Hi @suecameron3124 I am glad to hear this video has been helpful for you - thank you for letting me know! I am sorry to hear it sounds like you have been through so much with gout and COVID-19 in recent years, and yes - tendons are one of the places gout may happen, so it might potentially be gout there, as well as in your hands and feet. That is good that you have a diagnosis and are starting urate-lowering medicine treatment. As you say, it is possible you might have had gout first, then perhaps some uric acid level changes during or at the end of fighting a significant infection (like COVID-19) might potentially have triggered a gout flare; or your gout might have started during fighting COVID-19. One way to know would have been if samples from the affected areas had been taken before and during the infections, and the earliest sample with urate crystals in it would suggest that gout had already started by that date. Here is a link to a playlist of videos I have created so far about gout, and some of the medicines which may be prescribed for some people with gout (if they are suitable for the person's current health conditions and medicines), in case they may be of interest for you: th-cam.com/play/PLwyYRbsDY3ju2-aCCW8SBu6fcOxitCfCJ.html I hope this info may be helpful and you are welcome to ask questions about it if you like. I hope your treatment goes well. Best PHARMACIST Fi :>
@netkotreci3135 Hi netkotreći 313 Thankyou for your question about allopurinol 'maintenance dose' for a person with gout. Although most people with gout need to take a urate-lowering medicine (such as allopurinol, if it is suitable) life-long, the dose may occasionally need to be adjusted by the doctor (depending on your uric acid level) - so that is why it is a good idea to ask the doctor about getting a uric acid level blood test at least once a year (if the doctor has not already done this for you). This is because, as we get older, or if a disease were to affect our kidneys, or if we change our main drinks or foods, or if our weight changes: any of these changes might affect our uric acid level, which might then affect the personalized allopurinol dose needed to keep a person's uric acid level at ‘target level’ life-long (so that gout urate crystals can be melted, and prevented from ever being laid down in future). This TH-cam channel is for general info about medicines, not personal medicines advice, so I cannot advise you what allopurinol dose may or may not be suitable for you, but I recommend that you ask your doctor for a uric acid level blood test to find out whether your current dose of allopurinol may or may not be enough to bring your uric acid level down to ‘target level’. If your uric acid level is at or just below ‘target level’ on your current allopurinol dose, your doctor would be likely to recommend continuing your current allopurinol dose long-term (as long as you have no significant side effects), with an annual uric acid blood test to check whether or not it is still the right allopurinol dose to keep your uric acid level at 'target level'. If your uric acid level is above ‘target level’ on your current allopurinol dose, your doctor may advise gradually increasing the allopurinol dose by small amounts (the doctor would tell you the allopurinol amount to increase and how often), with uric acid level blood tests every 2-5 weeks, until you reach an allopurinol dose that keeps your uric acid level consistently at 'target level' - which would be the allopurinol dose to continue long-term (as long as you have no significant side effects; please see video and its description section, via this link, for some info on side effects: th-cam.com/users/shortsFepENI0eHW4?feature=share ), with an annual uric acid blood test to check whether or not it is still the right allopurinol dose to keep your uric acid level at 'target level'. Here is a link to my video about uric acid level blood tests which you might also find interesting (and you are welcome to show your doctor the information for doctors in the 'description section' of that video if you would like to use that info to talk with your doctor about getting a uric acid level blood test): th-cam.com/users/shortsE9ROcao5Amw?feature=share You could also show your doctor the info for doctors in the 'description section' of the following video about modern allopurinol dose schedules - and ask the doctor whether it may or may not be suitable for you: th-cam.com/users/shorts5r-j1AlRS0Q?feature=share Here is a link to my full playlist of gout SHORTS videos: th-cam.com/play/PLwyYRbsDY3jsgC6QHx6rkExPACfQbu9Du.html I hope this info may be helpful for you, and you are welcome to ask me questions about it if anything is unclear or if you would like more explanation. Best Fi :>
@dannymaiorana227 Hi Danny Maiorana Thank you for sharing your recent experience with gout and treatment. If you don’t have tophi but keep getting gout flares after 6 months of allopurinol maintenance dose treatment, I would definitely recommend to see a doctor and ask the doctor about getting uric acid blood tests - so the doctor can figure out whether your current allopurinol maintenance dose may or may not be enough to keep your uric acid level consistently at or just below ‘target level’ (please see description section of this video for ‘uric acid target levels’ in Australian gout management guidelines, and please note that ‘target level’ is lower than what you might hear called ‘normal’ or ‘reference range’ uric acid level). For example: if your uric acid level was slightly above target level, then you might not be able to completely melt the gout urate crystals, which might enable gout flares to keep happening - which may suggest that a higher allopurinol maintenance dose might be needed to achieve treatment success (treatment success