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Dull pain in morning after allopurinol dose change
Hi All,
I wanted to reach out to the community and see if anyone had similar experiences:
Age: 34
First attack: 24, didn’t come back till 30
Allopurinol: Age30 – 300mg
First UA: 12 went down to around 4 after 3 months.
Kept at it for a year and another blood test came and it was 4-5
So the doctor put me on 100mg to see if that could be enough, I started getting dull arthritic pain after a while, not like a flare but just stiff, aching pain under the foot and just below the toes when I walked so the doc put me back onto to 300mg, and it was fine.The thing is my gout attack was never on my big toe its be always behind the back of my foot, near the Achilles area, it was hard to also bend the ankle.
Over the next 3 years, I had been pretty lazy sometimes taking allopurinol. But sometimes not taking it. Then in the last 5 months, it has gone to the point where I was taking it and getting weekly flares so decided to stop and see a rheumatologist in April who said I was probably misdiagnosed years due to the fact my gout was never on my big toe and that I have had psoriasis near in the groin area (I showed this to a second doctor and he said it’s not enough to be wanted Psorotoic arthritis), its been 2 months and no flares but I’m back to that same dull arthritic pain under the foot, would rather this pain then a full-blown flare but I’m not sure if it’s because of gout or what as it comes and goes, but recently staying longer and longer. I’ve been eating pretty clean, low purine diet. He told me to stop taking it as well and that only we can find out if its “gout” if I have a flare so he can extract fluid out. At this point, my UA is 7.7 as I had done a blood test for him.
I did ultrasounds and x-rays and they all look fine no bone damage, slight bursitis
It’s now May, I currently have a home test and my UA is 8.4 increased in the last 2 months. It wasn’t a lab test but I might do one in the next month. I worry that if I don’t get flares but UA level is still high it is will doing damage internally, making it worse. Like I get people who have high UA might not get gout but I’ve had a history of these attacks. even tho it’s not in the typical joints.
So here are my questions:
Since I haven’t had a flare-up do you think:
a. Just not go back on allopurinol (I’m actually taking this time to see if diet and herbal supplements like celery seed [Celery Seed for Gout Forum linked above] and cherry tart will work).
I really don’t want to take it for life.b. Go back on Allopurinol but start off slowly again? since it has been 2 months since my last major attack would it be fine?
c. how long should you wait to retake allopurinol again to limit the flares since allopurinol exacerbates flares.
I’m just lost and don’t know what to do and it starting to affect my everyday life. and starting to worry it’s becoming super chronic. Any advice would be appreciated.