Help Gout Treatment

Question:

- Hide quoted text — Show quoted text – For the past six months I have been on Allopurinol and Indocine to control gout. While my uric acid blood levels are now in the normal range, it seems I still have an excess of uric acid distillate stored in both feet. Whenever I try to stop taking the 100 mg of Indocine per day for a couple of days, I end up with a general ache in both feet which makes even walking extremely difficult. Does anyone know of a drug treatment or flush that effectively rids the body of excess uric acid? The Allopurinol is effectively controlling excess production but my MD says it won’t get rid of the build up already in my system. You need colchicine. Allopurinol is useful in preventing a reccurance of an acute attack of gout but you need colchicine to treat an acute attack. By inhibiting the inflammatory process, and inturn decreasing the amount of lactic acid produced locally, colchicine causes the dissolution of the urate crystals that are causing you pain. You’ll be waiting a long time for allopurinol to do that. Michael Smar

you can also try probenecid to reduce uric acid – Hide quoted text — Show quoted text –

Response:

Since this is misc.health.alternative, I suppose you might want an alternative approach. I too suffer from gout. A) During acute attacks, try cherries. Yup, cherries. The deep red pigments contain flavonoids which help with the acute inflammation. I’ve had relief from using cherry concentrate which can be found in many health food stores. B) To help reduce uric acid buildup in your tissues, I have found burdock to be very helpful. I use compound tincture of burdock/yucca, 1:1, 40-50 drops, 2-3 times daily. It will take many weeks to months for significant gouty tophi to dissolve. Celery is also helpful, but you cannot eat enough to do much good. Make sure you drink copious amounts of water and other clear fluids (a gallon daily is pretty good). All of the above assumes generally good health aside from the gout. BTW, you should be aware that indomethacin can cause severe gastrointestinal irritation, blood disorders and depression in some individuals. If you can get off it, do so ASAP, at least switch to a less harsh NSAID. Also, if you do use probenecid it will stuff all the uric acid through your kidneys. You must make sure that you have good healthy kidneys and that you are allways very well hydrated (may your pee always be clear!) Good luck, Gary – Hide quoted text — Show quoted text – writes: writes: For the past six months I have been on Allopurinol and Indocine to control gout. While my uric acid blood levels are now in the normal range, it seems I still have an excess of uric acid distillate stored in both feet. Whenever I try to stop taking the 100 mg of Indocine per day for a couple of days, I end up with a general ache in both feet which makes even walking extremely difficult. Does anyone know of a drug treatment or flush that effectively rids the body of excess uric acid? The Allopurinol is effectively controlling excess production but my MD says it won’t get rid of the build up already in my system. You need colchicine. Allopurinol is useful in preventing a reccurance of an acute attack of gout but you need colchicine to treat an acute attack… you can also try probenecid to reduce uric acid

Response:

j RGDoes anyone know of a drug treatment or flush that effectively rids the body RGexcess uric acid? The Allopurinol is effectively controlling excess product RGbut RGmy MD says it won’t get rid of the build up already in my system. See th advice on Stones and Crystals in my post called Diet and Supplement Tips. turf

Just tonight on WOR I heard Dr Adkins give a "Protocol" for gout to keep off’n the allopurinol. 5 to 10 mgs folic acid (Minimum) 4 grams Vit C 2 Grams Cystine The Cystine is a new one on me. I have been taking 5 grams X 2 a day, for over a year, and no reoccurance. PS:: a protocol is a misnomer in alternative medicine. protocol implys it works the the same for all people. This you can try, and it either works for you or doesn’t. — TW Morey | If you can’t love your enemies, Flanders, NJ | at least be kind to your friends. |

Response:

2 litres of water a day will help get rid of the uric acid crystals add to that pure unprocessed apple cider vinegar 2 – 10 tsp daily (as your taste will allow), this also helps the body get rid of excess uric acid. Otherwise, the homempathic remedy Colchicum may be of use. My husband has found that by not overindulging in protein and taking apple cider vinegar, daily at first now one dose weekly, he is gout free. Its worth a try… Joan

Response:

Ahhh!! A discussion, exactly what I needed!! 6 months? He didn’t say he hadn’t had an attack in six months, did he?

He said he has been treated for gout for the last six months and every time he stopped taking the indomethacin, he got the pain back within a couple of days. That sounds like six months to me….or maybe I am reading it wrong. If he has pain, indicating the presence of crystal formation, he has an acute attack of gout (or some other underlying disease).

Agree. He doesn’t say whether he was treated for an acute attack, which of course must occur for the patient to be diagnosed as having gout. From his statements it would appear his doctor is treating an acute attack with a drug used to prevent acute attacks, not relieve them.

Yes, he is being treated with allopurinol, but from the post, it would sound like he had the acute attack 6 months ago, was started on the indomethacin (used to manage acute attacks as I recall), and further down the track the allopurinol (to prevent future attacks). Formation of the crystals is acute. This can be treated with colchicine, because the colchicine will alter the inflammatory response, which in turn allows the crytsals to dissolve (tissue microenvironmental pH will return to normal {increase}, increasing the solubility of the uric acid).

