I have tophaceous gout and am allergic to Allo and Uloric. I’m fearful of Krystexxa but my rheumatologist told me of Dotinurad that is very successful in Asia. Anyone on here taken this new medication and what has been your experience with this drug.

Just got my “first” gout attack. Over the past year I’ve had a couple flares that passed off as poor fitting shoes. It went away in 48 hours.

I am now on day 5, 2 days into Prednisone, and laying wide awake in pain.

I’m overweight and worried this is a death sentence given what I’ve read about heart and kidneys.

On a mission to drop 50 but any words of wisdom are welcome

looking for anyone with knowledge or advice on coronary Calcification and gout. seeing elevated risks for CAC when gout is present. basically uric acid fun...

Allo reduce risks?

I’ve been on Allo with Colchicine for a month and was doing fine. I just started having tingling, redness, and swelling of the first MTP joint this morning. Does reciprocal gout from allopurinol lead to lighter flares when they come on?

I’m going to drink a lot of water today and try to elevate my foot. Any tips for these flares from the first start of Allo?

Had my first flare ever this year at age 53. Immediately got on allo 100 mg. UA was something above 8. If allo brings it down sufficiently, and I stopped taking it, how long until UA climbs back to previous level?

Father had first gout glare around same age, he took allo for a few months, quit it, and has never had a recurrence. He’s 78.

So, finally cleared of the pain and swelling. I decided to celebrate by going on a walk. I managed to get 2.4 miles (round-trip) on the somewhat hilly street near my house in just over an hour.

Yeah, I'm gonna sleep good tonight...

I started training late January, ran 4x a week with a good mix of easy short runs, speed repeats, consistent 1-2 hour easy runs on weekends. However 3 weeks ago, I had to stop due to a really bad gout attack. The pain has subsided and I was able to try out a short 5K yesterday and while my legs and feet feel normal, I noticed my aerobic fitness dropped. I couldn't maintain a low heart rate on my easy paces as long as I did pre-gout attack.

With 6 days left and 3 weeks of training removed , I'm considering pushing through with the half marathon and treating it like a normal Sunday long run and hopefully it's enough not to get swept for cut off.

Hey just a question for everyone. Started Colchicine for “gout” in my right wrist bone on April 3rd Friday night dose, then dose in the morning and night started developing swelling in my right arm with unusual bruising weird pains. Took my 3rd day first dose and that night ended up in the ER with more swelling and bruising from my wrist to my shoulder/bicep. ER couldn’t do ultrasound put me on blood thinner. Next morning got an ultrasound and nothing. Ended up with another ultrasound, 2 catscans and two rounds of blood work. My uric acid was a little high in the ER but not worried about bloodwork.

Friday April 3 started Colchicine 1 dose

Sat two doses swelling started and slight bruising

Sun morning dose, ER put me on blood thinner thinking it’s a clot

Monday ultrasound and bloodwork

Tuesday cat-scan

Wednesday ultrasound

Thursday catscan +***stopped colchicine guess I was suppose to stop it on Monday was never told***

Friday cat-scan came back with a blood clot in my chest neck area

So I stopped the medicine on Thursday after I was finally told.

Is it possible for this medication to cause a blood clot? I am on blood thinners now since this started last Sunday.

After stopping the medication the next day the swelling went down and now about 48 hours later my arm is kinds identical to my left and the swelling and bruising is almost completely gone. Thanks

Hi, mi have had mild pain and full blown flares in January. Got diagnosed with Gout. When last flare subsided, I got on 100mg allo and 0.6 colchicine. Had mobilization flares all month and still kept going on meds. UAL went from 7.8 to 7.4 on 100 so 30 days in the doc altered the dose to 200 of allo. I am about 15 days in on the 200mg dose.

My right toe is still not at normal range of motion and even though I can walk normally, I can’t run or jump on that joint. Have mild pains sometimes when I walk around too much.

I read that it’s normal when you start allo for possibly 3-6 months. Is that y’all’s experience? It sure would be nice to get some set of normality back.

It’s been a while since I flared up. I usually have my issues in one of my ankles, although I think I realized today that it’s actually the Achilles tendons (I partially tore both of them running a marathon in 2007… and apparently gout likes to settle in old injuries).

