Simple Gout Treatment

I know gout can be complicated, but let’s try the simple approach to gout treatment before we look for difficulties.

Gout treatment is the heart of finding gout freedom.

Gout treatment must be preceded by a proper medical diagnosis of your gout symptoms.

Gout treatment might  be followed by adjustment to your gout diet.

So for all of you making life difficult for yourselves by worrying about food and drink – stop now. Do not even think about diet until you have a good gout management plan.

1. Starting A Gout Treatment Plan

The best gout treatment plan starts with good diagnosis from your doctor(s). If you have a confirmed gout diagnosis then move to step 2.

Gout diagnosis can be difficult for a small minority of gout patients. For most people, it is very simple.

If your gout symptoms are not confirmed, see your doctor or rheumatologist today. If they are confirmed, a more complete analysis of possible causes is useful, but not essential. If you have it, it may give you more options for gout treatment.

I will announce a personal gout symptoms assessment tool soon. In the meantime read the Gout Symptoms section, which is first in the list of sections near the top and bottom of every page. If you still have questions, ask in the Gout Symptoms forum.

Continue to read your simple 3 step gout treatment plan

Find more (see gouty search hints for guidance).


About Ads from GoutPal

Facebook Likes Gout – Hates GoutPal

Facebook likes gout so much, it does not want you to learn how to beat it. It hides most of what GoutPal tells you!
Make sure you get all GoutPal notifications.
1. Check ✔ Get Notifications
2. Interact more
   ☑ Like regularly
   ☑ Comment regularly
   ☑ Share regularly
   ☑ Post your gout status regularly

The band of gout sufferers in GoutPal’s Gout Chatroom is growing, but are you missing out? Sometimes Facebook can be frustrating, but, just like gout, there are simple ways to make it better.

When you Like my GoutPal page on Facebook, you get notifications when I post something. But Facebook only notifies you about some of them. Facebook watchers have different views, but a common statistic is that, you only see about 25% of GoutPal posts, unless you tell Facebook you want more. There are 2 ways to do this:

  1. Make sure Get Notifications is checked
  2. Interact regularly with Likes, Comments, and Shares

See how to tell Facebook You Hate Gout

Is 80mg Uloric always enough?

Uloric is prescribed as either 40mg or 80mg per day according to the latest Uloric Prescribing Label.

Standard procedure is to start with a 40mg dose, then test after two weeks to see if 5mg/dL has been reached. If not, then increase to 80mg per day. Note that there is little room for half measures here. The label says “below 6mg/dL,” and this should normally be interpreted as 5. Anything between 5 and 6 might be acceptable in certain patients with other health issues, but the target for safe uric acid levels is 5mg/dL or lower.

Unfortunately, a GoutPal follower in the gout chatroom is struggling to achieve anywhere near this:

Uloric Safety

Uloric is generally safe, though some isolated concerns about liver problems prompt me to recommend that every gout patient on Uloric should have liver function and kidney function tests whenever they have uric acid tests. This should be at least once per year. I also recommend this for allopurinol.

As a new drug, Uloric has been subjected to extensive tests during its trial period. As part of these trials, it was determined:

ULORIC was studied in healthy subjects in doses up to 300 mg daily for seven days without evidence of dose-limiting toxicities.

Is 80mg Uloric always enough?

If allopurinol or Uloric is not achieving target uric acid levels, a rheumatologist should be consulted. This is a specialist case, beyond most doctors, and definitely beyond the scope of an Internet support service such as GoutPal.

A rheumatologist would normally consider either increasing the dose or supporting with other gout medicines to achieve a reasonable target. There are no general guidelines for this, as each case has to be considered on a personal basis, with complete medical history.

In an ideal world, gout patients would have liver function, kidney function, and 24-hour uric acid excretion rate tests before starting treatment to lower uric acid. As Uloric and allopurinol are generally safe and effective, these tests might not always be done. In most cases, they are not required.

In edge cases, such as this one where 80mg Uloric is not enough, the test results might be useful. Only a rheumatologist who has good gout knowledge can judge this. Your rheumatologist might take you off uric acid lowering medication to take the tests so that he has the full facts.

What happens next is really beyond GoutPal. This website cannot provide medical help, and you must see your own rheumatologist. I can however help you ask the right questions. In this case, the questions are:

  • Uricosuric Support: can Uloric be supported with a uricosuric, such as probenecid, to assist with uric acid excretion?
  • Off-label Dose Increase: can Uloric dose be increased beyond 80mg in view of the reported safety up to 300mg per day.

Please note that Uloric is a brand name for febuxostat, which is also sold under other names, including Adenuric. As a new drug, it is not available under it’s generic name of febuxostat. It is also sold as Atenurix in and around the Philippines. Interestingly, from the limited prescribing information I have seen, maximum dose of febuxostat sold as Atenurix is set at 120mg per day.

Have you been in a situation where standard uric acid lowering treatment has failed to achieve safe uric acid levels? Please share your experiences, and your rheumatologist’s advice in my gout forum my gout network, or in the gout chatroom.

Leave Is 80mg Uloric always enough, to browse Uloric (febuxostat) guidelines

Are Purines the only Foods That Cause Gout?

Many gout sufferers think that purines are the only foods that cause gout. Not only is that not true, but for many sufferers, gout has nothing to do with food.

When we first get gout, we want to know “Why me?”

We ask doctors, we ask friends, we do our own research on the Internet. Many of us, including myself, get caught up in a gout diet obsession. More specifically, due to the fact that everyone over-emphasizes their importance, we get obsessed with high purine foods. Very early in my years creating GoutPal, I produced the definitive list of purine containing foods: Food High In Uric Acid. Despite it being wrong, I maintain it so that gout sufferers can see why it is wrong to take such a simplistic view.

