Gout Treatment Category

Uric acid crystals must be dissolved to permanently get rid of gout pain, but how long does it take to get rid of them?

Like all gouty issues, the answer is never simple. However, we can see some factors that affect the time it takes for crystals to dissolve, and see that the time to start dissolving is now.

In an earlier article, I explained how tophi shrink quicker with lower uric acid concentrations. But this does not mean that once you lower uric acid to a safe level you will immediately stop all gout attacks. In fact, partially dissolved uric acid crystals can start a gout attack, as I explained in Allopurinol Medication: Why It Hurts To Get Rid Of Gout. Though that article looks specifically at allopurinol, the effects of dissolving uric acid crystals might occur with any urate lowering treatment, including diet, until all urate deposits dissolve. But how long does this cleansing period take?
Read the rest of this Uric Acid Crystals article…

Acupuncture is commonly viewed as sticking needles into various parts of the body. Though needles are often involved, the aim is to stimulate energy flow in the body, and so other related techniques are often grouped under the acupuncture umbrella.

A detailed study of acupuncture is beyond the scope of this gout website, however I would like to draw your attention to 3 studies reported last year. (more…)

Do not start with the herbal mixture, and explain how you are sort-of-cured, but not quite.

Do not start with the allopurinol itch, and explain how your gout would be fixed if only you took the meds every day.

Do not hide behind food obsessions, and explain how gout never troubles you if you can only avoid purines.

Get a plan, and focus on fixing your gout. Let me help you focus on G.O.U.T.

The ⒼⓄⓊⓉ Plan To Fix Gout

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As far as I can see, there have been no studies of Devil Claw & gout. However, a number of studies have looked at the anti-inflammatory properties. I have summarized 3 studies below.

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Your gout symptoms clear faster with lower uric acid, but how low should you go?

It is very difficult to measure how fast old uric acid crystals are dissolving, but for chronic tophaceous gout sufferers, we can measure how fast their tophi shrink.

Allopurinol for gout has been around for 40 years, and febuxostat is the latest weapon in a growing list of medicines that will lower uric acid. But still people are unsure how low they need to go.
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Gout sufferers must manage their levels of uric acid – pain relief is usually a separate issue.

Some gout patients worry that their pain relief drugs might interfere with their uric acid levels.

Diclofenac (usually sold as Voltaren) is especially feared.

Is this another gout myth? Read on to see why this gout story came about, and why this gout myth is difficult to disprove.

Diclofenac gave vultures visceral gout.
Humans were tested and found to have nowt.
Are blood tests OK? Still there is doubt.
Just listen to GoutPal. He’ll soon sort you out.

Rubbish verse! Interesting uric acid & pain relief story.
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Popular Remedies for Gout Prevention

There are lots of different remedies for gout that are used in the various treatments.
Remedies are applied as part of different treatments, which are described in the Medical and Alternative Treatments sections.
The remedies that are listed here are for preventing gout or reducing the risk and severity of future attacks.
I’ve listed pain management remedies in the Pain Relief Gout Remedies section.

In this section, both medical and alternative remedies are listed, including gout home remedies and natural remedies for gout. Please note that even though alternative remedies may not be as tightly controlled as most drugs, they can still have significant effects on your health, especially if you are also taking prescribed medication. As always, you should consult a qualified medical practitioner before you start the treatment.

Before you start to decide which treatment might suit you, you should know your uric acid level. Also, you must be clear about why and how to lower uric acid, and what you need to reduce it to.

To choose which remedies are best for you, you should study them, noting particularly any side effects. You should also pay attention to how gout remedies react with other conditions and with other remedies.

What are your best remedies for gout?

This graph shows recent voting results.

Voting is now closed, but will re-open late 2010. Subscribe to the free gout update service to learn when voting starts again.

Remember, popularity is only a guide – you should study gout remedies as they apply best to your own situation. In particular, pay careful attention to possible side effects and other conditions.

