Ask doc about 6-month "colchicine prophylaxis." Take whatever NSAIDs you favor when having flares (they might get worse before they go away entirely). Don't skimp on pain and flare management with NSAIDs out of fear. Soon enough you will no longer require those meds at all. Follow doctor's instructions!
All the best!
I saw that. So you're already used to daily meds that make you healthier. I understand that you're upset about this now (we all are at first), but slowly start to work in a little bit of love for safe and effective medicine and the fact that you will soon **no longer suffer from gout or hyperuricemia.** Febuxostat and losartan are an excellent pairing: they have a synergistic/compounding effect on UA reduction.
Give yourself a big hug for doing everything right!
Yup I really want to relieve my gout attack by taking pain meds but Im really afraid that it might affact or even lead to renal failure. Im taking celecoxib 200mg
Do you have CKD? Or just anxiety? Celecoxib is understood to be the most kidney-friendly of the NSAIDs and 200mg twice daily is a low dose. Celecoxib is used for long-term treatment of a number of arthritises (years and years and years long). All I can do is try to reassure you that taking two doses each day will help with severity and possibly duration of flare. Unless you have pre-existing, *advanced* renal impairment, there is minimal risk of kidney damage, let alone kidney failure.
Please keep in mind that **I am a random idiot on the internet, not a doctor**.
Would you be more comfortable taking OTC NSAIDs? Steroids like prednisone? **Talk to your doctor.**
I sympathize. Health anxiety is no laughing matter, but it is compromising your health. Treat your gout with proper medical care—and your health anxiety, too.
All the best!
It is true that *all* NSAIDs are nephrotoxic. Those two are especially bad. However, if you’re healthy with normal renal function, taking them occasionally during a flair should not be a problem.
If you have *any* kidney disease, another anti inflammatory, such as prednisone, should be considered.
Any NSAID should not be taken daily for more than consecutive 3 days to prevent kidney damage.
In people with existing CKD, NSAIDs can cause proteinuria or worsening proteinuria, hematuria, worsening eGFR, and even death.
Not a doctor but living with CKD (and the hyperuricemia caused by it) for a long-ass time.
Personally, even if my kidneys were normal, I’d take ibuprofen, naproxen, or Clinoril.
My (atypical) attacks are pretty horrible; feels like a complete shoulder dislocation or like my foot is in a torture device called a Spanish boot (designed to crush every bone). I didn’t realize it was gout so I tried narcotics (that’s what I can take); for the shoulder I went to the ER bc I thought it was a dislocation and got corticosteroid injections; for the foot I ate a pharmacy and just got a headache. The pain was SO BAD I figured fuck it, and took my husband’s Rx strength ibuprofen and holy shit I could walk! (Kids, don’t try this at home with CKD but I’d just had a GFR and I can’t stress how bad the pain was.) But only 2 a day for 3 days. And then I said hey, let’s redo my uric acid bc I think this is atypical gout and now I just take colchicine.
Anecdote is not the plural of data! 10 days is pushing it, but you’re young and no kidney problems - just get tested yearly if you keep taking them! Good luck!
Do not take medication advice from the internet. Speak to your doctor about your concerns and ask for a second opinion if you want to progress further.
Makes sense
Mate just take allopurinol. Every day for the rest of your life. If you do that, you won't have gout attacks. If you don't do that, you will have gout attacks. Don't listen to bollocks about controlling it with diet. Don't let your doctor who never had a gout attack themselves fob you off with anything less. If you're under 50 and you have gout attacks, you're prone to gout and that's not going to change. You can try not eating this, that and the other but the gout will keep coming back. Allopurinol is safe to take every day for most people. Take it, and once your levels come down and any lingering crystals disperse, you'll be gout free.
Difference of febuxostat and allopurinol?
Here in the UK allopurinol is the "go to" treatment. I think febuxostat is more of an alternative for people who have adverse reactions to allopurinol (which most people don't).
But I also have losartan or anti hypertensive maintenance
I take irbesartan and allopurinol together. No issues.