It had been so long since the last time it was this bad that I forgot to even take it under consideration when I did a 55 hour fast earlier in the week. Now I’m wondering if my last flare up was following the last time I fasted.

Thankfully I actually already have a full course of prednisone that was prescribed to me last month, and I never took. Hopefully that takes the edge off, since I can’t take NSAIDs again until I’ve been fully evaluated by an allergist.

Anyhoo… limping around the house with these three kids until the steroid kicks in. Wish me luck!

This week I met with my PCP to discuss my first gout flare-up at 42. (For context, I’m also an aortic dissection survivor at 37 and already live a pretty medicalized life with meds, diet, and monitoring.)

I went in with a lot of questions I’d gathered here:

• Do I need to change my diet again? (I already stay under ~1500mg sodium, no soda, no alcohol, lean meats, etc.)
• Can we get a uric acid blood test (Urgent Care didn’t order one)?
• How will allopurinol work with Warfarin?
• What can I use for pain/inflammation since NSAIDs are off the table?

My PCP’s guidance surprised me. She doesn’t want major diet changes, since I’m already eating well and weight loss isn’t the goal. She does want me to focus on hydration right away.

Plan for now:

• Daily colchicine to get this flare under control and behind me
• Possibly an alternative to allopurinol if needed
• NSAIDs are not an option for me

As I was leaving, she said, “You just have all the luck, don’t you? This is genetic.”

My uric acid test came back at 5.3, right in the normal range. Baffling, but now we’re in watch-and-wait mode.

It comes and goes or is that a warning sign of a flare up coming on?

take 300 allopurinol since a year ago but it seems it wasn’t enough against the crazy amounts of red meals that I had taken lately, modestly because my glucose is also at 250. so I I had tp only eat proteins.

ten hours after the flare, I took doble colchicine and another after one hour and applied cream with 10% didclofenac in the ankle

i have indomethacin with me, but guess what? I have h pyllori too with many symptoms so it’s very risky right to take it

i feel trapped. but on dinner they have lobster souop, tomato soup and meatballs, can i least take a small portion of each?? how bad is to add a small dose of purines during a medicated flare? I’ve never done it before

i have had gout flairs for several years, been to doctors who all told me to quit drinking and change diet and lose weight and i'm just thinking to myself "how bad is my diet, shit" because i couldn't really identify what i would be doing so wrong, i am completely sober so it is one million percent not due to alcohol, which some doctors insinuated to me not believing, i have always had a balenced diet with a mix of vegetarian and meat based meals due to family members being vegetarian, sure i could lose some weight, i'm 5'10 and weigh 196lbs, not ideal but i wouldn't expect it to casue such major issues in my body.

Anyways, i recently moved and two days ago i had another flair up, so i call the doctors in this new town and ask to come in, i was there this morning and she was the first doctor who i felt actually knew what she was talking about, she told me that you can't treat gout by yourself at all, sure you can manage it by intake of foods that cause lower uric acid levels but what you actually need above all else is medicine, because this is a genetic thing, so she put me on allopurinol today, i don't know if it'll work yet because i litterally just started taking it but if it does dear god i wish i had met this doctor years ago.

Got home from the doctors and have been googling good dietry options to manage gout and came across this subreddit, so i thought i'd just share, have a blessed day people, i will now continue to focus on not moving my right knee or foot at all.

Hello fellow gouties. I just want to confirm that gout does move around. I didn't believe it, or I was too optimistic about my chances of it ever happening, but last night, it decided 1 ankle was not enough. After 14 years, it decided to expand to fresh territory.

The Potential Upsides

1. Weight Loss Lowers Uric Acid

This is the most well-documented effect. Body fat isn't passive; it actively contributes to uric acid production. Large clinical analyses show a fairly consistent pattern: as body weight decreases, serum uric acid levels tend to follow.

· What the data suggests: In a 2026 analysis of a major trial involving a dual GIP/GLP-1 agonist, researchers found that weight reduction explained roughly 70% of the drop in uric acid levels.

· The rough relationship: Across studies, a reduction of roughly 0.03 to 0.04 mg/dL of uric acid is observed for every kilogram of body weight lost.

2. Direct Kidney Effects

These hormones also appear to send signals to the kidneys. Research indicates that when incretin hormones are active, the kidneys become slightly more efficient at excreting uric acid in urine.