Remedies for Gout Prevention

Name	Description	Treatment
Allopurinol	Allopurinol (often called allopurinal) is hailed as a wonder drug for preventing gout attacks, but is it safe? Yes it usually is safe, but you still need to be aware of allopurinol side effects.	Uric Acid Inhibitor
Apple Cider Vineger	Apple Cider Vinegar (often called ACV) has been recommended by 2 readers. I’m researching this, and will add a page soon. If you’ve used ACV, please share your experience on the gout forum.	Anti-inflammatory?
Baking Soda	Treating gout effectively requires an understanding of how and why gout occurs. By increasing alkalinity, uric acid is less likely to crystallize and gout attacks are reduced.	Blood pH
Celery Seeds	Celery seeds should be infused in water – Simmer 1 tablespoon of celery seeds in 2 cups of water until soft. Drink half a cup four times a day. They help eliminate gout by increasing excretion of uric acid, but should not be taken when pregnant or with kidney disease. Drinking lots of water, always a good idea with gout, is particularly important. Celery seeds are also available in capsule form.	Uricosuric
Cherry Juice	Cherry juice gout treatments are claimed to be highly effective. Is there any reason why they shouldn’t work?	Uric Acid Inhibitor, Anti- Inflammatory
Febuxostat	Febuxostat brings a vital choice to gout sufferers. A real alternative to allopurinol. Another chance to lower uric acid which is crucial to fixing your gout. Brand names include Uloric and Adenuric.	Uric Acid Inhibitor
Flax	Is there a benefit of flax seed oil for gout? There are even more benefits from the crushed seed. Flax seed is a great general health booster. It’s even better for gout sufferers.	Fiber, Anti- Inflammatory
Probenecid	Probenecid prevents gout by lowering uric acid levels. Find out if its effects and side effects will suit you.	Uricosuric
Sulfinpyrazone	Sulfinpyrazone prevents gout by lowering uric acid levels through increased excretion by the kidneys. As with Probenecid, needs adequate fluid intake.	Uricosuric
Water	Water is the best of all home remedies for gout. Cheap and effective with no side effects. It also helps other gout treatments and remedies work better.	Hydration

Indomethacin (often sold under the Indocin brand name) is the most commonly prescribed anti-inflammatory drug for reducing painful gout swelling.
It acts upon the hormones that cause swelling and pain.

It is available as regular capsules, sustained release capsules, liquid and suppositories.
You may need to take capsules or liquid with milk or food to reduce the chance of stomach upset.
Do not open sustained release (SR) capsules – they must be taken whole.

Over-the-counter medicines can contain similar anti-inflammatory drugs, e.g. Ibuprofen, aspirin.
Do not take any other medication alongside Indomethacin without consulting your doctor.
Never exceed the prescribed dosage.
Always wait the prescribed time before taking your next dose.
If you think you have overdosed, seek emergency medical treatment immediately.
Symptoms of overdose include any of the following:

• Blurred vision
• Breathing
• Dizziness
• Drowsiness
• Headache
• Nausea
• Ringing in the ears
• Seizures
• Stomach pain
• Sweating
• Tingling or numbness
• Urine much reduced or stopped
• Vomiting

Side Effects

Not everybody suffers side-effects. The most common problem is stomach upset, but more serious stomach problems can occur. As with all treatments, you must decide what is best for you in your particular circumstances. You must discuss side-effects fully with your doctor before you start to take any drug and whenever you experience any adverse effects.

The following list may not be complete – if you experience any other problem that you think may be related to taking the drug, then you must consult your doctor.

Minor side effects that may go away

You only need consult your doctor if these become severe or prolonged

• Constipation
• Depression
• Diarrhea
• Dizziness
• Drowsiness
• Fatigue
• Headache
• Stomach pain
• Unusual hair loss
• Nausea, unless with skin rash – this is serious – see below
• Vomiting

Serious side effects

You must stop taking Indomethacin and consult your doctor if you have any of the following

• Aching or painful muscles
• Blood in stools or black, tarry stools
• Blood in vomit
• Breathing troubled or short
• Bruising or bleeding without obvious cause
• Chest tight or wheezing
• Eyes yellow
• Hands or feet numb, tingling, painful or weak
• Hearing diminished or ringing in ears
• Hives
• Itching
• Lethargy (tiredness or weakness without obvious cause)
• Mouth ulcers
• Rash, especially with vomiting or nausea
• Skin yellow
• Swelling of hands, feet, lower legs or ankles
• Tarry, black stools
• Urine suddenly decreases in amount

Health warnings

Indomethacin is a member of the NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) group of drugs. All these drugs can have severe, even fatal, effects on the stomach. It is appropriate for short term use, at the lowest dose possible, to treat pain from gout flares, but never for more than a few days.