In GoutPal’s Gout Chatroom, a gout sufferer sent me a message about foods that cause gout:

Dear Keith Taylor
I am 25 with 78Kg weight, 169cm height and my uric acid level above 7 for past few years.

Last month after playing soccer i felt pain in my big toe and pain get bad in the night and it lasted for 2hours. After that my pain was relieved but some swelling disturbed me for 3 days… still i feel some discomfort in the foot while driving my bike… I am afraid to take medicine so i have reduced my 5kg weight within a month by taking water and juices and stopped meat and now i am 73Kg.

I have heard only 7% people never experience the second attack i want to be one of them. My question is my URIC ACID level is still above 7, i am unable to control its trend even after taking 1 month low purine diet. Can i take control without medicine? if yes how long do you think will it take? If medicine is necessary as some people say, how long should i take?

I am very confused. Please please please guide me…

Read about the Foods That Cause Gout

No Diet For Gout On Uloric?

We are all obsessed with diet for gout, but can you forget it when you take Uloric, allopurinol, or other uric acid lowering medicine?

In a recent post in GoutPal’s Gout Chatroom, a gout patient commented that Uloric should be taken with food, adding a photo of his preference – the delicious seafood platter you see below. This raises several points of interest to gout sufferers. Commenting in the chatroom is limited, so I’ll explain these points here, and add some pointers for discussing diet for gout at the end.

When you take control of gout, it’s a wonderful feeling. After years of diet restrictions, you can eat what you like, knowing that gout will not return. Here we are talking about Uloric, but I have shared the same experience on allopurinol. Before I explain my views on that in more detail, I need to address the issue about food with Uloric.

Many people prefer to take gout medicines with food. In the case of Uloric, there is no need to, unless that is your personal preference. The Uloric Prescribing Label makes it clear:

ULORIC can be administered without regard to food or antacid use.

Read more points about No Diet For Gout On Uloric

Alkaline Foods: More Myths Exposed

I originally published this article about alkaline foods and gout well before I realized the full value of an alkaline diet for gout. Since then, more evidence has been discovered by various gout studies to show that alkaline foods can encourage excretion of uric acid.

I have since developed a complete section of my gout diet guidelines to explain the value of an alkalizing gout diet menu. This early work is still relevant however, and so I retained it to explain the value of alkaline foods on uric acid kidney stones, which cause kidney damage to some gout sufferers.


Alkaline foods raise more controversy than they are worth.

People swear they are the holy grail of health – a magic cure for gout and every other health problem in the world.

Skeptics swear back: “You’re wasting your *#@!$&! time.

It’s time for us to see the real truth behind alkaline diet and gouty arthritis.

Myth 1: Alkaline Foods Turn Red Litmus Blue

Despite my best efforts to explain otherwise, people still believe that you can measure the power of alkaline foods by testing their pH. There are even lists of alkaline foods touted round the Internet that show the pH value for common foods. But these have nothing to do with the alkalizing effect, so why do they exist?

They stem from a US government table of pH values produced for the canning industry. Whilst they might help food packagers determine what balancing agents they need to avoid food reacting with it’s container, these values have absolutely nothing to do with the effect of food on our bodies.

The science of alkaline foods recognizes that elements and compounds in food cause different reactions in our body when digested. Some elements, e.g. proteins and phosphorous produce acidic salts. Other elements, e.g. potassium, magnesium and calcium, produce alkaline salts. These salts end up at our kidneys, where they alter the pH environment. This process has resulted in the Potential Renal Acid Load (PRAL) calculation, which is an approximate estimate of the effect of foods on the acidity/alkalinity of our bodies. Or more specifically, of urine, as this is the measurable result.

Still, people remain confused as to how an acidic food item, like lemons or vinegar, can have an alkalizing effect on urine and the kidneys. This happens because the acids in food are very weak acids, e.g. citric acid in lemons and acetic acid in vinegar. The alkalizing components in the fruits do not register on a pH test, or our taste buds. This all changes as we digest the food, and the alkalizing components combine with acid compounds in or bodies, thus reducing the acid load at the kidneys.

In fact, the only reliable way to test the value of alkaline foods is to measure the pH of urine, but beware of the obsession that leads to the second myth.

Read the rest of Alkaline Foods: More Myths Exposed

How To Relieve Pain From Gout

How To Relieve Pain From Gout: Introduction from GoutPal

“How To Relieve Pain From Gout” is the first project in GoutPal’s personal gout support service. I am indebted to Graeme Austin for volunteering to test drive GoutPal Membership, AKA How To Treat Gout. This project page summarizes public and private correspondence. I am currently preparing explanations of this new gout support scheme. For now, you should read How To Treat Gout At Home for more information.

Graeme’s project continues…

Continue reading How To Relieve Pain From Gout

How To Treat Gout At Home

Learning how to treat gout at home is the heart of GoutPal. I learn all about gout, and the best ways to treat it, then I help you with your gout.

At first, GoutPal was my way of recording my experiences and my discoveries. Once I introduced a gout forum, I joined with many other gout sufferers. Together, we discussed many more aspects of gout, and collectively learned more than most doctors. After all, gout sufferers are passionate about their pain, and seek knowledge and improvement every day. We want the best for ourselves, but for doctors, it’s just another disease amongst the thousands they see every year.

Along the way, I learned how to control gout pain, then how to stop it ever returning. I’m still a gout patient, but I’m not a sufferer. Since then, I’ve written every page to help you work with your doctor and learn how to treat your gout. I’ve returned to most of my early pages to improve them in the light of current best practice.

I’ve written all these pages for a general audience, and provided personal support in my gout forum, and latterly in my gout network, and in my gout chatroom.

Continue reading How To Treat Gout At Home