Taking Allopurinol but Uric Acid levels going up again!

[lawlorbr]

Hi All, Firstly let me say how relieved i was to find this website. i have learned so much about this condition from here. So thanks GoutPal and co. – without this site I think I would still be stumbling around in the dark with a blindfold on wondering whats happening to me!. Have Gout 5 months now, im 40. started on allopurinol 2 weeks ago and at first it seemed to be working 100mg for first week took uric acid levels down to an average of 5 from an average of 8. next week on 200mg I was down to an average of 4. However 2 days ago towards the end of the 2nd week it has shot up to an average of 6.5 .. and whats worse Gouts back. I have just started on the 3rd week AP and dose raised to 300mg. -One thing to note I started 12hr  night shifts 4 days ago which seems to have concided with the rise in uric acid levels- working 12 or 13 hrs sitting at a desk could this somehow be the cause of the rise?. Im am using a kernal meter to measure my uric. I have taken 100+ readings over the last 4 weeks. both before AP when I was trying to lower uric levels with diet alone ..(no luck there!). and after. I have graphed the whole thing and will post later. Anyway guys what do you think – is my sudden rise in Uric acid levels while on AP unusual? One other thing I drank copious amounts of alcohol 3 or 4 days before the rise in Uric – could that be the cause even though there was a 4 day gap to the rise in uric? It was my gout free Dads 70th birthday party that led to the copiousness of the alcohol consumption

[davidk]

are you drinking lots of water?  as I understand it alcohol is a diuretic, so you may be getting dehydrated which will cause UA to go up.

[lawlorbr]

I Guess It could be the alcohol  – It was 2 or 3 days after the drinking that my ankle started to swell though and my uric acid levels were averiging 3.5 until the attack started in earnest  – 3 days after.

I have managed to graph my uric acid measurements over the last month before AP, and during my gradual introduction 100mg one week 200mg 2nd week and 300mg  -just started on that.

here are the results – It looked as if all was going to plan until  the last few days!

[trev]

Hi Law- I'm going to be boring and say if you take a med (which will have side effects, even if unseen) and drink alcohol overmuch (which is a poison to the body, though I like a drop too), then you can't expect to get away with it, this early on anyway!

Thanks for the graph, very instructive- shows that you had almost as low levels of SUA before you started treatment.

I can't quite tally the lower red line with your Gout pain numbers though…

My main comment would be ( a personal view) that it takes many years for gout to develop – it's not going to give up easily ,especially if you don't work with the treatment and add other defensive measure in too!

Bear with it a bit longer- and please do keep the charts flowing!

Note also , that the absolute level of SUA is not a direct indication of the likelihood of an attack (or not)- as it's the urate in the joint areas that predispose to these.

[lawlorbr]

Hi Trev , Thanks for the reply, appreciate your insights, certainly am finding it difficult to cut back on the booze. On the plus side i have cut out meat and fish entirely, reduced cheese and egg intake.  I still have a few drinks at the weekend   -not normally as many as last weekend though!

Currently my UA levels are fluctuating between 5 and 6 – and im now on 300mg of AP. I was down to between 3 and 4 (holy grail of UA) for a few days the week before last- at the time I was on 200mg AP.  – im not really doing that much differently either  -although I got no exersize all through last week. Was working 12 hr nights.

-So back to long walks this week no alcohol and the 300mg AP – should hopefully get mu UA levels down again. At the mo im only having gouty twinges in my toes so not so bad.

Thanks again for the advice.

[zip2play]

Law,

What if anything is the significance of the abscissa numbers that go to 202. At first I thought those were days but your inital post says no to that.

You must have dropped a FORTUNE on test strips.

The most startling effect was the U-shaped uric acid swing on your 200 mg. period coinciding with the incidence of a bad attack. Probably casued by a burst of urate that had been quietly stored somewhere.

I really prefer people starting right on 300 mg. allopurinol; that 100-200-300 progression often seems to cause attacks that might have been avoided.

Your last attack seems to show as a lie the theory that uric acid drops precipitously when an attack starts…yours soared coincident with the attack.

Thanks for the hands on (or feet-on) research. There's no substitute for our own facts.

[Author]

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