Vision problems are associated with this drug.

Alternative Spellings

This drug is sometimes referred to as:

• Indocin (this is a brand name)
• indomethacine
• indomethicin
• indometacin – most common outside USA

Indomethacin and Gout Pain

Indometacin works by controlling the bodies reaction to uric acid deposits in the joints. It reduces pain, but does nothing to help reduce those deposits. See the Reaction part of U-D-R-P for more information.

Return from Indomethacin to Gout Treatments

Allopurinol Medication:
The Gout Cure That Can Hurt

1. Do you understand uric acid?
2. Do you know the crippling danger it presents?
3. Do you know why they must reduce uric acid?
4. Do you understand why reducing uric acid can temporarily cause more pain?

As a gout patient, you must understand why you need to endure the pain of allopurinol medication to get rid of gout.

Understanding Uric Acid

Uric acid is vital to humans, but, like many a good thing, too much of it is bad.

Too much causes uric acid crystals to form in and around your joints, and under your skin.

Many people imagine these crystals to be painful, often describing them as sharp and needle-like. They are actually so small, that they don’t cause physical pain directly, but your immune system sees them as virus-like invaders, and attacks them causing inflammation and acute pain.

It is not enough simply to get rid of this pain.

The Crippling Danger Of Uric Acid

Most people need some additional medication to tolerate the pain. This is usually colchicine or other anti-inflammatory drug, but pain relief will do nothing to get rid of uric acid crystals.

The inflammation and pain will gradually disperse as your immune system stops fighting the uric acid crystals. But, unlike a virus, your immune system cannot kill uric acid crystals. Instead, it hides them in a protein coating, and they will build up to cause crippling joint damage unless you do something to get rid of them.

I’ve seen a 70 year old man in tears with this pain, and I do not want it to happen to you.

Why You Must Focus On Lowering Uric Acid

The uric acid crystals build up gradually, often over several years, and they don’t always cause the traditionally painful, swollen acute gout flare.

Often numbness or tingling are the only signs, yet under your skin the uric acid deposits increase until they burst through as tophi, or damage your joints, or both.

The only way to get rid of uric acid deposits, and avoid the critically painful tophaceous gout stage, is to lower uric acid below 6mg/dL.

Though there are several uric acid lowering drugs, and new ones being developed, allopurinol medication is most widely prescribed and currently the most effective, as long as the correct dose is taken every day.

Lowering Uric Acid Can Cause Pain

At the correct dose, all uric acid lowering treatments will cause uric acid crystals to dissolve. Remember, this is what we must do to avoid skin-bursting tophi and crippling joint deposits.

Unfortunately, as they are dissolving, uric acid crystals shed the protein coating, and the immune system starts to attack again, which may result in a painful gout flare. You must be prepared for this, and discuss with your doctor whether you take anti-inflammatory pain relief with the allopurinol medication, or take pain relief when a gout flare occurs.

Deal With The Pain Of Allopurinol Medication

All too often gout sufferers concentrate on finding pain relief and forget about the dangers of a long-term buildup of uric acid crystals.

You must understand the dangers of uric acid, how crystals can cause serious damage, often without pain, and how lowering uric acid might temporarily increase pain.

Distinguishing between pain relief and lowering uric acid is one of the key aspects of managing gout. Understand it, and you are less likely to be amongst the 90% of gout patients who fail to endure the pain of allopurinol medication to get rid of gout.

More Allopurinol Information

Read more vital allopurinol information:

Are Allopurinol Side Effects Serious?

Allopurinol side effects worry many people, so just how serious are they?

