Lower Uric Acid for Faster Gout Recovery is my review of a gout study. So, we see tophi reduction rates at different uric acid levels. Then, we look at how you might apply this to your uric acid treatment plan.

Faster Gout Recovery Audiences

I wrote Faster Gout Recovery for GoutPal Patients. Because it will help them at Step 3 of their GoutPal Plan for Gout Patients. At this point, you need to understand how to treat uric acid safely to get the fastest gout recovery. So this report establishes a fundamental truth about gout management. That is, you get rid of old uric acid crystals faster when uric acid is lower.

I organize gout resources according to the needs of different types of gout sufferer. So, if you are new to this, start at Questions for Gout Sufferers.

Lower Uric Acid for Faster Gout Recovery

This is my review of a 2002 study which proves gout recovery is faster at lower uric acid levels[1]. In particular, I focus on the principle of low uric acid. Because the methods used to achieve different uric acid levels in this gout study are now out of date. Also, we have more uric acid lowering medicines now. So, it is possible to set targets at any level to suit the individual gout patient.

Lower Uric Acid for Faster Gout Recovery Report

Firstly, note that this 2002 gout study predates rheumatologists professional recommendations for gout management. But, it has become an important reference for most current rheumatology guidelines. Because it answers the first question posed in the report’s introduction.

Questions for daily clinical practice should include:

  1. Whether uric acid is low enough during treatment to achieve enough reduction in uric acid crystals.
  2. What is the best uric acid lowering schedule?

However, the second question remains unanswered. But, subsequent development of rheumatology guidelines has made it clear. Because guidelines say uric acid lowering doses must be set for individual target levels.

Uric Acid Levels and Gout Recovery Rates

The report describes three different treatments that produced different average uric acid levels. Then, the authors measured the rate at which tophi reduced. Finally, they calculated rates of tophi reduction at different uric acid levels. So, I’ve taken these rates and applied them to an example tophi size of 15 mm. Even though I presented these figures as a single average, your personal situation will differ. Therefore, this is just an estimate of gout recovery time.

Uric Acid Level Tophi Reduction Rate Estimated Gout Recovery
5.37 mg/dL 0.57 mm/month 21 months
4.22 mg/dL 1.21 mm/month 10 months
3.97 mg/dL 1.53 mm/month 8 months
Lower Uric Acid = Faster Gout Recovery
Lower Uric Acid = Faster Gout Recovery

Lower Uric Acid for Faster Gout Recovery Summary

To summarize, this report gives gout patients 2 important facts:

  1. Gouty tophi shrink faster when uric acid is lower.
  2. When uric acid won’t go low enough with a single drug, a combination might be better.

The first finding confirms earlier research linking uric acid levels with tophi size[2]. In that case, patients with uric acid averaging 6.2 mg/dL had reduced tophi over a 10-year period. Whereas patients averaging 8.2 mg/dL uric acid showed increased tophi. Or, no change. Also, more recent gout studies of pegloticase confirm that very low uric acid levels give rapid uric acid debulking[3-4]. Because gout recovery in those studies is measured in weeks, rather than months, when uric acid is below 1 mg/dL.

Secondly, new gout treatments since this research give scope for much faster gout recovery rates. Because this gout study used the largely obsolete benzbromarone for combining with allopurinol. But, since the study was completed, we now have access to more uric acid lowering drugs. Also, continuing research for new ones.

Finally, at the time of the report, measuring tophi reduction was the best way to assess successful treatment. But now, doctors have access to imaging systems that give new ways to assess how much uric acid crystals are dissolving.

Your Plan for Faster Gout Recovery

In conclusion, you can see that lower uric acid will give you faster gout recovery. But, the numbers in this report are just examples that confirm the principle. In your case, you and your doctor will agree on individual targets for uric acid levels. In turn, that will determine how long you are at risk of gout flares.

Do you need more help to understand uric acid levels during the debulking stage of your gout recovery plan? If so, please ask in the gout forums now.

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Gout Recovery References

  1. Perez-Ruiz, Fernando, et al. “Effect of urate-lowering therapy on the velocity of size reduction of tophi in chronic gout.” Arthritis Care & Research 47.4 (2002): 356-360.
  2. Mccarthy, Geraldine M., et al. “Influence of antihyperuricemic therapy on the clinical and radiographic progression of gout.” Arthritis & Rheumatology 34.12 (1991): 1489-1494.
  3. Baraf, Herbert SB, et al. “Resolution of gouty tophi after twelve weeks of pegloticase treatment.” Arthritis & Rheumatology 58.11 (2008): 3632-3634. Gouty Tophi Removed in 15 weeks with Pegloticase.
  4. Hershfield, Michael S., et al. “Treating gout with pegloticase, a PEGylated urate oxidase, provides insight into the importance of uric acid as an antioxidant in vivo.” Proceedings of the National Academy of Sciences 107.32 (2010): 14351-14356.

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