meaning to enable a person with gout to never get gout flares again in future, by keeping uric acid at or just below target level life-long, in order fully melt gout urate crystals and then also prevent gout urate crystals from ever re-forming). Remember to only make medicine dose decisions with a doctor - not on your own, because significant changes in allopurinol dose (especially if the dose change is more than 100mg) might trigger gout flares in some people, because of changing uric acid level suddenly. How high a maintenance dose of allopurinol may be needed by a particular person might depend on things like a person’s genetics affecting how well their body gets rid of uric acid via ‘uric acid transporters’ in the lining of their kidneys or intestines, or how much uric acid their body makes in their liver, or side effects of some types of drinks, foods, medicines, or herbal products. If you haven’t already seen them, you might find my gout shorts videos (and the extra info in their description sections) interesting, about things that may affect uric acid level (playlist via this link: th-cam.com/play/PLwyYRbsDY3jsgC6QHx6rkExPACfQbu9Du.html ) - especially videos 5 to 8. Regarding your question about a person mostly getting gout in joints on one side of the body, the guidelines for doctors about gout management which I have read don’t discuss this, but I can make some guesses based on research - but please note that the following ideas are just guesses and are not proven facts. Some research articles I have read suggest that if a person’s uric acid level is high, the colder the temperature, the more likely uric acid is to bind together to form gout urate crystals, so perhaps if your hand and foot on one side were slightly colder than the other side, that might slightly increase likelihood of gout affecting joints on that side (for example, if circulation was slightly slower on one side of the body due to subtle differences in the diameter of blood vessels)? Just as the right and left side of our face are not an exact mirror image of eachother, other parts of our body (like blood vessels) might potentially also be a bit different on one side compared to the other. Some research suggests that the enzyme which makes uric acid (called xanthine oxidase) may be more active (and might therefore make more uric acid) if there is a lower concentration of oxygen in an area of the body - so, once again, if there was slightly slower circulation to one arm and leg than the other side, perhaps that might reduce the oxygen level slightly and potentially be a contributing factor to a slightly higher uric acid level in the area, and therefore higher chance of gout urate crystals being laid down? Thank you for your question and it will be interesting to see if any research ever comes out with some answers about why gout may mostly happen in joints on one side for some people. I hope you get a good treatment outcome. Best Fi :>
Nice but how do you stop the crystallization in the first time? How do you reduce the levels. Is there an underlying problem causing uric acid? How do I treat it. Medication is dealing with symptomatic treatment, but is absolutely not the answer to get rid of the underlying problem, so that you can one day ditch the medication once and for all.
Hi crabby paddy @crabbypaddy5549 Thankyou for your question about causes of gout. Here are links to my videos about the wide range of things that may potentially cause gout or trigger gout flares, and there is more info about potential gout causes in the description sections of these videos as well: th-cam.com/users/shortsaeFzWMTciDY?feature=share th-cam.com/users/shorts65IuNvDjE3o?feature=share th-cam.com/users/shorts65IuNvDjE3o?feature=share One of the most common causes of gout (via causing a high uric acid level) is having uric acid transporters in our kidneys or intestines which are slower at getting rid of uric acid from our body than some other people’s transporters, due to genetic differences between people. Another potential contributor to a high uric acid level is that certain types of foods and drinks may increase our body’s production of uric acid (like cane sugar or corn syrup in drinks and foods; alcohol; fruit juices; or the purines in meats, seafoods or beer). For some people with uric acid transporters in their kidneys that are slower at getting rid of uric acid, changing their main foods and drinks to significantly reduce their uric acid production may not quite be enough to bring down their uric acid level to ‘target level’. Also, some people may not wish to try significantly changing what they eat and drink. These are some of the reasons why most people with gout need to take a urate-lowering medicine (such as allopurinol, if it is suitable) life-long, because keeping uric acid level consistently at ‘target level’ is necessary to melt gout urate crystals, and also necessary to prevent gout urate crystals from re-forming in future, in order to prevent gout flares from being able to happen. Please note that there are more potential causes of gout in the videos via the links above, and if you think any of them might apply to you, as soon as possible, ask a doctor for advice about the most likely cause/s of your gout and the best personalized management option/s for you (and remember to make decisions about medicines together with the doctor, not on your own - to try to be as safe as possible). I hope this info may be helpful, and you are welcome to ask questions if you like. Here is a link to my ’10 Things You May Not Know About Gout’ SHORTS video series, in case that info may also be of interest: th-cam.com/play/PLwyYRbsDY3jsgC6QHx6rkExPACfQbu9Du.html Best PHARMACIST Fi
Hi @suecameron3124
I am glad to hear this video has been helpful for you - thank you for letting me know!