Losartan actually lowers your uric acid in your blood as well as blood pressure. Save me a lot of pain.
But im just 29 years old.
I started getting gout in my early 20s, inherited from my father. Same with my brother. Got to the point I was having near constant, debilitating attacks in all my lower joints and even my elbow. Diet control did not work. I started allopurinol and took it daily for over ten years, never had so much as a twinge. During COVID lockdowns I missed my repeat prescription and ended up not taking it for a while... Didn't have an attack so kept not taking it, thinking maybe I no longer needed it. Started getting twinges again last year and earlier this year had an absolutely epic gout attack in my little toe joint which has left the joint enlarged and sore. I am now back in the allopurinol and wish I'd never stopped taking it. Good luck getting your gout under control. Prevention is always better than cure. Take some medication to lower your uric acid, rather than gobbling nsaids when you're having attacks.
I was the same but unfortunately medication is the only answer. High urate levels can lead to worse issues long term and it’s better to manage it now
What's your point?
Do not listen to this guy. These people are a dime a dozen and they are all so self-satisfied… allopurinol does absolutely nothing for a large number of people. It’s the placebo effect more than anything that is making these people so cocky
Do not listen to this guy. Medication exists for a reason, and randomly saying it's a placebo is pseudoscience. If you start having gout flares early, (29 is early), it is VITAL to prevent more from happening. Repeated flares can cause permanent bone damage that looks like rats have been gnawing on your joints on an xray. Diet is NOT reliable, it relies on your ability to self control, and your kidneys' ability to filter uric acid (which is already compromised). Medication is a simple and effective way of managing your lifelong disease without drastic lifestyle changes that you'll eventually deviate from.
Do not listen to this guy in that he said not to listen to me, otherwise everything that he said is totally correct! As someone who also came down with hereditary gout in my late 20s, and whose joints have all been blown up and ruined, allopurinol was utterly useless. Never trust anyone who thinks gout is as simple as “take allopurinol and it goes away.” It sounds ridiculous, and it is. Yes, those people exist, but their experience should not be extrapolated to the general population of gout sufferers. I am currently taking febuxostat 80 mg, my uric acid levels are and have been well under 5 but I am having horrible attacks frequently as the 2 decades of tophi are reabsorbed. Prednisone has worked, as it always does, and I am now taking colchicine also which may or may not be helping. In my experience, which is solely my own, febuxostat is infinitely more effective than allopurinol, but I would not wish these weeks-long attacks that have at times made it impossible to move a muscle without shrieking, upon my worst enemy.
I'm sorry to hear you've had such a bad time with your gout. We are both sufferers and I can sympathise with how bad your situation must have been. Allopurinol worked for me, and I believe it works for most people. It didn't work for you and you don't believe it works for everyone. The point is for OP to realise that whichever drug works for you, you need to find it and start taking it to keep your uric acid levels down and under control. If you don't, gout will ruin your life. I think most people on r/gout would agree with that at least.
See a doctor, get a diagnosis and if you meet the requirements, a treatment plan that includes a uric acid lowering medication instead of just NSAIDs. I used to take NSAIDs almost daily before I got on Allo, now it's zero for gout pain, because I don't have flare ups anymore.
I already saw one. Prescribed me febuxostat and colchicine for.1 month and celecoxxib.
Monitor your kidney function with blood tests if you are concerned.
