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To be more specific I go Gym from 6 to 8pm > come home and straight away eat dinner > take Allop when dinner is about to end > then go to bed. So technically I am kind of dampning the food + Gym + slepp related spike. I also dink two glasses of water with the food. Then another glass fo water before I sleep.
Thanks for the link GP.
“ A gouty arthritis is less likely and would be of an early phase.”
That to me just means that he is guessing that it is not Gout and if it is Gout then it is at a very early stage so can't be visually pinned on scans yet. For your sake I hope you don't have anything but does not seem very consclusive to me.
“bony irregularity along the medial aspect of the first metatarsophalangeal joint. These findings could be result of degenerative joint disease.”
Again could be result of standard arthritis or Gouty one. Bottom line is that something seems to be causing joint wear. You coudl always come off AlloP and see what happens in next few years
Or you can come off it drink lot of beer and eat tons of sea food to get a quick answer.Any chance of putting the scans (MRI/xray) up? Would love to look at them and compare with mine. I just have X-rays though. My next appointment with a good Rhumatologist is 1 month away so I might ask him for MRI scan too.
GoutPal said:
Gout pain is not caused by “sharp” or “needle-like” crystals stimulating nerve responses. It is caused by an immune reaction. Just like a virus, your white blood cells (WBC) attack microscopic uric acid crystals. As they are trying to kill the crystals, they send out messages for more reinforcements. The combination of message signals and fighting WBCs is what gives gout its exquisite pain. At least with flu, there is some respite as the virus cells are killed, but gout continues until sufficient WBCs have isolated all the uric acid crystals.
This leaves clusters of protein-wrapped uric acid crystals of varying sizes. Most times, the lower uric acid concentration encourages crystals to dissolve unnoticed. However, a larger cluster might not get chance to dissolve between the protein coating falling off, and the immune system recognizing its old enemy.
.
GP nice description. Almost like a great battle scene
Jess,
1+ month on AlloP and did not feel any dizziness but lot of doziness
Some eye/headache type of pain but not sure if it was even related as it had started one day before my first AlloP.So all in all I would say my body is handling AlloP quiet well (fingers crossed). Only thing I notice is slight tiredness. Something I can live with if it means healthy joints and long active life.
trev said:
The cruciferous vegs have a bad name- a shame, as Broccolli is called a wonder food for its vitamin content. I keep these down in amount & freq -but not banned completely. I would not risk much asparagus, as it has too much a bad reputatiion and not something I normally eat- though i like it, of course!
I think in these cases the actual chemical content of the food is the culprit (naturally enough) and therefore have to be treated as potential triggers, even if they don't add much urate from content. [Research backs this view]
What do you make of this?
Consumption of purine-rich foods. A 2004 study showed that higher consumption of purine-rich foods such as meat and seafood was associated with a significantly increased risk of gout. However, purine-rich vegetables did not increase gout risk. Interestingly, the same study showed that consumption of dairy products had a protective effect against gout. A 2005 study confirmed these results and found that total protein intake was not associated with increased uric acid levels
zip2play said:
Post edited 1:23 pm – March 21, 2010 by zip2play
Very few people can control their uric acid and thus their gout with diet.
Back before the drugs, gout was often a slow death sentence.
Again I agree with you. The amount of Gout people I am bumping online who keep saying that they are “completely cured” is unbelievable. These people are not on any SUA lowering meds but think they are cured. They have absolutely no idea what their SUA readings are either.
originallyyours said:
they wouldnt share with me my uric levels
What the…..
Why won't they share it? I also think that you might have somethig else but I do know another girl in her 20s who has Gout too. She is not overweight and infact slim. So all is possible. Have X-rays been taken? Get triple opinion as lot of Docs are useless.
steven-johnson syndrome is very rare from my understanding. It scares me too. I have been on AlloP for 1 month and apart from feeling tired I seem to be doing ok.
