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Well I have been on Allopurinol for a month now. I did have to stop taking for a few days after a rash broke out 3 weeks in but the rash was not related to the AP, desert allergies can be brutal. My foot has been leaps and bounds better and have only had one attack so far while on AP, predisone put the KIbash on that and I have my next round lined up. I have read in many places that “heavy” exercise should be avoided while in questionable periods related to UA levels. I have read that heavy exercise can actually raise UA levels. Is there any validity to this? If so why would that be? What would be considered heavy exercise. I am a hiker and backpacker and this last round of attacks prior to me starting on AP convinced me to start AP but also had kept me inside much longer then I can stand. I have since started my training regime again as I am headed to Deer Creek Grand Canyon in April and have to get miles in before I head to the big ditch. I have not had any negitive affects although I am only knocking out 6 miles over moderate hilly terrian 3 days a week and will be doubling the miles a few days a week very soon. In the past when I was trying to manage UA through diet and exercise I would at times get attacks while on long trips, that sucked. I am looking to avoid a similar event by use of AP but am concerned about this idea that heavy exercise will increase my UA therefore increase my chances of attack.
Good progress RD!
I don't think heavy exercise raises UA directly, it's just that lactic acid levels rise and get precedence in clearance.
Obviously, if you can measure your SUA as discussed here using the units available , you would be one stop nearer handling your exercise regime.
Failing that, Gently Does It -and build up to higher levels, bit by bit. The risk of extended over exertion is high for causing gout flares, but having flexible boots and hydrating will reduce this happening.
You'll just have to be flexible with your program and NOT take on TOO much before you know what you can manage comfortably.
Even now winning the UA war- I still notice sudden strange night sensitivity on old sites , like a folk memory! Though generally, I'm not sensing an attack being at all likely.
You need to use a meter , really – to be more in control on this.
rdavisii,
Heavy muscle breakdown most definitely releases copious quantities of nucleic acid and the normal route for these nucleic acids is conversion to uric acid as an endpoint. Allopurinol blocks much of the final conversion and thus prevents too high a serum urate level…but the serum urate can still overwhelm the drug
Hiking, being more modestly aerobic shouldn't have so much of an effect on muscle breakdown (unless you try to climb the wall of the Grand Canyon.
) More breakdown would be expected from heavy werightlifting or “to the wall” aerobic-anaerobic workouts like a marathon at a good time.So, your chances of an attack during the trip will certainly be greater than watching the Olympics but the allopurinol will probably keep your uric acid down…that's what it's made for.
Have fun! (I haven't been to the Grand Canyon in 40 years.)
I've been trying to get the fully researched answer to this together all day, but too many interuptions.
The short answer is that, if you are on allopurinol (assuming your dose is right), you have absolutely no need to worry about exercising raising uric acid levels.
Long answer, with references, mañana
Do you have recent uric acid levels to prove your dose is right?
Thanks for the replies! zip2play, 40 years to too long to not see that place, I try to make it 2-3 times a year. I do monitor my levels with a kernel meter. Right now I am seeing anything from 5.1-7.1 but it is still early in my AP career. I will go back for labs in May and take it from there. So far I am very excited with what AP has done so far, I never saw my levels below 8 when I was not on it and am very anxious to get hammering again at the long steep and remote miles. My heart pounding trips are at the end of April so I should have a real good idea by then of what AP is doing for my levels by then. Right now I only experience sorness in the typical places but it goes away over night. I have been very cautious not to jump the distance or frequency too fast, I just remind myself what all of Dec. and Jan. was like
Once I start going gym again and re stock on my SUA testing strips then I will clearly mark my reading accordingly (in my Allop diary thread 2nd post). I am very interested to see how my readings behave when I do gym on AlloP.
When not on AlloP I remember seeing readings of 13+ straight after gym and also next morning.