Yup, this is only one of the other million or so theories on how colchicine works, don’t think anybody REALLY knows do they? Pain in the joints, indicating crystal formation, is an acute attack!

Yup, agree with you again. Not disagreeing with the pathophysiology of gout!! So your answer is… Take the Indocin to releive the pain, wait a few years for the crystals to dissolve (maybe) and in the mean time treat recurrent gastic/peptic ulcers caused by the Indocin? Polypharmacy at its finest.

Umm….so what exactly was your answer?? The risk of peptic ulcers is rather low with the NSAIDs and using your own example, one could also argue that after giving the guy colchicine (at what dose and for how long?), he may get the gastrointestinal cramps, diarrhoea, peripheral neuritis and haematological effects. And then we will give him some hyoscine/atropine for his cramps, some loperamide (atropine/diphenoxylate) for his diarrhoea and out of hysteria give him some pyridoxine in the hope of improving his neuritis?? This too is polypharmacy?? Just as a side issue, just how effective is colchicine in "dissolving" those crystals? Compared with allopurinol/probenecid…given the edu bit in your e-mail address I assume you are an academic or something and would have some info on this! Overall, I do agree with you, but this case does go to show that there are multiple assumptions that are being made. Most of all, we have assumed that it is gout…what if it isn’t?? What if he is getting multiple acute attacks which have nothing to do with stopping the indomethacin just coincidence? etc, etc. Nonetheless this is a very interesting discussion. I look forward to your reply. Cheers, Dave

Response:

According to Clarke’s dictonary of practical materia medica, potentised Colchicum is used for gout along with other things. The symptoms that would require this remedy, according to clarke are: ‘ "Tearings in the feet, the legs and the toes,. Hot odemetaous swelling of the legs with acute pains duringmovement. Tingling of the toes as if they had been frozen" Of course there are other remedies which prescribed in accordance with the law of similars, will work eqully well. I am happy to provide more info if needed. Joan

Response:

WHAT??? He hasn’t got an acute attack (6 months does not seem "acute")! He has chronic tophi. Colchicine does not have an effect on that as I recall!

6 months? He didn’t say he hadn’t had an attack in six months, did he? If he has pain, indicating the presence of crystal formation, he has an acute attack of gout (or some other underlying disease). He doesn’t say whether he was treated for an acute attack, which of course must occur for the patient to be diagnosed as having gout. From his statements it would appear his doctor is treating an acute attack with a drug used to prevent acute attacks, not relieve them. Formation of the crystals is acute. This can be treated with colchicine, because the colchicine will alter the inflammatory response, which in turn allows the crytsals to dissolve (tissue microenvironmental pH will return to normal {increase}, increasing the solubility of the uric acid). NB, HE SAID HIS DR. TOLD HIM HE HAD AN EXCESS OF URIC ACID DISTILLATE [crystalls] (geez, hold old is this Dr.?) STORED IN BOTH FEET. THIS IS THE CAUSE OF AN ACUTE ATTACK OF GOUT. The chronic part of gout is not crytal formation. The chronic part is the over-production/under-excretion of uric acid. Pain in the joints, indicating crystal formation, is an acute attack! Besides…colchicine is a rather nasty drug, and long term use has it’s own consequences….probably worse than taking indomethacin and/or allopurinol!

That’s certainly true, which is why colchicine isn’t indicated for the chronic treatment of gout, the goal of which is to prevent future crystal formation, inflammation and pain. Indocmethacin not without its problems either. If used properly, colchicine isn’t any more likely to cause untoward effects than a number of other drugs. From the statements of the original poster, it would appear that the Indocin is relieving the pain caused by the inflammation caused by the crystals of uric acid but it’s not treating the underlying cause of the pain, i.e., uric acid crystals in the joints. Given time (albeit a very long time) allopurinol may reduce the presence of the tophi…but unfortunately there ain’t much to do in the short term! : )

So your answer is… Take the Indocin to releive the pain, wait a few years for the crystals to dissolve (maybe) and in the mean time treat recurrent gastic/peptic ulcers caused by the Indocin? Polypharmacy at its finest. No, you need to treat the underlying cause of the pain (assuming it’s not being caused by something else, of course), crystal formation. – Hide quoted text — Show quoted text -Dave For the past six months I have been on Allopurinol and Indocine to control gout. While my uric acid blood levels are now in the normal range, it seems I still have an excess of uric acid distillate stored in both feet. Whenever I try to stop taking the 100 mg of Indocine per day for a couple of days, I end up with a general ache in both feet which makes even walking extremely difficult. Does anyone know of a drug treatment or flush that effectively rids the body of excess uric acid? You need colchicine. Allopurinol is useful in preventing a reccurance of an acute attack of gout but you need colchicine to treat an acute attack.