Can steven-johnson syndrome occur anytime or is it mainly at the start?
That said some people have peanut allergy but that does not mean that the whole world stays away from peanuts. So AlloP can be your best friend if you don't react negatively to it.
Welcome to Gout paradise
I am 36 too. Have been vegetarian for almost a decade and almost never drank alcohol in those years. I am in top physical condition but still got hit by Gout thanks to hereditary reasons. Life can be so unfair!Btw the SUA measuring kit works quiet well once you get the hang of it (the one from UK atleast).
No expert but did you say that movement in the toe joint has gone away permanently? I assume it was due to Gout related damage? So in essence the Doc would be sawing off your non performing joint and performing a permanent bone fusion?
> My question is whether the allopurinol is likely to melt the tophi away in time
In time for what?
I am not sure if few months of AlloP will get rid of it very quickly. If you are not in pain then maybe give AlloP a try. If pain increases then you can take up the OP option.The Gout veterans here will soon chime in. Good luck and wishing you a speedy recovery.
Once I start going gym again and re stock on my SUA testing strips then I will clearly mark my reading accordingly (in my Allop diary thread 2nd post). I am very interested to see how my readings behave when I do gym on AlloP.
When not on AlloP I remember seeing readings of 13+ straight after gym and also next morning.
Charles 23 said:
I'd just like to know what ages most of you were diagnosed or even suspected you first had gout. Whether or not gout had affected 1 or more family members. I still have not run into anyone who suffers from gout and is under the age of 30. Am I alone in thinking it's hereditary?
My father and grandfather on mum's side. I have suspected Gout but not confirmed yet. I am in my mid 30s. Very fit (I don't know how much longer though) and have an extremely healthy diet. In my case if it turns out to be Gout then it's 100% hereditary as I am a perfect non Gout canidate because of my lifestyle. The irony of it all makes me wanna cry 🙂
From my non professional understanding the answer would be NO! You can keep it in check but not cure yourself of it.
paulevans said:
when I went back to the docs on Tuesday, she said my acid levels were slightly high, then gave me the talk about the comitment of going on Allopurinol….. I rufused chose not to go on it, I think with my attacks having been better in the last year that weight loss and better diet will help more, I dont think I'm bad enough for the stuff, besides I want cure rather than a course of tablets for the rest of my life
Good luck. I sincerely hope that you don't end up with shot out joints down the road. It seems like you are heading down that road to me.
Only for your knowledge I am a very fit 36 year old guy who does not touch alcohol and has been eating very healthy veg diet for last 10 years. It has had ZERO effect on my high UA readings. I know we are all different but if I was in your shoes with confirmed mulitple Gout attacks then I would go on AlloP straigth away.
trev said:
I never realised you had such high steady UA readings, VG!
Have you kept that quiet , or I have I just missed it?
Yeah you missed it
I have been drumming it into each and every “specialist” that my UA readings are high and that there is family history of Gout on mother and father's side. They all brushed it aside and said that you 100% don't have Gout. None of them were willing to test my joint fluid either. They said my UV readings were nothign to worry about.ER Doc (female Doc) is the first doc who atleast acknowledged the possibility of it being Gout and handed me Alluprinaol prescription to try out. She is not fully convinced about the cause yet. She was assistant Doc and left the room to consult senior Rhumatologist. Would have been easier if the senior Doc just came into the room! Anyway he probably is the one who gave her the OK for handing me Alluprinol.
> Where DO you get yours from normally? Protein , that is…
Tofu, Lentils, Beans, Nuts, Chick peas, Broccoli…..etc etc
>Anyways- if you are soon starting AP you will find out more as it kicks in hopefully. It will be interesting to see >whether you escape further flares now you are over the worst of the last attack.
Yes I wonder what will happen when I start Alluprinol or how many crystals I have built up in last one or more years. More importantly how much easily preventable damage might have occured to my bone joints!!!!!!
