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Is this gout?

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    • #9102


      I’ve had what I believe is my first gout attack. But my doctor wasn’t sure it was gout and my Uric acid levels sound high but not clearly over the normal range.

      The weird thing that kept my dr from thinking it was gout was that my toe wasn’t swollen constantly but my ankle was (pain started all in big toe area). I am relatively healthy and active, and don’t eat a lot of high Uric acid foods or drink alcohol. There are times where it feels not as bad when I’m laying down, but when I stand up the blood seems to rush to the foot and it’s super painful. Is that a normal symptom? Is it typical for the entire foot to swell not just the impacted joint? If so it is strange to me that elevation and icing are recommended even when they cause more pain.

      Thanks for any help you can provide or for letting me know if this sounds like normal experiences of gout 🙂

      If your doctor doesn’t know what gout is, it’s best to consult a rheumatologist.

    • #9103

      Keep in mind you can have gout as well as something else at the same time. If something reduced the blood flow to your toe for instance, that would increase the odds of a gout attack.
      While ankle pain isn’t the most common symptom of gout, I think it’s still pretty common. The whole foot being swollen while the toe isn’t constantly swollen on the other hand, that might be less common.
      Icing is somewhat problematic but elevation should work provided you are resting your foot when it’s elevated and not relying on your muscles to hold its position.
      All in all, I’d say the signs of gout aren’t very clear for the time being.
      An ultrasound and joint fluid test (easier said than done!) might provide more information and possibly a definitive diagnosis. But your doctor may prefer to simply wait for more symptoms. Just don’t keep waiting if similar symptoms occur time and time again!

      One thing you should definitely take control over is your uric acid testing:
      a) the “normal range” (whatever your doctor means by that) is irrelevant and you need to know your actual test result (number and unit both!)
      b) you need to get your uric acid tested again after the symptoms have gone away completely (or in a few weeks if they persist), and if you haven’t been tested regularly so far you need to schedule yet another test in a few months regardless of the result (after that, a yearly test might be sufficient if you aren’t overwhelmed by gout-like symptoms)
      Uric acid testing is cheap and easy so don’t allow yourself to be short-changed by poor medical habits or the inability of your doctor to make use the results! It’s not your last uric acid test result which matters but your uric acid history so start documenting it even if you aren’t seeing a knowledgeable doctor right now.

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