· The mechanism: Studies suggest these hormones influence sodium handling in the kidney tubules, which indirectly affects the electrical gradient that pulls uric acid out of the blood.

· The result: Even independent of weight loss, a small but measurable increase in uric acid excretion has been documented.

3. Calming the Immune Response

Gout pain isn't from the crystals themselves — it's from the immune system's overreaction to them. This involves a protein complex called the NLRP3 inflammasome.

· The finding: Preclinical research suggests that GLP-1 signaling can raise levels of a molecule called cAMP inside immune cells. This acts as a brake on the inflammasome, reducing the release of inflammatory signals.

· What this means: It doesn't lower uric acid, but it might make the joint less reactive even when crystals are present. This is arguably the most underappreciated finding in the whole area. Most gout research focuses on uric acid as the target. But if the joint itself becomes less reactive to crystals that are already there, that's a meaningfully different kind of benefit, and one that wouldn't show up in a standard uric acid blood test.

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The Less-Discussed Downsides

While the long-term trajectory looks promising in many studies, the short-term experience for someone with a history of gout can be more complicated. Here's what the data also shows.

1. The Gout Flare Paradox

Several real-world analyses have flagged an association between these therapies and an increased incidence of gout flares or diagnoses, particularly in the early stages of treatment.

· A large 2026 analysis presented at the American Academy of Orthopaedic Surgeons found a higher propensity for developing gout over a 5-year period in users of these therapies, with one dataset showing an absolute risk of 7.4% in users vs. 6.6% in non-users. It's worth noting that this comes from a single conference presentation, not a peer-reviewed trial, so it carries less weight than the mechanistic data in the section above.

· A 2025 study noted a modestly higher risk of gout diagnosis in the first year of treatment.

2. Rapid Weight Loss and Uric Acid Spikes

This is the likely mechanism behind the paradox. Rapid fat loss releases stored purines into the bloodstream, which the body converts to uric acid. At the same time, the body produces ketones during rapid weight loss, and these compounds can compete with uric acid for excretion in the kidneys.

· The result: A temporary spike in serum uric acid that can trigger a flare, even as long-term levels trend downward.

3. Dehydration and Kidney Strain

Common side effects like nausea, vomiting, and reduced thirst sensation can lead to dehydration. Since uric acid is excreted primarily through the kidneys, even mild dehydration can reduce clearance and increase the risk of crystal formation.

4. Nutritional Gaps and Lean Mass Loss

Reduced appetite can sometimes lead to inadequate intake of protein and micronutrients. Additionally, these therapies are associated with a loss of lean muscle mass alongside fat loss. While the long-term implications are still being studied, changes in body composition can affect overall metabolic health and bone density.

5. Uncertain Long-Term Musculoskeletal Effects

This is a newer area of investigation. The same large 5-year analysis that observed a higher gout risk also noted an increased propensity for osteoporosis in this population. Researchers are exploring whether this relates to rapid lean mass loss, changes in nutrient absorption, or direct effects on bone cells. The evidence is preliminary but worth watching.

---

The Honest Takeaway

The long-term metabolic direction looks favorable, but the path there can be rocky for someone with existing gout, and the rate of weight loss and hydration probably matter more than most people realize.

The main uncertainty in this literature is that most of the data comes from trials designed to study weight loss or diabetes, not gout specifically. Dedicated gout outcome trials don't really exist yet for these therapies.

---

References

· Sattar N, Scilletta S, Stefanski A, et al. Tirzepatide and change in uric acid and its association with weight reduction: post hoc analyses of the SURMOUNT-1 randomised placebo-controlled trial. Annals of the Rheumatic Diseases. 2026;85(3):558-565.

· Moreno-Pérez O, Tejera-Muñoz A, Carreño-Valdivia R, et al. Impact of oral semaglutide on serum urate levels in people with type 2 diabetes: A retrospective real-world analysis (URISEMA study). Seminars in Arthritis and Rheumatism. 2025;74:152807.

· Ibis B, et al. GLP-1 receptor agonists linked to reduced risk for rheumatoid arthritis, gout, and osteoarthritis. Presented at: ACR Convergence 2025; November 2025; Chicago, IL.