When I had done blood test at my GP's in 2007 as part of general check up he said my blood tests were normal.In 2009 when this problem started I asked for copy of all my blood tests from the past. That is when I discovered that in 2007 my UV readings were already over 7mg/dl. Right next to the reading on the same sheet is clearly labeled the normal range for various blood tests. How the hell did my GP say that everything was normal back then is beyond me. Even a school kid could compare the readings.
So advice to everyone that even if you have no health problems and if you do general blood check up then do ask your Doc for a copy and research yourself if the readings are truly ok.
trev said:
If I pulled a name out of the hat for your description VegGuy, it would be 'Psuedo'gout – though it usually attacks in the knees.
Have you had your Calcium levels checked?
Don't think my calcium levels were ever checked. Unless the ER Doc is testing that too. She has my blood currently. Do you mean calcium in blood or in bones? Not really clued up on calcium side of things or how the readings are taken. I will Google it up. I do understand 'Psuedo'gout though. I don't know how relevant it is but I have hardly eaten dairy stuff in years. Some cottage cheese once in a while only.
VERY VERY INTERESTING DEVELOPMENT-
I just woke up and decided to check my blood uric acid levels. Guess what? I thought I was dreaming when I saw the reading so I re did the test. Holy batman they were in 5.6mg/dL range. What is so special about that reading you might ask. Well in 40+ readings that I have taken over last one year (including the ones at the GP's place and one single reading from 2007) I have never got a reading below 7.13mg/dL (7.13mg/dL was my lowest ever until today). My average readings have always been in 7.5 to 10mg/dL range!!!!!!
My conclusion? —> As we know that during a Gout attack the blood uric acid reading drops so the case for what I had one day ago being a Gout attack strengthens. Do you see any merit in my thinking or am I wrong?
P.S- No I have not started taking Alluprinol yet. I will start it on 13th so the above reading is without Alluprinol.
P.S 2- One day before the attack it was 7.3.
Utubelite said:
Hi vegetarianGuy,
I will write more details soon. Just going to attend an urgent meeting.
Do not worry 🙂
Ok after another 6 hours of sleep the difference in pain is like night and day. I can press areas which I could not even touch earlier today.So Ibuprofen did it's work by the looks of it. My foot is still puffy but not as much as before. I am not sure if the pain has actually gone or the pain killer is masking it. Can a Gout attack calm down within 12 hours? Or does this calming down point away from Gout?
trev said:
Post edited 12:10 pm – February 8, 2010 by trev
However, your pic is a beaut for a gout book-
It's a beauty ain't it?
I was starting to lose credibility round here. I bet you guys were starting to think that I was moaning too much and dreaming up the pain LOL Well the volcano burst and I am covered in hot lava for all to see.So I went to ER today as I was not able to walk. Lady Doc was not sure what was causing this. She thinks it could still very well be non Gout related.She thinks that Gout attacks come and go suddenly and 10 months of non stop pain sounds rather strange and not typical Gout modus operandi.
She remarked that my left foot was hot to the touch. She will be ordering reports from all the specialists I visited to form a fuller picture. She took my blood to conduct various tests. She gave me Ibofrofen 400mg tablets for next 3-4 days. After which I am supposed to take 300mg Alluprinol dose for a month to see what effect that has on my readings. She said that if Alluprinol works then we know it is Gout. If not then we know it is non gout related. She will be calling me next week. She did seem clued up on the whole.
Anyway the pain is flattening me. Walking is impossible. I went to ER by taxi but came back by public transport as I had to pick up Alluprinol from pharmacy. Big mistake as the trip home was torture and comical. I am really drained so I am hitting the bed.
P.S- Can only one month of Alluprinol 300mg use show noticeable reduction in blood uric acid levels? I mean enough to judge Gout as the cause?