Michael Smar

Response:

use. Colchicum isn’t a homeopathic drug. To be a homeopathic drug (at least according to Hahnemann (the father of homeopathy; Similia similibus curantur – like cures like)) a drug must cause symptoms similar to the diease state you’re trying to cure. Given that colchicum doesn’t do this, it can’t be considered to be a homeopathic remedy (at least according to Hahnemann’s definition). Just because it’s a natural product and it’s used in minute doses doesn’t qualify it as homeopathic remedy. For all I know it may work when used this way, I doubt it, but it can’t be considered to be a homeopathic remedy. Besides, no one should be using colchicum in an unsupervised manner. This isn’t an anti-homeopath response so please don’t flame me. My husband has found that by not overindulging in protein and taking apple cider vinegar, daily at first now one dose weekly, he is gout free. Its worth a try… Joan

I suspect your husband’s success is related to his diet and not the cider vinegar. NB: Gout used to be known as a rich man’s (person’s?) disease because the rich were generally the only people who could afford to eat well enough to get gout. Michael Smar

Response:

See th advice on Stones and Crystals in my post called Diet and Supplement Tips. turf

Response:

I’ve had success with 300 mg. Allopurinol every day and 200 mg. Sulindac (Clinoril) at first every day but now every other day. No noticable side effects from either. I’ve not (knock on wood) had any problems with arthritis affecting my knees or the bottom of my feet seriously or gout for many years now. I also drink lots of liquids and stay away from organ meats. I find Clinoril is much easier on the stomach than Indocine or aspirin, which I can only take for a day or two. Good luck. Ken

Response:

For the past six months I have been on Allopurinol and Indocine to control gout. While my uric acid blood levels are now in the normal range, it seems I still have an excess of uric acid distillate stored in both feet. Whenever I try to stop taking the 100 mg of Indocine per day for a couple of days, I end up with a general ache in both feet which makes even walking extremely difficult. Does anyone know of a drug treatment or flush that effectively rids the body of excess uric acid? The Allopurinol is effectively controlling excess production but my MD says it won’t get rid of the build up already in my system.

Well, first you want to be sure it’s gout that’s causing your pain. Gout involves joint spaces primarily, and often asymmetrically. I would wonder if you don’t have plantar fasciitis if your pain isn’t in the joints themselves. Secondly, the allopurinol is designed to reduce your uric acid production, and you want to aim for low normal levels (less than 4mg/dl) to prevent recurrent flares. Unless you have tophi, I wouldn’t worry about getting rid of uric acid per se, but you can enhance urinary excretion with probenecid. The response to Indocin is nonspecific, which is why I wonder if you don’t have something else causing pain when you stop it, despite good uric acid control…. H2

Response:

You need colchicine. Allopurinol is useful in preventing a reccurance of an acute attack of gout but you need colchicine to treat an acute attack. By inhibiting the inflammatory process, and inturn decreasing the amount of lactic acid produced locally, colchicine causes the dissolution of the urate crystals that are causing you pain. You’ll be waiting a long time for allopurinol to do that. Michael Smar

Response:

WHAT??? He hasn’t got an acute attack (6 months does not seem "acute")! He has chronic tophi. Colchicine does not have an effect on that as I recall! Besides…colchicine is a rather nasty drug, and long term use has it’s own consequences….probably worse than taking indomethacin and/or allopurinol! Given time (albeit a very long time) allopurinol may reduce the presence of the tophi…but unfortunately there ain’t much to do in the short term! : ) Just a thought on a side issue….is it gout when you stop taking the indomethacin??? A general ache in both feet does not sound like an acute gouty attack. Any other meds??? Just out of curiosity or medical conditions?? Dave – Hide quoted text — Show quoted text – For the past six months I have been on Allopurinol and Indocine to control gout. While my uric acid blood levels are now in the normal range, it seems I still have an excess of uric acid distillate stored in both feet. Whenever I try to stop taking the 100 mg of Indocine per day for a couple of days, I end up with a general ache in both feet which makes even walking extremely difficult. Does anyone know of a drug treatment or flush that effectively rids the body of excess uric acid? The Allopurinol is effectively controlling excess production but my MD says it won’t get rid of the build up already in my system. You need colchicine. Allopurinol is useful in preventing a reccurance of an acute attack of gout but you need colchicine to treat an acute attack. By inhibiting the inflammatory process, and inturn decreasing the amount of lactic acid produced locally, colchicine causes the dissolution of the urate crystals that are causing you pain. You’ll be waiting a long time for allopurinol to do that. Michael Smar

Response:

RGFor the past six months I have been on Allopurinol and Indocine to control g RGWhile my uric acid blood levels are now in the normal range, it seems I stil RGve an excess of uric acid distillate stored in both feet. Whenever I try to stop ng the 100 mg of Indocine per day for a couple of days, I end up with a general RGe in RGboth feet which makes even walking extremely difficult. RGDoes anyone know of a drug treatment or flush that effectively rids the body RGexcess uric acid? The Allopurinol is effectively controlling excess product RGbut RGmy MD says it won’t get rid of the build up already in my system. Are you currently drinking 2 quarts of *water* a day? —- |Ye Olde Bailey BBS Zyxel 713-520-1569(V.32bis) USR 713-520-9566(V.34/FC)| | Houston,Texas yob.com Home of alt.cosuard |

Response:

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