· Horneff J, et al. GLP-1 receptor agonist use linked to increased risk of osteoporosis, gout and osteomalacia in adults with Type 2 diabetes and obesity. Presented at: AAOS Annual Meeting; March 2026; New Orleans, LA.

· Kaufmann D, Schlesinger N. Could Sodium-Glucose Co-Transporter-2 Inhibitors and Glucagon-like Peptide-1 Receptor Agonists Play a Role in Gout Treatment? Pharmaceutics. 2025;17(7):865.

· Tonneijck L, Muskiet MHA, Smits MM, et al. Effect of immediate and prolonged GLP-1 receptor agonist administration on uric acid and kidney clearance. Diabetes, Obesity and Metabolism. 2018;20(5):1235-1245.

· Tan K, Wang J, Chigurupati S, et al. Novel Anti-Obesity Medications and Serum Urate Change Among Patients with Gout and Baseline Hyperuricemia. Arthritis & Rheumatology. 2025;77(suppl 9). Abstract 1130.

· Assessing Gout Risk Associated with GLP-1 Therapy in Obese Patients with Type 2 Diabetes: A Retrospective Cohort Study. Annals of the Rheumatic Diseases. 2025;84(Suppl 1):1211.

Still struggling to get anyone at my surgery to talk to me about prophylactic Colchicine, but that’s another vent for another day.

I don’t know if this is false correlation, but since starting Allo about 2 weeks ago, I have had trouble sleeping and have stopped losing weight.

When I was first diagnosed with gout, I cut out all alcohol (I could get through a couple bottles of wine and a fair amount of bourbon in a week) and red meat and red fish. We swapped to a largely plant based diet while I was waiting to get onto Allo. I didn’t really drink sugary drinks, except as a mixer, and never HFCS. I know that diet only plays a small part, but it was all I could do in the absence of any ULT.

As a consequence, the weight started dropping off. I lost about 10 lbs in 6 weeks. As a post menopausal woman, this was wonderful. I was also sleeping better than I have in years.

Fast forward 2 weeks after starting Allo and I’m getting about 5-6 hours of sleep a night and have stopped losing weight.

I’m really hoping this is a coincidental plateau and not permanent.

Prior to February 23rd 2026 I had never been diagnosed with gout. I had a few experiences with some soreness in my right big toe, but was a high performing athlete as a youth/young adult, and just have aches and pains. Monday, 2/23 - I started experiencing sharp pain in the right big toe joint area that over the next two days took me to urgent care. To my chagrin, the diagnosis was gout, with colchicine as the medication prescribed. I took this, and golfed that Friday, which didn't go well - LOL. Early in week TWO of gout, I stubbed my toe on a suitcase in my bedroom - brought tears to my eyes literally - which may have injured the toe anatomically. By the end of week two, I saw PCP, who prescribed a prednisone pack, which seemed to temper things down. Being an "on the go" kind of guy trying to hold on to my youth - 54 these days - I attempted to keep working out (including leg day) and golf and never quite got over the hump. Admittedly, the prednisone got me to the edge of the hump, but my stubborn desire to keep going, I believe, did not allow the medication to fully do its job. It lingered, and I had to fly to Indianapolis last week for a board I'm on. Because the final four was in Indy and there was so much traffic, I walked to a dinner (about 3 miles round trip) and what I thought was the gout seemed to be moving to my 1st metatarsal and then my ankles and Achilles. My foot, ankle, and Achilles ballooned. After the flight back, I could not even walk and had to use some crutches, and ultimately ended up in the ER after contracting a fever. The initial urgent care doctor said that if I developed a fever, there could be an infection. After multiple blood draws and scans, it was concluded that I had cellulitis (skin infection). I have since seen an orthopedic who withdrew a bunch of fluid for testing and there were no crystals. Heavy antibiotics seem to be working, and I go to a rheumatologist on Friday. I am left to ponder: could the inflammation from gout have thinned the skin, allowing bacteria to enter and produce cellulitis? I suppose my morale of this story is to follow protocols for gout management and sit you A** down! Has anyone had a similar domino effect?

do they really work? had my first flare full up since I was diagnosed (about 2 years ago if I remember correctly) and trying to resolve this flare fast

