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Suffering from frequent gout attacks. Red, swollen and sore wrist. Treated for diabetes. Any advice?

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Practicing since : 1985
Answered : 45 Questions

My father has been suffering from frequent gout attacks for years..they're only getting worse. He has abstained from purine XXXXXXX foods yet his wrist is red, swollen and sore to the touch...usually it is his big toe. He is at his wits end and has benn surfing the net lately, He found that XXXXXXX Cider Vinegar, Blueberries, Cherries and Strawberries can help eliviate the excruciating pain. He is taking Prednisone as he can't have NSAIDS. He also is being treated for high blood pressure. He has been told he is on the borderline for developing diabetes and has been diagnosed with Myocardial infarction...for which he takes blood thinners. For gout he was prescribed Alpurinol. The gout is ruining his life and his doctors don't seem to care! How can I help him help himself? BTW His younger sister passed from a form of Dermatomyositis & Polymyositis...would have to get the exact name...
Posted Fri, 27 Jul 2012 in Lupus
Answered by Dr. Praveen Jadhav 11 hours later
It seems psoriasis could be the cause of his gout, a condition which produces more uric acid. Is it under control? If not, get it under control at the earliest.

Secondly, which are the blood pressure medications he is taking? Some hypertension medications like hydrochlorthiazide can cause rise in uric acid levels. A shift to medication like losartan can help reducing uric acid levels.

What is the dose of allopurinol he is taking? If the current dose is not controlling his uric acid levels, you can increase the dose and go up to 600 mg per day.

It is unfortunate that he cannot tolerate NSAIDs. So he may have to continue steroids for a short duration.

Lastly, newer medications for gout can also be tried. This includes febuxostat 80 mg per day can give a good control of uric acid levels.

Hope this information helps.

Dr Jadhav
Above answer was peer-reviewed by
Follow-up: Suffering from frequent gout attacks. Red, swollen and sore wrist. Treated for diabetes. Any advice? 28 minutes later
Thank you... also, could sleep apnea be a culprit? My father snores very loud and I have witnessed him pause his breathing while sleeping. His gout diagnosis was made based on symptoms and blood tests. He has never had the joint fluid tested. I am concerned that he is doing everything he was asked to do to help prevent an attack and yet he is suffering constantly! He often is tired during the day and has no energy...should sleep apnea be investigated?
Answered by Dr. Praveen Jadhav 17 minutes later
Sleep apnea should definitely be investigated, but it has no role in gout.
Above answer was peer-reviewed by
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