Well, yesterday, I had a full hand x-ray, which I won't get the result for just yet, but my GP also added a urate test to my usual CRP and ESR blood test. ESR is fine at 10, CRP is abnormal at 32, my normal is usually between 12 and 15. Urate is abnormal, and says I have Gout!! That really makes me feel old. Is Gout the same as arthritis? It says Plasma urate level (XaDvn) 0.27 mmol/1(0.14 0.36) Normal urate levels may be found during an attack of gout. In patients on treatment aim for a level below 300umolL. Even if target is achieved gout may occur for up to 12 months. Prophylactic treatment (Colchicine or NSAID) is recommended for up to 6 months. This value has been converted from 274.0 umol/L
GP hasn't prescribed anything, so advise please as to where I go from here. Currently going down from 2.5mg to 2.25mg over 6 week period, which I shall stop doing now of course.
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Purplegloss
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Gout is a form of inflammatory arthritis - and you don't have to be old to have it!! Patients can be in their 20s and have gout. It isn't always due to high living either!!
Yes, stop reducing the pred for now until it is sorted out. Actually, a short course of pred can be used to relieve the pain of a flare of gout - it had an instant effect on my husband and the GP agreed with me it was preferable to the other medications for him given his history. So in your place - I would ask if you can try it since you shouldn't be taking NSAIDs together with pred longterm (or at all at your age of over 65 - doubles the risk of kidney injury so why most use of NSAIDs is in over 65s is questionable!!!)
Not for me to say - discuss it with your GP because you will need some pred. It is the sort of dose used for acute chest propblems or the like too. This paper about it says 30-40mg for 5 days and that worked really well for my husband.
Yes, but very unlikely…most people will take medicine as soon as the blood tests prove it’s gout…colchicine, or allopurinol, then they are taken from then onwards…unless it’s just a mild bout. But as soon as it’s proven to be something regular, you continue to take it, as a preventative.
The uric acid test is raised in everyone with gout and the symptoms are important. The definitive test is to aspirate fluid from the affected joint and look at it under a microscope. There is also psuedogout - same symptoms, no raised uric acid and different crystals found in the joint.
Uric acid blood test to see if it’s gout or pseudo gout, they have similar symptoms, but blood test will show. Do you believe you have gout,please…you seem so interested in it! It’s very bad when it happens, nobody would ignore it! Hubby’s was on his knee and he couldn’t walk & had an unheard of 3 weeks off work! S x
Well all my diagnosis from tests mri s exrays etc suggest osteoarthritis never any talk of gout and I dont have problem with pain in toe where I understand usually starts
So it doesn’t sound like you have it. That’s good. I have bad osteoarthritis in both big toes,& it’s not gout..so don’t assume if you get pain in your toes that it’s gout!! And yes, the pain in my toes is very strong, & painkillers are not helping it…but my blood test shows it’s not gout! Glad you haven’t got it!
I just got a presentation in my email from Medscape about gout!! In it it says it can resolve on its own in a couple of weeks and symptoms disappear for a time until another episode. If not treated, it may progress to involve more joints, larger joints and joints nearer to the trunk - the typical first joint to be affected is the big toe joint. Swellings called tophi develop, containing the uric acid crystals. All patients with gout have high uric acid - not all patients with high uric acid have gout. And diet is quite important.
My husband had gout in his 40’s! He took Allopurinol, but after a second bout was told he had to take it for life. So far, 40 years have rolled by & he hasn’t had another attack! There’s help for gout & it works!!
As long as you keep taking it!!! My numpty decided that since he hadn't had another attack he could stop!! And what happened????? Of course!! For a supposedly intelligent HCP he could be a bit dense ...
No - allopurinal is a POM so must be prescribed by your doctor. It's purpose is to reduce the amount of uric acid your body produces so that it stops forming crystals in the joints which is what causes the inflammation and pain. It isn't a pain reliever or antiinflammatory - its purpose is purely preventative. If you were to have a flare up you would still get acute medication.
My husband had no side effects at all, & once he had a second bout of gout he was out on allopurinol for life. But your Dr will prescribe it. It’s a good preventative medicine, but onky when people are proven to get gout. My husband wasn’t prescribed it for first bout, but as soon as it re-occurred he went onto the preventative for life. Good luck!
Oh, ok, so it is something I could suggest my GP to prescribe if further problem occur then.
Meanwhile I balanced up the time it would take to ask my GP if I should take 30mg/40mg Pred for five days, with the fact that my hand/fingers would be swollen whilst I waited, probably a week for a phone call and at least two weeks for a face to face if I am lucky. My GP is only at the surgery 3 days a week, and one of those is always emergency calls, so you get two days in reality which is Wednesdays and Thursdays, I think he does other GP type stuff the other days like training others etc. So, as after 7 years of taking Pred and quite some time since I have needed to be as high as 5mg I have quite a stash of in-date Pred some 2025 others 2026. I took 30mg yesterday, and another 30mg this morning, and what a difference already to my hand when I got up this morning, I could actually use my right hand almost properly which I had not been able to do for about a month. I will take 30mg for three more days, but wondered when I stop on Monday, if it will be ok to go straight back to 2.5mg which is where I was before I started reducing to 2.25mg. I would probably stay at 2.5mg for a couple of months and start up again reducing n the New Year if all is well.
With regard to my slither of broken bone that I had from way back in the summer(I have always been able to feel it moving) so although I tried the splint it did not do anything for it, and would probably have been ok for a full finger break, so I thought about it, and decided to use my own method, which was to put a sticking plaster over the broken area at about 9pm each night until 8am the next morning, thus holding it in place. Did this for three nights, and it is sorted!! Can't feel in moving now, and the x-ray says healed old break. Funnily enough whilst I have been typing this the Physio has just telephoned me from the Practice, and I explained what I had done about the slither of broken bone, and she said " that's great, you don't need us"! However I did have to explain what I was doing about the swelling and she is sending a note to my GP, so the cat is out of the bag that I have upped my Pred for 5 days, so hope he is ok about that, but as he isn't in until Tuesday, I will have completed my 5 days anyway. Thanks for all your help.
Yup - if you take a short course of pred it is no different to anyone else doing it, just your baselines isn't zero, it is your old dose.
Apparently, in some places they do also use low dose pred for prophylaxis. So I suppose it is possible it is appearing because of your lower dose of pred and a bit more might kill 2 birds with one stone!!!
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Blood tests reveal high ESR whilst CRP in normal range
CRP readings
Update on who to believe 
? PMR flare without raised ESR or CRP 
Back to where I started in February 2022 😥