I am sorry to hear it sounds like you have been through so much with gout and COVID-19 in recent years, and yes - tendons are one of the places gout may happen, so it might potentially be gout there, as well as in your hands and feet.
That is good that you have a diagnosis and are starting urate-lowering medicine treatment.
As you say, it is possible you might have had gout first, then perhaps some uric acid level changes during or at the end of fighting a significant infection (like COVID-19) might potentially have triggered a gout flare; or your gout might have started during fighting COVID-19. One way to know would have been if samples from the affected areas had been taken before and during the infections, and the earliest sample with urate crystals in it would suggest that gout had already started by that date.
Here is a link to a playlist of videos I have created so far about gout, and some of the medicines which may be prescribed for some people with gout (if they are suitable for the person's current health conditions and medicines), in case they may be of interest for you: th-cam.com/play/PLwyYRbsDY3ju2-aCCW8SBu6fcOxitCfCJ.html
I hope this info may be helpful and you are welcome to ask questions about it if you like.
I hope your treatment goes well.
Best
PHARMACIST Fi :>
@netkotreci3135
Hi netkotreći 313
Thankyou for your question about allopurinol 'maintenance dose' for a person with gout. Although most people with gout need to take a urate-lowering medicine (such as allopurinol, if it is suitable) life-long, the dose may occasionally need to be adjusted by the doctor (depending on your uric acid level) - so that is why it is a good idea to ask the doctor about getting a uric acid level blood test at least once a year (if the doctor has not already done this for you).
This is because, as we get older, or if a disease were to affect our kidneys, or if we change our main drinks or foods, or if our weight changes: any of these changes might affect our uric acid level, which might then affect the personalized allopurinol dose needed to keep a person's uric acid level at ‘target level’ life-long (so that gout urate crystals can be melted, and prevented from ever being laid down in future).
This TH-cam channel is for general info about medicines, not personal medicines advice, so I cannot advise you what allopurinol dose may or may not be suitable for you, but I recommend that you ask your doctor for a uric acid level blood test to find out whether your current dose of allopurinol may or may not be enough to bring your uric acid level down to ‘target level’.
If your uric acid level is at or just below ‘target level’ on your current allopurinol dose, your doctor would be likely to recommend continuing your current allopurinol dose long-term (as long as you have no significant side effects), with an annual uric acid blood test to check whether or not it is still the right allopurinol dose to keep your uric acid level at 'target level'.
If your uric acid level is above ‘target level’ on your current allopurinol dose, your doctor may advise gradually increasing the allopurinol dose by small amounts (the doctor would tell you the allopurinol amount to increase and how often), with uric acid level blood tests every 2-5 weeks, until you reach an allopurinol dose that keeps your uric acid level consistently at 'target level' - which would be the allopurinol dose to continue long-term (as long as you have no significant side effects; please see video and its description section, via this link, for some info on side effects: th-cam.com/users/shortsFepENI0eHW4?feature=share ), with an annual uric acid blood test to check whether or not it is still the right allopurinol dose to keep your uric acid level at 'target level'.
Here is a link to my video about uric acid level blood tests which you might also find interesting (and you are welcome to show your doctor the information for doctors in the 'description section' of that video if you would like to use that info to talk with your doctor about getting a uric acid level blood test):
th-cam.com/users/shortsE9ROcao5Amw?feature=share
You could also show your doctor the info for doctors in the 'description section' of the following video about modern allopurinol dose schedules - and ask the doctor whether it may or may not be suitable for you:
th-cam.com/users/shorts5r-j1AlRS0Q?feature=share
Here is a link to my full playlist of gout SHORTS videos:
th-cam.com/play/PLwyYRbsDY3jsgC6QHx6rkExPACfQbu9Du.html
I hope this info may be helpful for you, and you are welcome to ask me questions about it if anything is unclear or if you would like more explanation.
Best
Fi :>
@dannymaiorana227
Hi Danny Maiorana
Thank you for sharing your recent experience with gout and treatment. If you don’t have tophi but keep getting gout flares after 6 months of allopurinol maintenance dose treatment, I would definitely recommend to see a doctor and ask the doctor about getting uric acid blood tests - so the doctor can figure out whether your current allopurinol maintenance dose may or may not be enough to keep your uric acid level consistently at or just below ‘target level’ (please see description section of this video for ‘uric acid target levels’ in Australian gout management guidelines, and please note that ‘target level’ is lower than what you might hear called ‘normal’ or ‘reference range’ uric acid level).