Following from my last night post……
……I have absolutely clear photographic evidence now. Left foot is lot swollen and definitely red in colour with dash of blue. It is also warmer to the touch compared to right foot.The cross marks show where I have hardcore pain. I cannot put my body weight on the X mark. Absolutely not as it hurts badly. This is completely new and higher level of pain compared to last 10-11 months.
What do you guys think?
NEW DEVELOPMENT!!!
7th Feb Sunday– I was working through the night on my computer (which I do quiet often) and noticed around 6am that I was starting to feel bit more pain than usual. It was slightly further up the actual MPJ1 joint and towards the side of my toe. Also similar pain on the ball of my foot. I went to bed and woke up around 3pm. The pain has climbed to completely new level and more interestingly I can't bend my toe anymore. Through out last 1 year I have always had full movement of my toe joint and suddenly overnight I can't bend it. It hurt very much when I try to bend it. Actually I can't bend it even if I try to go past the pain barrier. It's as if the tendons have been cut and I have lost control of all the bending functions.
The ball of my left foot looks swollen and slightly reddish. The Orthopedist that I last visited said that I have “Big toes arthritis”. The pain is away from the MPJ1 now so I feel quiet confident that as suspected by me that he was talking bull just like all the other “specialists”!
I don't know what to do now or what my next step should be? Who do I see? Do I go back to wise @ss Rheumatologist who were clueless? Am I finally having a proper Gout attack or is it non Gout related? I really don't know who to see now nor what the hell I really have
Utubelite said:
Hi vegetarianGuy,
I have gone through more( and still going through( than 75% of similar stuff that you are going through now.
I will write more details later but only wanted to tell you that though they told me similar arthritis stroy, I have been able to reduce my pain to a large extent and walk much better now.
Waiting for your reply
I will hold on to anything right now for hope and solution. I joined a foot health forum and posted my X-rays there. The doc there thinks just like all the Rhumetologists I visited that my X-rays seem normal. I just feel that Osteopathist saying that I have Arthritis is bull and just guess work.
Yes it seems as if I don't have Gout. Unless I have some hybrid version just bubbling under the radar
Online a Doc said that maybe Bursitis could be the reason. I have looked into it's symptoms and does not look like it is that. I have taken online symptom quiz for Gout, Arthritis, bursitis etc etc and they all come to only 20-30% chance. Wtf do I have? (don't expect an answer just shouting out)
This is what doctor at the X-ray place wrote about my big toe-
“Inconspicuous bony structures without osteolysis or sclerotic changes. No degeneration in the Big metatarsophalangeal joints. Appears normal to the sesamoid. Normal position. No soft tissue swelling”
I found this chart online. Could I be on Stage 1 hence nothing in the X-ray? Although my joint pain is constant and hardly vague. Granted not extreme pain but based on the chart I think something would show up on the X-ray if it was athritis.
haracteristic Findings By Stage Of Hallux Limitus Symptoms External appearance of the joint X-ray findings Treatment Stage 1 Vague joint pain No change evident No changes noted Dancer's pad or sub 1 cut out in an orthotic Stage 2 Increased frequency and duration of pain Mild dorsal exostosis Dorsal exostosis on lateral x-ray Carbon plate with Morton's extension. Possible joint revision. Stage 3 Pain with all activities Large dorsal exostosis Increased dorsal exostosis. Asymmetrical joint space narrowing Youngswick osteotomy with joint revision. Stage 4 Significant pain with any range of motion of the joint Enlargement of the entire joint Flattening of the joint with prolific spurring surrounding the entire joint Joint replacement, fusion or Keller bunionectomy So I went to another specialist that I was referred to. Technical orthopedist section of a hospital. The specialist checked my joint and called the head of the team too. They concluded that it's not Gout but starting of arthritis of the big toe. They took me to ultra sound section as they are testing a technique of using ultrasound to try to see the thickness of cartilage as X-rays don't reveal that.
