[nobody]

Good foods vs. bad foods is the wrong approach. You need to look at the whole diet.
For instance if you’re not eating fish or meat, you need to eat large amounts of stuff which isn’t on your list. Tomates and carrots can make you feel like you’ve eaten a lot while olive oil and honey will give you energy… potentially leaving you badly malnourished.
But I’ll play you game anyway. Opinions ahoy!

I think it would be hard to argue against tomatoes and carrots. As always, there’s a point in which “larger quantities” is too much. But within reason, they’re fine. Tomatoes are often reported as a gout trigger for some reason but gout triggers aren’t necessarily the foods which cause gout.
Sweet potatoes are easier to abuse but are in principle OK. Hypoxanthine has been detected in sweet potatoes and there is evidence about hypoxanthine and uric acid but as long as you don’t that stuff with abandon as if it was a less nutritious food, you ought to be fine.
Olive oil obviously contains lots of fat… there’s much potential for abuse there. It could also be a gout trigger (not sure). In any case a couple teaspoons per day is fine.
Honey though… now that’s a fructose bomb! Expensive fructose is still fructose. It’s the one thing in your list there’s decent evidence about (that I’m aware of anyway). If you’re talking a couple of teaspoons, that’s not so bad but the less you eat, the better (again within reason: there’s not going to be a material benefit in reducing very small amounts).

[nobody]

So the pills are indeed made in Germany. I bet all pills for the European market are made at the same factory.
I had misunderstood you earlier and assumed the pills themselves were different, not merely the cardboard. The shape and color of the pills could vary without changing their effectiveness but it looks like you’re getting the exact same pills anyway. Mine look the same as well.

[nobody]

Chicken breast actually seems pretty bad purine-wise. There are several typed of purines which do not have the same effect. I don’t eat meat so I haven’t looked into the issue but the japanese numbers I just looked at suggest that in addition to its large purine content, the purines mix in chicken breast is worse than in most beef cuts. But the samples might have been biased.

There’s a chance a period without attacks simply coincided with your chicken diet. More extensive trials would be needed to establish that there really is a relationship.

Gout is not all about purines, and it might be something else in beef which triggers gout in some people. It might even depend on how the animal was raised or its health as opposed to the nutritive value of the meat. When something hasn’t been studied properly, you never know.
The fat in many beef cuts might be a problem. Certainly that’s a major difference with lean chicken parts. The processing of different types of fats in the human body has been (indirectly) linked to gout attacks.
And for all we know the problem many seem to have noticed with red meat might have to do with the way people tend to cook or season it rather than with the meat itself. The side-dishes people tend to eat with chicken might also differ.
What we do know is that eating meat of any kind is associated with an increased risk of gout.
At the end of the day, avoiding triggers is only a way to delay the inevitable and the only way to cure gout is to lower the amount of uric acid in your body. Measuring the amount of uric acid in your blood when you are feeling well is the cheapest way to know if a time bomb is ticking or if you’re actually solving your gout problem.

[nobody]

Makes sense to me. An attack is an immune crisis. They’re definitely stressful which can cause all sorts of nervous and psychological trouble. A mindfulness practice should help with that (as do the right drugs).
But in contrast with drugs, being mindful will also make the consequences of stress more apparent to you. The same thing might be happening to many gout sufferers, only they (and their busy doctors) haven’t noticed.

[nobody]

I have no idea how trustworthy your manufacturers are. If the manufacturers are doing their job (and if they are EU manufacturers, they should be!), the only way brand and location of manufacture would matter would be if the packaging mattered (drugs which are broken down by stomach acid, delayed-release pills and so forth). A molecule is a molecule and I don’t know that the packaging matters for febuxostat. Maybe it actually does though.
Out of curiosity, what have they switched you to? You used to get Adenuric pills, right? There’s nothing on my packaging that says where the pills come from but if I had to guess, I’d say the pills were made in Germany though the actual febuxostat might have been produced in Italy or even further afield.

Often times, people lie about the difference between brands. There’s quite a bit of money in this game and little accountability.

[nobody]

That’s good news, though you’ll have to keep monitoring your kidney function to make sure allopurinol isn’t making it worse.
Maybe you are one of those people who flush uric acid slowly so that the full effect of the drug takes a long time to become apparent. If your next test shows that your last result wasn’t a fluke you could possibly try lowering your dose a little.

I would recommend against randomly increasing your dose. Allopurinol isn’t a harmless drug. If your body starts reacting to it badly, you’ll be very sorry so don’t take chances. If you have an attack, taking anti-inflammatories on top of your regular allopurinol dose is recommended instead.
And drinking more water when you feel an attack coming to help flush out the crap can’t hurt. You could also try eating more foods which make urine less acidic such as most vegetables. That could help too.

[nobody]

Hi!
Understand that these attacks are damaging your body. Over time, this crap can eat into bone at which point it takes forever to get rid of it. It also increases your risk of developing stuff like OA.
Now you are correct that allopurinol is dangerous. So if you want to be safe, start with very small doses, increase the dose slowly, never take much more than you actually need and get your blood tested regularly for signs of distress as long as you are in the process of increasing your dose. You might also want to get a genetic test prior to starting the drug if you have East Asian ancestry.

