Hi
I’ve read conflicting reports online about the treatmen of gout. Is gout really curable or simply manageable with current medications/therapies?
IANAPharmacist, but from what I have learned since my first contact with gout about 15 years ago, if you have chronic gout you can take allopurinol regularly to help your body excrete excess uric acid (which causes gout). You would need to be taking it for the duration, and if you tolerated it well (no severe side effects), this is the route a lot of people take.
You can also manage the risk of getting an attack or flare by following the myriad of diet suggestions and adopting a healthy lifestyle (quit smoking, get more active, lose some weight, eat less animal protein, eat more fruits and vegetables and grains and nuts, drink less beer and alcohol and less soft drinks, drink more water to flush your system of the uric acid).
I do not think it is “curable” tho, as I understand your body makes most of the uric acid in your blood and diet only contributes a smaller percentage of that, so you will not have complete control over it (like cholesterol). Also, triggers will be different for everyone, so what works for me may not work for someone else. I will yield to someone more in the know, but this is what I have learned over the years and I have learned to manage it without the allopurinol (granted, with a few minor mistakes here and there on my part).
I had my first episode of gout in June of 2013. The doctor I saw told me I had to give up beer and make some drastic dietary changes (turns out I eat a diet consisting of all the bad foods for gout).
Rather than change my diet and give up beer shudder, I began drinking a ton of water instead. No medication, no lifestyle changes, just hyper-hydration. I had a second flare-up 14 months later, likely related to trauma (I kicked a wall in the barn out of frustration).
So, symptom free now for nearly 8 years with only water to thank.
Yeah, that has been my primary strategy, too, as well as just keeping an eye on certain foods known generally to be triggers (I do not eliminate anything, just maybe have a be less of it, or compensate by going meatless before/after a planned meaty meal plus taking on lots of water around said meaty meal). The mistakes I mentioned I can trace to dehydration. It sucks that making one little error can lead to a week of pain - such is getting old, I guess.
If drinking copious amounts of water was a cheap and easy way to manage gout don’t you think doctors would just suggest… of wait, I forgot for a second how modern medicine works.
You can suggest all you want, doesn’t mean people will follow it. My doctors always start with the basics, probably because most people don’t. They always seem astonished when I present the facts that I do indeed hydrate more than normal and eat well beyond RDA of fiber and so on. or that I don’t smoke, drink regularly, or subsist on carbonated sugar beverages. I mean, even here (where people are smarter than average) a lot of members have pretty unhealthy habits and refuse to change those (which is their want/right). IRL, especially since I’m in a working class environment (IMHO, and other environments have their own unhealthy vices to be sure) for some people it’s as normal to sleep 3-4 hours, drink no water, drink no unprocessed food with any nutritional substance, drink 3-4 energy drinks and get no exercise outside of work. While for me it’s just normal and a bare minimum to do none of those things, exercise daily, sleep 8 or so hours (6-7 if it’s a really bad day), eat fiber and protein, drink a gallon or 2 of water, etc.
Knew several people had gout, all of them managed quite well after the initial diagnosis. Or said they handled it well, I’m sure a couple of them probably went off their diets and had flare ups.
Anyway, since none of them ever mentioned different types of gout I took a look at the Gout Wiki and saw nothing about different types or total cures or different types. There was some indication that a person could be misdiagnosed but the alternatives don’t look great either. I hope you’re not a drinker, the wiki says complete abstinence is a requirement, but it also says untreated sleep apnea could make it worse.
Which I’ve proven wrong.
I’ve been taking 200mg of allopurinol for years, and in that time gout has not been a problem. (It was before!)
In my experience, gout is totally manageable with a miracle drug called Allopurinol.
On a side note, my doctor was alarmed at one time about my sodium levels (low), and told me that I was drinking too much water. I told him that I would just add more sodium to my diet, and he contended that “It” doesn’t work that way.
And abstinence from alcohol is something that I’ve never known. Homebrew I had to give up, just too much yeast. As it turns out, in my case, yeast kicks allopurinol’s ass. But storebought beer, even IPA, has never overcome the mighty allopurinol.
The world and science thank you.
My doc has me on allopurinol permanently now - after a bout of gout - because the same chemistry that underlies gout also leads to kidney stones.