Just wanted to follow up on this. Been on 300mg of AP since mid late Jan 2010. I went back to the doc in late May and he took some more blood. He found that I was right at 6. We discussed in detail what I had been doing in relation to exercise and diet. He was not really that concerned with my diet but was with my exercise. At least once a week I was hiking 10+ miles a day and exceeding 2000 to 3000 feet of elevation gain on those hikes. It is not uncommon for me to do 2-3 days a week with similar miles and elevation gain/loss. He was pretty confident that this was contributing to my high numbers so we upped my dose to 600mg. This of course triggered another attack and I am just waiting out the tail end(hopefully) before I strike out again. I introduced a bike into the mix now because I find my joints just feel so much better when I bike more often. I will admit I feel safer with the rattle snakes on the trail then I do with the traffic on the roads. I find the affect of exercise on Uric Acid fascinating and a little misunderstood. It is amazing the advice I recieve about gout from the general population and alot in the medical community. Just after it was confirmed gout I was lifting weights and hammering the cardio in an effort to improve my overall health, to make that lifestyle change. My numba$$ doc at the time did not even blink at this, he actually encouraged this. No wonder my attacks increased with a vengence over the last few years, any progress I may of had from diet changes were being blown away by the exercise I was performing. My current doc left me with this advice, eat what you want in moderation. Avoid benders and long stretches with highly questionable foods. Exercise the way you want so you will continue to do so and improve. We can adjust the meds to suit your lifestyle but the most important thing is to get healty and stay healthy and that won't happen if we stick you on a program that you hate. I just wish I had that advice 4 years ago.
This is so interesting. My recent heavy weight lifting has been giving me issues with gout too, a few weeks ago it started at the left foot, then I got it in the right foot and not as much on the left. Then it went up to my pinkies and now not as much in the right foot. 2 weeks ago I was taking meloxicam which seemed to be working at first (for about a week) then a week ago a doctor put me on colchicine which seemed to work for the feet but not the pinky fingers? My blood tests came back and I was a UA level 5.4 but that blood test was taking 4 days after my heavy workout, I skipped my typical Saturday workout because I was afraid of an even worse attack. Now my doctor doesn't even know what to think after seeing my blood results. He has told me to go off of colchicine wants me to come back when I get a big attack. To be honest I'm scared to go off colchicine and get a big attack, it is pretty frustrating but I guess I have to do it.
My theory, every time I worked out my toe joints would get attacked then I stopped doing heavy calves lifting and that actually helped (so maybe all of the stress you put on the toe joint is triggering something to happen). My Thursday workout, I didn't do heavy calves work, but light (my own weight, instead of heavy weights) and I am fine today.
Sometimes you have to have mercy on the doctors (but not too often.)
Recurrent foot pain that is slight, with a low normal uric acid reading, and a good response to colchicine is a vexing issue. One might just make a guess and say “It's gout” but for the fact that the cure is a LIFETIME of drugs. That single item makes it mandatory to be certain of the diagnosis…and that certainty means both doctor AND patient.
So having a doctor say “Let's wait for the big one” is not unreasonable. In the absence of a very high serum uric acid reading, the BIG ONE is often the only way to tell whether or not it's gout. I waited out about 4 “little ones” (but not so little that I didn't need crutches each time) and I only took action when I met Beelzebub face to face…and then he went down on me, and tried to eat off my big toe for 9 days of the most excruciating pain.
monaco,
If you decide to wait for the big one, make sure you have a bottle of colchicine handy so you can abort the attack when you cannot stand any more pain. Have a couple more blood tests while you wait. Who knows, you might see an 8 or a 9 pop up?
zip2play said:
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monaco,
If you decide to wait for the big one, make sure you have a bottle of colchicine handy so you can abort the attack when you cannot stand any more pain. Have a couple more blood tests while you wait. Who knows, you might see an 8 or a 9 pop up?
Besides all the good advice from Zip, you may also want to have a bottle of Naproxen=Aleve handy (Read up on earlier/other forum post concerning Naproxen=Aleve.
Weight Lifting and Gout Update
As this topic is especially for gout sufferers who need to exercise, you should check out 2 other website pages.
1. Keith has updated Gout and Exercise to reduce Uric Acid to include new evidence to show that aerobic exercise for 45 days can reduce uric acid.
2. I have grouped new exercise discussions for gout sufferers into the Gout and Exercise Forum. So please join those discussions and add your own questions, experiences, and opinions about weight lifting and other heavy exercises with gout.
Please remember if you want personal help with any aspect of gout, the new place to ask is GoutPal’s Gout Forum. So we look forward to chatting with you about your weight training and gout.
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