[nobody]

I have no idea what colchicine would do to your hemo given your condition. But I wouldn’t take less than one every other day. And that’s not going to do much.
If you handle NSAIDs well, maybe it’d be best to take a delayed-release anti-inflammatory pill every day for a little while? Or simply to take a fast-acting nti-inflammatory pill whenever symptoms seem to start stirring?

[nobody]

I’m going to sound like a broken record but there you go…

If you used to have more uric acid in your blood before 2017, some of the resulting crystals could still be in your body. It sometimes takes longer for the crystals to go away.
But the longer your problem goes on while your test results remain this low, the less likely it becomes that your problem is caused by uric acid.
At some point you’ll have to ask medical professionals to investigate other causes, especially if your symptoms haven’t improved. If on the other hand the problem was becoming less severe over time, it would make more sense to keep waiting.

I guess there is also a chance that the tests you’ve been taking are biased.
But your symptoms aren’t typical gout symptoms in the first place.

[nobody]

One of the first arthritic symptoms I got was achilles tendonitis. I also had random hip pain a while back. It could have been gouty symptoms or it could have been something else. Hard to tell.
I had a number of big toe episodes as well so the gout diagnosis was more obvious. The most-affected locations in my case have been: toes, ankles, wrists, fingers and knees (in that order). Achilles tendons and hips come way behind.

Gnome, you could ask your doctors about a drug more specific to gout symptoms called colchicine. Whether it works for you or does nothing, that might be one more clue to help with your diagnosis.
Regular anti-inflammatories such as Ibuprofen might also be worth trying. They’re not specific to gout but work pretty well if the dose is sufficient.

[nobody]

Unless you’ve exercised vigorously before every one of these tests or something, it definitively looks like your uric acid level is high enough for concern.
Even if uric acid has nothing to do with your ankle/foot issue, chances are that letting it remain that high will in time cause you harm. There are risks involved in taking any drug as well of course so this is a matter of getting the balance right. That’s your doctor’s job. Just make sure they’re dutifully monitoring how your body handles allopurinol (blood tests for liver and kidney function in particular are recommended after starting the drug).
Be aware that if you are prone to gout, taking allopurinol could trigger a violent attack (in which case it was only a matter of time before you experienced something like that) and that it will take a long time before your symptoms are cured. In other words, allopurinol doesn’t replace a drug which controls inflammation. If you experience swelling and/or are in pain, you will need at least one other drug on top of allopurinol so make sure you have it on hand. You don’t want to wait for an appointment with your doctor when gout strikes.

[nobody]

If you were to repeatedly test around 366 on 60mg (which is doubtful), yes: 70mg and especially 80mg should be enough to nudge your test results into safe values.
Obviously if your next test result was around 390, that would be all the more reason to increase take 80mg. Hopefully it’ll be around 350 instead.

The risk of attacks beign increased while on ULT doesn’t mean you’ll get a serious attack every week. It’s what most people seem to report over several months. Your symptoms might improve over a couple of months before you are suddenly be hit by a serious attack. Or maybe you’ll never have another one… all I can tell you is: be prepared regardless of how well you’re feeling. Just in case.

I was actually thinking your situation might warrant more aggressive pain management (meaning stronger drugs). You want to be especially careful with drugs when you don’t know how long you’ll be taking them but when your trouble is temporary…

[nobody]

Hi!

1) I’m no doctor but 10.0 seems high enough to be dangerous. You might want to double-check that value with a second test before starting a daily medication though.
Among things which can raise uric acid are: certain foods and alcohol (when consumed without moderation), strenuous exercise, certain drugs as well as certain serious diseases. So you want to make sure you aren’t taking a drug which increases uric acid (in that case, perhaps you could change that medication instead of adding yet another drug to your regimen). And if you have had old blood tests showing a much lower value for uric acid, you want to make sure you’ve been checked for the most common diseases which can increase uric acid.

2) Allopurinol could in principle lead to kidney stones for a different reason. But so far as I know, it’s on balance more likely to protect you from kidney stones in the long run. Breaking down the crystals might lead to an existing stone passing though. Anyway, that’s not a reason to avoid allopurinol.

3) It’s different in every case. It depends on how efficient your body is at getting rid of uric acid and on how much allopurinol you’re taking (you’ll probably need more than 100mg per day but it’s safer to start with a small dose). In any case, your will most likely need to keep taking allopurinol for quite a while after the level in your blood has dropped before your body is cleansed of the crystals.