The ultrasound technician said that he did not see a huge difference between the more painful left toe joint cartilage thickness and the less painful right toe cartilage thickness. The specialist wanted to be present there too so he arrived later. He seemed more interested in the technique than me. So he thinks it is early phase of big toe arthritis.
The ultra sound technical said the difference was simialr to 1.23mm against 1.27mm for example. She was not convinced of any big difference outside the scope of ultra sound error.
Here is the thing-
My Canvas SUPER flexible thin soled shoes cause the least amount of pain when walking.
My Addidas stiffer soled shoe but still able to bend shoe cause the maximum pain when walking.
This confused the doc as stiffer soul normally helps in this case and flexible soul is bad for the joint. His superior came then and explained the reason the Addias hurt more is because they are not stiff enough ie. they still bend and hence put greater force on the joint. Stiff and bendable = more force on the joint. I need shoes that don't bend at all. Stiff as wood to protect the joint. Made kind of sense to me…..I think.
Anyway there is not much they can do now. They have a shoe section inside the hospital and they made me try some stiff shoes. I must say that if I wear my Addidas shoes then within few steps of walking I can feel greater pain. Their super stiff soled shoes did not cause similar pain after taking few steps. I don't know how it will be I wear for longer period though. They were very expensive and the choice was very limited. So I wil be buying similar stiff shoes from mountaineering/hiking/sports type of shop. Completely stiff with rocker effect soul to make walking possible despite the stiffness of the sole.
So there is where I stand currently. If you remember my X-rays were normal according to everyone who had seen them. Althought the X-ray has a comment section where the X-ray department had written everything normal…..very slight irrelevant “bone scelorisis”.
So looks like I don't have Gout. Not sure if it was better to have Gout or this
I definitely have higher blood uric acid levels but all docs have said I should not worry about that 
Ultra sound also revealed that I don't have any build up of fluid in the joint. Which is a good sign with regards to infection or fluid build up that occure in Gout patients. Hence easier to draw the fluid to test from the little joint. For a joint without any extra fluid buid up it is close to impossible to draw liquid for testing. Which different specialists have repeatedly told me.
To conclude I really don't know what to think of last 10 months or what I really have. I will go with big toe arthritis for now I guess and buy the super stiff soled shoe. Hope that helps a bit but looks like I will be going down slippery and painful slope of arthritis if the doc's diagnosis is correct. In my 30s and body already falling apart.
This thread is really long.
>It is amazing. My doctors also tell me the same thing – some mechanical problem, not gout, >though they agree gout was present in the initial stages.
So you have confirmed Gout then? I hope you are getting it treated along with your mechanical problem? I don't even know what the hell is truly wrong with me. I am 100% convinced that I have something more than “just” mechanical problem.
Is your pain roughly constant 24/7?
10 more days to go to my next appointment. Why do I feel that I will never get to the bottom of this unless I put an axe to my foot? Sounds really tempting I must say.
Photos or it did not happen
Least you should do is disinfect the needle before doing such things. I have a tiny lump or cyst accordign to Google in my ear lobe for last few months. Non Gout related I hope and am tempted to stick the needle in and see what if anything comes out.
gigi said:
to vegetarian guy: you say you were taking Berocca supplement which contained B vitamins and niacin among other things. i also was taking a supplement that contained B vitamins and niacin among other things. Isagenix. i had been on this for about a month and a half. could there be a correlation? i also had started a pretty vigorous exercise regimen of pilates 2 x a week, yoga 3 x a week and running 3 x a week.
Well I do take them but not very regularly. There have been long periods when I did not take them and it did not change my toe pain level. My B6 and B12 levels are in the normal range but on the lower level side hence I take Berocca or cheaper multi vitamins sometimes. I have been reading about side effects of Berocca and I don't have other mentioned side effects. Well apart from joint pain (toes only). I don't have pain in any other joints though.
I called the hospital and the next available appointment was in early January so I took it. Wasted money on these shoe inserts and they do jack for me! Maybe they help slightly.
