Gout and hydroxycarbamide

[Joetcalr]

I’ve suddenly come down with gout in my big toe, it’s come out of the blue for no apparent reason.

Does anyone know if there’s a connection with hydroxy which I’ve now taken for numerous years? I’m puzzled, I thought I had a healthy diet with no sugar and little alcohol.

I haven’t found the way to search this site for mentions of gout, tho I think I’ve seen it before in questions.

Any light anyone can shed would be most welcome. Thank you. Jo

[SingleMaltLover]

Are you taking aspirin? It can raise uric acid in your blood and increase chances of gout ..

[Joetcalr in reply to SingleMaltLover]

no I’m not taking aspirin, I don’t trust it not to upset my stomach. Thank you Jo

[Goose2023]

I started my mpn journey 2 years ago.....I went to doctors for gout,never had before or family history......blood tests later and bmb revealed mylofibrosis....

[Joetcalr in reply to Goose2023]

that’s interesting, thank you Goose

[hunter5582]

The short answer is that yes, hydroxycarbamide can impair kidney function (increase uric acid) and cause gout. Best to consult with a MPN Specialist on this issue. Not all docs are aware of the potential connection.

[Joetcalr in reply to hunter5582]

Thanks Hunter, I’m seeing an MPN consultant next Monday so I’ll ask them if they think there’s a connection, there’s nothing on the hydroxy side-effects list. Sounds like there should be.

[hunter5582 in reply to Joetcalr]

Some sources will list "renal impairment" while others will list "gout" or "high levels of uric acid in the blood." Gout/uric acid elevation is one form of renal impairment. The potential adverse effect on kidney function is usually listed anywhere there is information on hydroxyurea adverse effects, just worded differently and with more specificity.

[JaK2ET]

When I started treatment with Hydroxycarbamide chemotherapy, I was prescribed some Allopurinol to take just during the first few months of the new treatment. I was told that when the starting level of platelets is high, the destruction of the excess platelets by the Hydroxycarbamide can lead to an increase in substances related to uric acid and hence a potential risk of gout. The Allopurinol was used to reduce this risk, as it is much better to prevent gout than to have to treat it once established.

However, you say that you have already been taking Hydroxycarbamide for many years. Has your dose been increased recently?

My late father suffered from gout at different times. I remember his podiatrist advising him to stop having an orange juice drink which for years had been part of his breakfast - but by then I suspect that the main cause was chronic kidney disease rather than anything to do with diet.

I hope you get help with the gout as soon as possible and also find the root cause so that further occurrences can be prevented.

[Joetcalr in reply to JaK2ET]

thanks Jak2, I definitely don’t want it coming back again! Even though it was a mild case.

I saw the GP this morning and he said to have a blood test in two weeks time to check for the uric acid crystals. No my hydroxy dose has not gone up, I’m not taking the full amount they would like me to, so my platelets are slowly creeping up - around 800 at the moment.

[ainslie]

I don’t know a lot about this subject, high uric acid is fairly common with MPN, I know some on venisection only had similar problems, hence it may or may not be just the hydroxy, your Haem should be able to advise and give meds to help

[Joetcalr in reply to ainslie]

thanks Ainslie, i’ve upped my water quantities to nearer 3 L a day, and added garlic tablets back in, which I’d stopped taking as I was on holiday.

I think these two things may be more useful than any tablets the doctor plans to give me. I’ll see what the blood test says.

[jointpain]

My wife's uric acid is high possibly from hydroxycarbamide, though could be from only having one working kidney these days, she takes allopurinol so she doesn't get gout, which we assume works, and no unwanted side effects, that show.

[DJK12]

If you look at the MPN Voice website under 'additional treatments' there is a very helpful section about MPNs and gout and ways of controlling it.