[nobody]

Hi!
What’s most likely going on is that you’ve taking 80mg Uloric which is a very strong dose. On top of that you took other things known to lower uric acid. 80mg Ulric alone is typically slightly less effective (one would expect your uric acid to drop to about 3.4 rather than 3.0 on the basis of that pill alone) but your test result is certainly not surprising since there are differences between individuals which make the drug more or less effective. There are also some random variations in one’s uric acid test results so I would not rush to conclusions based on a single test.
But maybe you could try taking 60mg Uloric instead of 80mg? In the long run, you might do well with a lower dose such as 40mg (or possibly even less). But in the meantime, uric acid testing at 3.0 for a few months is not dangerous as such. The latest guidelines I’ve seen recommend against letting your uric acid remain under 3.0 for an extended period of time so I think it would be prudent for you to avoid taking so much Uloric for years on end. More to the point, there is the matter of the drug’s side effects…

I’m not familiar with all the abbreviations in your blood test result but I am not seeing liver function tests in there. If you are taking a strong Uloric dose, it is vital that your liver function in particular be tested.
It is also very important that you report suspected Uloric side effect such as the itch you are experiencing to a skilled doctor. Drugs can be very dangerous if taken carelessly. So if your itch gets progressively worse, do not allow the problem to fester without an explanation as to what’s causing it! In doubt, you could lower your Uloric dose or replace it with a different drug to see if that helps with your itch. It is not necessary to keep your uric acid lower than 5 or 6 so you should not accept serious side effects. Just be sure to keep monitoring your uric acid if you change your dose or switch to a different drug.

I would also recommend you discontinue bicarbonate for gout in particular unless you know for a fact that it is safe for you to take.
I think you could also do without cherry pills and ACV. Eating actual cherries is of course healthy and there is no particular reason for you to avoid vinegar. I would simply avoid unecessary supplements seeing that the Uloric you’re taking is more than sufficient to control your uric acid.

Finally, gout symptoms aren’t expected to go away immediately after lowering one’s uric acid. The symptoms may instead become progressive milder over the course of several months. In some cases when gout has gone untreated for a long time, years of low uric acid are necessary for the patient to be cured.

[nobody]

Hi!
I didn’t answer earlier since I don’t know anything about the drugs you’ve been taking. But since your post remains unanswered, here’s my opinion:
First, you should try to put an end to this swelling. What you describe sounds harmful. If the steroids didn’t help, you could ask a doctor if you could try regular anti-inflammatory drugs. A strong dose might be required but these drugs can be dangerous so be sure to discuss the matter with a professional, especially if you feel side effects.
Second, you will have to keep monitoring your uric acid. Maybe it was only high because of the virus. But if you’ve had high uric acid for a long time, you may need lifelong uric acid medication such as allopurinol to stop gout from coming back more and more often. It may also take a long time after you start the treatment for the strange swelling and pains to go away for good. So people often take a drug which prevents gout swelling and pain along with the uric acid treatment during the first few months.
Good luck!

[nobody]

I don’t know what process your chemist uses but there are reports of cheap tests underestimating uric acid so I would recommend you get a full blood test (including liver and kindney function) because allopurinol is usually not that effective (meaning that you might indeed need more than the beginning dose if your chemist’s numbers are off).
I must also stress once more that having at least one liver and kidney function test a month or so after starting allopurinol is strongly recommened. Your doctor is taking chances if they didn’t make sure you got tested at least once.
Taking allopurinol only when you eat richly makes little sense by the way. The drug stays in your system quite a while (you wouldn’t actually need to take it every day but that makes things easier and smoother).
What allopurinol needs to get rid of crystals is an adequate dose (how much that is varies quite a bit between individuals) and a lot of patience. After having thoroughly cleansed their system, some people find that they can discontinue allopurinol for a few months or even years before the symptoms come back.

So far as I know, pseudogout shouldn’t respond to allopurinol.
Both gout and pseudogout should respond to Naproxen however. Naproxen should be immediately effecive in suppressing any kind of inflammation (assuming the dose is adequate) unlike allopurinol which acts on the root cause of gout.

[nobody]

8mg/dl is enough to develop gout but as you probably know, lots of people have that much uric acid without developing gout.
Since you already started allopurinol, it makes sense to simply stick with it for a while and see what (if any) symptoms persist. In my opinion, the symptoms you described make more sense as gout symptoms in the context of having started allopurinol recently. Having little uric acid in your blood will help keep gouty episodes short, ideally so short that redness and swelling do not develop. Irritating deposits are also known to migrate in the initial phase of therapy. If you’ve had untreated gout for years, gout symptoms could take a long time to go away completely.
But people who had gout (especially untreated for a long time) are at risk of developing joints problems such as OA. These won’t go away after successful allopurinol treatment unfortunately.

I wouldn’t recommend increasing you allopurinol dose if 100mg is enough to drop your uric acid to 3.5 mg/dl. Lowering it further could provide a small benefit but you’ll have to wait for allopurinol to do its work anyway.
I would however recommend verifying that 100mg is indeed enough by getting another blood test if you only had one test returning such a low value after starting allopurinol. If your average result was more like 4.5, increasing your dose would make more sense (but note that you could increase your dose to 150mg rather than 200mg). It would be prudent to get frequent blood tests in the initial phase of allopurinol treatment anyway in order to detect troublesome side effects, especially on the liver and kidneys. If you were to increase your dose, liver and kidney tests would be strongly recommended.

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