3 Vital Allopurinol Dosage Rules

Allopurinol dosage needs to be planned, measured and adjusted for different treatment phases. A standard 300mg dose might be just what you need – but make sure that it is set by diagnosis and judgment, not by dangerous guesswork.

Allopurinol For Gout Control

In-depth look at the management of gout using allopurinol.

Allopurinol Drug Not Just For Gout

Though mostly used in gouty arthritis, the allopurinol drug has found to be useful for other conditions.

Allopurinol Drug Spelling

The allopurinol drug is often spelled differently, especially with an “al” ending. The spellings I have noticed include:

• alipurinal
• alipurinol
• allipurinal
• allopurino
• alopurenol
• alopurinal

All these refer to the allopurinol gout drug.

I list the standard allopurinol side effects below, but before you look at these, you need to know about one side effect that is rarely explained properly.

This is not a side effect of allopurinol as such, as it applies to all uric acid lowering therapies. When you lower uric acid properly, to a level that gets rid of old uric acid crystals, the melting uric acid crystals can trigger a gout flare. This is a necessary, though sometimes painful consequence of proper treatment.

Don’t avoid allopurinol just because it might trigger a painful flare. This is one side effect that you should welcome, as it indicates that you are getting better. This effect will diminish, as long as you continue taking allopurinol daily and get your uric acid level checked frequently.

See below for More Allopurinol Information including more on the most common, but least discussed of allopurinol side effects: pain.

Allopurinol Side Effects

Note that the side effects listed below are not experienced by everyone. Some are common, others rare, some people have no side-effects, or are happy to accept a little discomfort in exchange for the permanent relief from acute gout attacks. As with all treatments, you must decide what is best for you in your particular circumstances and you must discuss side-effects fully with your doctor before you start to take any drug and whenever you experience any adverse effects.

The following list may not be complete – if you experience any other problem that you think may be related to taking the drug, then you must consult your doctor.

Minor side effects that may go away

You only need consult your doctor if these become severe

• Indigestion
• Drowsiness
• Headache
• Stomach pain
• Unusual hair loss
• Diarrhea
• Nausea, unless with skin rash – this is serious – see below

Serious side effects

The most serious side effect is known as allopurinol hypersensitivity syndrome which effects 1 in 1000 patients. The risk of this increases with age. You must stop taking the drug and consult your doctor if you have any of the following

• Aching or painful muscles
• Blood in stools
• Blood in urine
• Breathing troubled or short
• Bruising or bleeding without obvious cause
• Chest tight or wheezing
• Chills
• Eyes irritated or red or yellow
• Fever
• Fingernails loose
• Glands swollen or painful
• Hands or feet numb, tingling, painful or weak
• Hives
• Itching
• Lethargy (tiredness or weakness without obvious cause)
• Lower back or side pain
• Mouth or lips sore, ulcerated or showing white spots
• Painful or difficult urination
• Rapid weight gain
• Rash, especially with vomtting or nausea
• Red pinpoint skin spots
• Skin red, tender, burning or peeling
• Skin sores
• Skin thickened or scaly
• Skin yellow
• Sore, bleeding lips
• Swelling of face, feet, fingers, lower legs or stomach
• Tarry, black stools
• Throat sore and feverish
• Urine suddenly decreases in amount

More Allopurinol Information

Read more vital allopurinol information:

Are Allopurinol Side Effects Serious?

Allopurinol side effects worry many people, so just how serious are they?

3 Vital Allopurinol Dosage Rules

Allopurinol dosage needs to be planned, measured and adjusted for different treatment phases. A standard 300mg dose might be just what you need – but make sure that it is set by diagnosis and judgment, not by dangerous guesswork.

Allopurinol For Gout Control

In-depth look at the management of gout using allopurinol.

Allopurinol Drug Not Just For Gout

Though mostly used in gouty arthritis, the allopurinol drug has found to be useful for other conditions.

Allopurinol Drug Spelling

The allopurinol drug is often spelled differently, especially with an “al” ending. The spellings I have noticed include:

• alipurinal
• alipurinol
• allipurinal
• allopurino
• alopurenol
• alopurinal

All these refer to the allopurinol gout drug.