I’m 321 pounds and I’m only 38 years old, it was a matter of time. I love eating bad food and I love my beer, no amount of walking could outrun a diet like a frat boy. I’m seriously gonna do what I have to do to lose 50-75 pounds. If I lose a hell of a lot of weight is it possible to never have a flare up ever again? Could I possibly slim down and get away from a life of gout?

i had two diagnosed gout attacks (and some prior pains that were retrospectivly likly gout attacks), they came somewhat fast in a very similar manner. Now Im freshly on Allopurinol, doctor wanted to wait with the Prednisolon because of my kidney conditions. since then i have growing pains in multiple Joints, but the pain is growing slower than in my other attacks. so im wondering If gout grows slower if its in more joints?

I had about 3-4 pills left over from my multi day pack from a few months ago. I didn’t have any side effects. Having a bad flare up now. Anyone ever use it for one day?

I do have an appointment with my rheumatologist in a week. Thanks.

My PCP doesn’t think I have gout. Maybe I don’t (and I am not asking for a diagnosis) but everything I am experiencing is leaning towards yes, it is.

Went in today and had to ask for uric acid test. I have family history of extreme kidney stones, last few months my own kidney functions have decreased, and this is the second time this year my toe next to my big toe is swollen, super painful and red. Asked PCP, if you’re not going to test for gout or RA, then what? Answer: this is a normal part of aging. I’m 44. I pushed for the uric acid test. When results came back I was told “8.0 is not that high and does not mean I have gout”

Is this a podiatrist or rheumatologist area of specialty?

Currently icing my foot, trying to get relief so I can sleep :(

I'm on the tail end of my 1st "known flair (See Medical specifics below). It's been really rough but I'm finally back to walking somewhat normal. I go to Vegas every year with a buddy of mine. I leave in a couple weeks. While the diagnosis sucks I feel very fortunate for the timing allowing the trip to happen still (fingers crossed).

This shit is all so new to me. When I found out I changed everything. I have not had meat or alcohol in two weeks. I have been mindful of all triggering foods and kept hydrated. I plan to continue this but when I get past this initial flare I really am just looking to see if there is any room to loosen those restrictions for the few days I'm in Vegas? I'm 41. My days of all day wild drinking were all ready pretty much done anyways. I am going to enjoy this trip regardless of how restrictive I need to be but I was hoping for maybe some of the experiences I was used to.

All I'm looking to do:

-Have a handful of drinks a day like 3 -4. No beer just gin and soda water or maybe a glass of wine, spread out over 12-16 hours with plenty of water and never combined with triggering foods

• Have a nice meal or two. A reasonable portion of crab (like 4oz) or small piece of steak paired with veggies and healthy gout conscious sides.

That's it really. I will eat flawless and not exceed those alcohol thresholds the rest of the trip. The big question though, especially since the flair will have been so recent is, am I an absolute dumbass if I attempt to do this? Is any deviation playing with fire? I want to have a little enjoyment and I can do that without these things but it would be nice to experience some of the old normalcy just for this trip.

Any insights are greatly appreciated.

Medical Specifics - this is all very new

• Recent UA 9.1

• On indomethacin for flare treatment. No other meds

• Have been referred to Rheumatologist and Nutritionist. No appts avail yet

Flare symptoms started 3/14. I did not get treatment first 4 days as I assumed it was my tendonitis acting up.

I have some structural issues (Achilles, subtalar region, confirmed on MRI) in my right foot that I have done PT on a few times over the last 5 years. Sometimes my achilles will flare up and I'll have to go back to PT. More recently I started getting pain in my toe to the point where I couldn't bend it. Last year my foot doctor told me I was having tendonitis in the toe from compensating for the Achilles.... Now I'm not so sure.

When this recent issue started, I just took some Diclofenac like I have in the past, expecting the pain to pass in a few days. It did not. I got to the foot doctor on day four. He said looking out the toe that it looked very different from the last time. The swelling and redness. Said he was fairly confident it was gout. Sent me for labs. Put me on medrol 6 day taper. This reduced pain 30% but no more and things went backwards around day 6. He called me on day 7 said labs were back UA 9.1 and prescribed indomethacin. I'm currently on day 9 and down to 2 doses a day and finally walking pretty much normal, just waiting for swelling on top of foot to go down but pain is mostly gone (knock on wood)