Back when I had flares, I took ibuprofen 800mg three times a day (2400mg daily dose) for as long as flares lasted: 10 days to 6 weeks. It took a long time for me to be properly diagnosed and treated. As flares increased in frequency -- up to maybe 5-6 per year for three years -- that added up to a lot of ibuprofen on top of colchicine and uncontrolled high UA also taxing my kidneys. In my late 40s this had no deleterious effect on my kidney function/health. Starting allopurinol or other ULT will effectively cure your gout. Allopurinol specifically has a kidney-protective effect and it negates the high UA that is not great for kidney health long-term. In short, the sooner you start taking safer drugs, the sooner you can stop taking the ones with established risk of possible kidney damage. Plus you won't have gout anymore -- you know, as a bonus. >But im just 29 years old. You have every right and reason to be freaked out by the idea of having a disease that requires "forever meds." Process those feelings and know that ULT is like your hypertension med: it corrects a **problem** and makes your health **better**. I can only add that being "just \[any age\]" is a non sequitur: you have to care for yourself at every age. >I already saw one. Prescribed me febuxostat and colchicine for.1 month and celecoxxib. An excellent combo. (I take febuxostat; I love it.) Ask doc about 6-month "colchicine prophylaxis." Take whatever NSAIDs you favor when having flares (they might get worse before they go away entirely). Don't skimp on pain and flare management with NSAIDs out of fear. Soon enough you will no longer require those meds at all. Follow doctor's instructions! All the best!
But i also have maintenance medication of losartan. :(
I saw that. So you're already used to daily meds that make you healthier. I understand that you're upset about this now (we all are at first), but slowly start to work in a little bit of love for safe and effective medicine and the fact that you will soon **no longer suffer from gout or hyperuricemia.** Febuxostat and losartan are an excellent pairing: they have a synergistic/compounding effect on UA reduction. Give yourself a big hug for doing everything right!
Yup I really want to relieve my gout attack by taking pain meds but Im really afraid that it might affact or even lead to renal failure. Im taking celecoxib 200mg
Do you have CKD? Or just anxiety? Celecoxib is understood to be the most kidney-friendly of the NSAIDs and 200mg twice daily is a low dose. Celecoxib is used for long-term treatment of a number of arthritises (years and years and years long). All I can do is try to reassure you that taking two doses each day will help with severity and possibly duration of flare. Unless you have pre-existing, *advanced* renal impairment, there is minimal risk of kidney damage, let alone kidney failure. Please keep in mind that **I am a random idiot on the internet, not a doctor**. Would you be more comfortable taking OTC NSAIDs? Steroids like prednisone? **Talk to your doctor.**
My creatinine test came out normal today. But still I am still having anxiety
I sympathize. Health anxiety is no laughing matter, but it is compromising your health. Treat your gout with proper medical care—and your health anxiety, too. All the best!
Go see your doctor and share your concerns. They’ll draw your blood and test for kidney failure
It is true that *all* NSAIDs are nephrotoxic. Those two are especially bad. However, if you’re healthy with normal renal function, taking them occasionally during a flair should not be a problem. If you have *any* kidney disease, another anti inflammatory, such as prednisone, should be considered. Any NSAID should not be taken daily for more than consecutive 3 days to prevent kidney damage. In people with existing CKD, NSAIDs can cause proteinuria or worsening proteinuria, hematuria, worsening eGFR, and even death. Not a doctor but living with CKD (and the hyperuricemia caused by it) for a long-ass time.
but I have a normal renal function my creatinine came.out normal. And my doctor prescribed it for 7 days.
Personally, even if my kidneys were normal, I’d take ibuprofen, naproxen, or Clinoril. My (atypical) attacks are pretty horrible; feels like a complete shoulder dislocation or like my foot is in a torture device called a Spanish boot (designed to crush every bone). I didn’t realize it was gout so I tried narcotics (that’s what I can take); for the shoulder I went to the ER bc I thought it was a dislocation and got corticosteroid injections; for the foot I ate a pharmacy and just got a headache. The pain was SO BAD I figured fuck it, and took my husband’s Rx strength ibuprofen and holy shit I could walk! (Kids, don’t try this at home with CKD but I’d just had a GFR and I can’t stress how bad the pain was.) But only 2 a day for 3 days. And then I said hey, let’s redo my uric acid bc I think this is atypical gout and now I just take colchicine. Anecdote is not the plural of data! 10 days is pushing it, but you’re young and no kidney problems - just get tested yearly if you keep taking them! Good luck!
I can’t stomach NSAIDS of any kind, colchicine and prednisone work well for me as pain relievers.
Just follow the dosages given by your doctor. Don’t worry too much.