For example: if your uric acid level was slightly above target level, then you might not be able to completely melt the gout urate crystals, which might enable gout flares to keep happening - which may suggest that a higher allopurinol maintenance dose might be needed to achieve treatment success (treatment success meaning to enable a person with gout to never get gout flares again in future, by keeping uric acid at or just below target level life-long, in order fully melt gout urate crystals and then also prevent gout urate crystals from ever re-forming).
Remember to only make medicine dose decisions with a doctor - not on your own, because significant changes in allopurinol dose (especially if the dose change is more than 100mg) might trigger gout flares in some people, because of changing uric acid level suddenly.
How high a maintenance dose of allopurinol may be needed by a particular person might depend on things like a person’s genetics affecting how well their body gets rid of uric acid via ‘uric acid transporters’ in the lining of their kidneys or intestines, or how much uric acid their body makes in their liver, or side effects of some types of drinks, foods, medicines, or herbal products.
If you haven’t already seen them, you might find my gout shorts videos (and the extra info in their description sections) interesting, about things that may affect uric acid level (playlist via this link: th-cam.com/play/PLwyYRbsDY3jsgC6QHx6rkExPACfQbu9Du.html ) - especially videos 5 to 8.
Regarding your question about a person mostly getting gout in joints on one side of the body, the guidelines for doctors about gout management which I have read don’t discuss this, but I can make some guesses based on research - but please note that the following ideas are just guesses and are not proven facts.
Some research articles I have read suggest that if a person’s uric acid level is high, the colder the temperature, the more likely uric acid is to bind together to form gout urate crystals, so perhaps if your hand and foot on one side were slightly colder than the other side, that might slightly increase likelihood of gout affecting joints on that side (for example, if circulation was slightly slower on one side of the body due to subtle differences in the diameter of blood vessels)? Just as the right and left side of our face are not an exact mirror image of eachother, other parts of our body (like blood vessels) might potentially also be a bit different on one side compared to the other.
Some research suggests that the enzyme which makes uric acid (called xanthine oxidase) may be more active (and might therefore make more uric acid) if there is a lower concentration of oxygen in an area of the body - so, once again, if there was slightly slower circulation to one arm and leg than the other side, perhaps that might reduce the oxygen level slightly and potentially be a contributing factor to a slightly higher uric acid level in the area, and therefore higher chance of gout urate crystals being laid down?
Thank you for your question and it will be interesting to see if any research ever comes out with some answers about why gout may mostly happen in joints on one side for some people.
I hope you get a good treatment outcome.
Best
Fi :>
Nice but how do you stop the crystallization in the first time? How do you reduce the levels. Is there an underlying problem causing uric acid? How do I treat it. Medication is dealing with symptomatic treatment, but is absolutely not the answer to get rid of the underlying problem, so that you can one day ditch the medication once and for all.
Hi crabby paddy @crabbypaddy5549
Thankyou for your question about causes of gout. Here are links to my videos about the wide range of things that may potentially cause gout or trigger gout flares, and there is more info about potential gout causes in the description sections of these videos as well:
th-cam.com/users/shortsaeFzWMTciDY?feature=share
th-cam.com/users/shorts65IuNvDjE3o?feature=share
th-cam.com/users/shorts65IuNvDjE3o?feature=share
One of the most common causes of gout (via causing a high uric acid level) is having uric acid transporters in our kidneys or intestines which are slower at getting rid of uric acid from our body than some other people’s transporters, due to genetic differences between people.
Another potential contributor to a high uric acid level is that certain types of foods and drinks may increase our body’s production of uric acid (like cane sugar or corn syrup in drinks and foods; alcohol; fruit juices; or the purines in meats, seafoods or beer).
For some people with uric acid transporters in their kidneys that are slower at getting rid of uric acid, changing their main foods and drinks to significantly reduce their uric acid production may not quite be enough to bring down their uric acid level to ‘target level’. Also, some people may not wish to try significantly changing what they eat and drink.
These are some of the reasons why most people with gout need to take a urate-lowering medicine (such as allopurinol, if it is suitable) life-long, because keeping uric acid level consistently at ‘target level’ is necessary to melt gout urate crystals, and also necessary to prevent gout urate crystals from re-forming in future, in order to prevent gout flares from being able to happen.
Please note that there are more potential causes of gout in the videos via the links above, and if you think any of them might apply to you, as soon as possible, ask a doctor for advice about the most likely cause/s of your gout and the best personalized management option/s for you (and remember to make decisions about medicines together with the doctor, not on your own - to try to be as safe as possible).
I hope this info may be helpful, and you are welcome to ask questions if you like.
Here is a link to my ’10 Things You May Not Know About Gout’ SHORTS video series, in case that info may also be of interest: th-cam.com/play/PLwyYRbsDY3jsgC6QHx6rkExPACfQbu9Du.html
Best
PHARMACIST Fi