Gout

Treatment

How can I bring my uric acid levels down?

There are three types of uric acid medicines. Your doctor, nurse or pharmacist will explain which uric acid medicine is right for you and why. They will also talk to you about how to take your uric acid medicine.

You will start on a low dose of uric acid medicine. Every month your dose will be increased until your uric acid level comes down to .36 mmol/L or .30 mmol/L if you have lumps of uric acid crystals under your skin.

You must take your uric acid medicine every day. If you stop taking your uric acid medicine, then your uric acid will increase very quickly. You will get a painful gout attack.

You might get a gout attack when you first start taking uric acid medicine as your body gets rid of the extra uric acid already in your body.

To help you manage any gout attacks, your doctor, nurse or pharmacist will give you a gout attack medicine to take for 3 to 6 months when you first start taking uric acid medicine.

Medicines for gout

1. Uric acid medicines – bring your uric acid down

Take uric acid medicine every day. This will stop you having gout attacks.

Serious side effects of uric acid medicines – stop taking your uric acid medicine if you get a bad skin rash. Tell your doctor, nurse or pharmacist immediately. You will need to change to another uric acid medicine.

2. Gout attack medicines – treat the pain of gout attacks

You will need to take a low dose of a gout attack medicine to prevent gout attacks for 3 to 6 months when you start your uric acid medicine. It takes time for your uric acid to come down.

Your doctor, nurse or pharmacist might also give you another medicine to take for a week in case you get a bad gout attack.

Serious side effects of gout attack medicines – stop taking gout attack medicines if you vomit, get really bad pain in your stomach or blood in your poo. Tell your doctor, nurse or pharmacist immediately. You will need to change to another gout attack medicine.

Starting on uric acid medicine

Your doctor, nurse or pharmacist should start you on a low dose and slowly build up to a stronger dose. Remember when you start on uric acid medicine you also need to take a low dose of a gout attack medicine such as colchicine. You will be taking at least two medicines for up to 6 months. Some people might have to take three medicines.

Checking your uric acid level

When you take uric acid medicine your target is to get your uric acid levels down to 0.36. You need to get your uric acid level checked regularly. You might need to take a stronger dose of your uric acid medicine if your levels don’t come down. If you have tophi you need to get your uric acid levels down to 0.30 to get rid of your tophi.

Prevention

Risk factors for gout

You are Māori or Pacific

Many Māori and Pacific people have genes that make it harder to get rid of uric acid from their bodies.

Your doctor has told you you have high uric acid levels

Uric acid is a chemical that everyone has in their body. Some people have higher uric acid levels than others. High levels of uric acid can turn into gout.

You can reduce your uric acid levels by keeping active, staying fit, keeping your weight down, eating a healthy diet and not drinking beer and sugary drinks.

You have a family history of gout

If people in your family have gout then you have a higher chance of getting gout.

Things you can do to reduce your chances of getting gout by bringing down your uric acid levels

Exercise

Being overweight increases your uric acid levels.

• Keep active.
• Stay fit.
• Keep playing sport.
• Keep going to the gym.
• Keep your weight down.

Food

Some foods, such as red meat and seafood, increase your uric acid levels.

• Keep eating a healthy diet.
• Eat lots of vegetables and some fruit.
• Eat low fat yoghurt or cheese such as Edam.
• Eat only small amounts of red meat or seafood. Eat chicken and white fish.
• Eat takeaways only once a week.

Drink

Alcohol, sugary soft drinks and fruit juice increase uric acid levels.

• Keep drinking water, coffee and tea, diet soft drinks and lite blue and green milk.
• Don’t drink too much beer, RTDs or other alcohol.
• Don’t drink sugary drinks such as energy drinks, ordinary soft drinks, orange juice and powdered drinks.

Living with

Choosing the right shoe

If you get gout in your foot, try not to wear:

• sandals
• jandals
• slippers
• old shoes.

These shoes don’t support your feet properly when you are walking or standing. This can affect your balance and make your pain worse.

People with gout in their feet need to wear shoes that:

1. are comfortable (not too tight), so there is room if your foot swells up
2. have a wide toe to leave room for your sore toe
3. have laces or velcro so you can tighten or loosen your shoe
4. have a cushioned insole that supports your foot
5. have a deep heel so your foot fits into your shoe properly
6. have a small heel because high heels can cause problems with your feet, knees and legs
7. have a firm sole that is not worn.

You need to buy a good quality shoe but your shoes don’t have to be expensive.

If you are not sure about what shoes to buy, take this list with you and talk to the salesperson in the shop.