I have been wearing canvas shoes as their soul is thin and very flexible. I can get on with daily activity but if I wear my older Addidas shoes whose soul is thicker then I have problems walking as pain on the toes increases noticeably. It's amazing how shoes I could wear all the time before are almost unusable now.
GP the thing is that I might have slight mechanical issues but I am convinced that it is NOT what is cauing me this pain. Mechanical problem in my opinion should create more pain when I do mechanically intensive things like running in the gym or walking a lot.I just don't see any clear relation between mechanical movement and increase or decrease in pain.
> I suggest a foot specialist rather than back to the rheumatologist.
I will go back to him once more just to give him a chance. All the heavy hitting medical equipment is in the hospital anyway. By the way what do you mean by a foot specialist? Are they more specialized than rheumatologists?
cjeezy said:
Hi Veg,
Any updates on your status/treatment?
Sorry for not replying earlier. I had typed a long post but I lost it thanks to hitting the back button. Then I had PC probems etc etc.
Ok so I finally went to the Rheumatologist at the hospital for my appointment. I was well prepared with timetable of pain, blood readings, X-rays, my lifestyle and possible treatment. Doc was impressed with my thoroughness and smiled. He checked my feet properly. Pushing the bottom of my toe with his palm was a sure way of recreating the pain. Anyway he said that he is very sure that I don't have Gout. He straight away remarked that my feet are bit flat. He also noticed that the gap between my toe and the second finger is large (scroll up to see photos). As a result proportionally he thinks that my feet are bit wide towards the front. On the right foot he found some hardened skin underneath which he said supports his theory. Although it was on the non problem feet. Just for the record left toe main problem foot. Right toe semi problem foot.
He said that there is no way I have Gout. Gout attacks don't last for months on end like I have specially first Gout attack. Chronic Gout later on could give constant pain. In my case he thinks it's not Gout so question of Chronic gout does not even arise. He thinks it's mechanical problem and a shoe insert would take care after 2-3 months of use.
He then called the head Rheumatologist who checked me and concluded the same thing. I asked him about my high blood uric acid reading. And the head Rhumetologist said that if I had gout then those readings would be cause for worry. As what I have is in no way gout so those readings are not relevant. He said relation between blood uric acid and Gout is very complicated and not straightforward as some would liek to make it out. In my case it does not matter anyway as what I have is not a Gout attack.
Long story short I then went to have my feet measured and scanned to get a shoe insert made. I have been wearing an insert in my shoe for last 2+ months but I have not noticed any consistent change. First week felt bit better but afterwards it was same as always. It's coming to 9-10 months since I first noticed the pain and since then I have constant mid level pain
I will be making another appointment and going back to the hospital to say that the foot insert did not solve the problem. He did say wear it for 3months. Thing is I am not noticing any real difference after 2 months so I doubt it will change suddenly.So to recap-
– In total 3 Rheutatologists have seen my feet. The two at the hospital and the one I went to see privately.
– All three say that my feet are wide at the front and slightly flat.
– All three say I don't have Gout irrespective of my above normal uric blood acid readings
– All three refused to have my joint fluid taken because they say there is no Gout like swelling to extract anything from. “You don't have gout”.
– I have been eating tons of Beans, Mushrooms, peas and it makes no difference to my toe pain. The sucker is there all the time constantly at 5 out of 10 pain level.
– I go gym regularly and that does not increase or decrease my pain either.
– Unlike typical Gout sufferers pain has never been so great that I could not squeeze my toe (all of last 9 months)
– No extra pain in the morning or night like some Gout people mention.I am completely LOST and depressed about the whole issue!!!!!! I try to blank it out but having constant mid level burning type of pain sensation for last 9 months 24/7 on both toes is hard to ignore
At this moment I have no clue what I have. I thought the shoe insert would be the answer but so far it has failed.