I’m not a doctor. I’ve had a few bouts with gout, though, after overdoing it with beer, tomatoes and beef (concentrate) in one or two days’ time. My big toe hurt so bad I thought I’d stubbed it on something. It went away in about 48 hours and came back a few months later, the next time those three things coincided in my diet (they increase levels of uric acid). So, in my case, I thought I was able to manage it by avoiding too much of those things at the same time. I may have gotten lucky, though. Since then, I’ve noticed an occasional passing twinge of pain in a wrist or ankle that was unsettlingly similar to what I felt in my big toe, and, after several years of not going in for a check-up, I was told the other day that my levels of cholesterol, uric acid and triglycerides are through the roof. I think one of them triples the acceptable maximum. So, no more beer, pork, shrimp, etc. for me for the next three months. 
I suspect that if I’d gone on being ignorantly happy, the gout could have eventually become a real problem, and I guess I’m not out of the proverbial woods yet.
Thanks snowthx. I read that selzer water is also quite good for you. How true is that.
Thanks snowthx. I read that selzer water is also quite good for you. How true is that?
Gout is a condition where urate crystals deposit in certain joints rather than being converted into liquid uric acid, and then urinated out. Though this can be caused by excessive alcohol or high protein diets, often the cause is the level of an enzyme named xanthine oxidase. Allopurinol inhibits this enzyme and is useful for preventing attacks. But it does not work well during an acute attack. Colchicine, pain medicines and prednisone can be effective during an exacerbation. Dehydration can make things worse.
So curable? If the cause is excessive intake it is worth trying changes on diet and drinking water. Medicine may work better if the cause is too much enzyme - by inhibiting it.
I (knock on wood) have never had gout or a gout attack, but I eat all the foods bad for gout and was generally unhealthy when I started doing various things to get my personal health back in order. Part of that was going for some bloodwork, and while I can’t remember the specifics, I was basically told that I was “at risk of gout”, and it was recommended I eat basically nothing but vegetables and limited non-red meats for a time, cut out all alcohol etc and go from there.
I simply decided…that was not going to happen. I continued what I had been doing that lead me to the doctor’s office–kept working on improving my health, got more weight off, drank more water like you did, got back into an exercise routine (while I have been religious about weight lifting for over 40 years, after I retired from the Army I was a slouch about any kind of cardio exercise) and at my next bloodwork the doctor said there weren’t any problems anymore along the lines of gout. I didn’t bother to tell him I hadn’t taken his advice. I don’t have any doubt that what he advised to me was the appropriate and medically sound steps to take to get your blood work right and reduce risk of developing gout. But I also know myself, I really am not going to live out my days abstaining from all alcohol and red meat, just isn’t reality for me. So I had to see if I could be healthier but still sometimes consume the things I enjoy consuming. Fortunately for me, I could. And I’ve never experienced a gout attack, they sound like they can be miserable and if I was laid up with those regularly I can imagine maybe I’d start to make concessions about the red meat and booze.
Gout sucks the sweat off a dead mans nuts. I put it in the top three worst pains I’ve ever had right between a kidney stone and a horrible toothache.
I take 300mg of allopurinol every day and haven’t had a flare in over a decade. I haven’t had to watch my diet either. It’s a very effective drug. Allopurinol is quite inexpensive too, even without insurance.
If I would happen to get a flare I have a supply of the medicaion Indomethacin, which helps knock out a flare within a day or two. But man, it would have to be a bad flare for me to use it. Indomethacin really caused havoc with my stomach and bowels.
Yup. Me too. But it’s only been about 4 years. Gout really sucks and this has practically changed my life.
Indomethacin is a pain medicine which works very well but does not directly address the cause.
Taking 300 mg allopurinol and have been getting flare-ups regularly, monthly, since surgery and hormone therapy. Even before that, would get 1-2 flare-ups a year, often connected, I think, to specific things: less exercise, or drinking less water, that sort of thing. Drink very moderately, no beer, watch diet for purines. Indomethacin doesn’t upset my stomach, but colchicine works better for fast relief; the indomethacin takes the edge off and I hope reduces accompanying inflammation. I’m pretty tired of gout, frankly.