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Suggest Treatment For Pain In Foot And High Uric Acid Levels
Question: I had pain in my foot,after consulting orthopedic doctor he got my uric acid level tested which was around 7.I used tablet feburic40mg for couple of months after which uric acid got reduced to 3.5(However pain is not reduced completely)..But after a month(after I stopped using tablet) my uric acid has again increased to 7..I did follow right diet like avoiding red meat,chicken etc..but still uric acid got increased..so could you please guide me on what should I do next,I am looking to control using diet without using medicine,could you please help me on the following
1.Firstly is it safe to use feburic 40mg daily,will it have long term side affects
2.who is the specialist doctor to treat this?.Could you suggest any doctor in XXXXXXX
3.I am not clear on what exactly is the right diet,like few say tomato has high uric acid and few say it has less uric acid.Could you please help me on the right diet
4.Also is really pain related to gout as it did not reduce even after uric acid decreased to 3.5
1.Firstly is it safe to use feburic 40mg daily,will it have long term side affects
2.who is the specialist doctor to treat this?.Could you suggest any doctor in XXXXXXX
3.I am not clear on what exactly is the right diet,like few say tomato has high uric acid and few say it has less uric acid.Could you please help me on the right diet
4.Also is really pain related to gout as it did not reduce even after uric acid decreased to 3.5
Brief Answer:
Is it gout
Detailed Answer:
Good evening
Thank you for writing on health care magic
I have gone through your history. but the management doesnt seem to be going the right way. As per your queries, I would explain to you further
1. Feburic is a safe drug as such, but you need to monitor your liver function tests with it.. But was it the right indication to start in your case? The answer is no. Firstly one doesnt give it in the acute attacks of gout.. It should be avoided as it can only make the gout pain worse. .. Secondly 1st attack of gout is a never an indication for starting drugs like feburic or allopurinol. There has to be more than 3 attacks/year , which justifies us starting the treatment. SO i wont recommend you continue it
2.. You need to consult a Rheumatologist for a proper management of the gout/other causes of your foot pain. There is a big department in Nizams, . In private, Dr Chidambram is also there in XXXXXXX But I am not sure about the location, but consult a rheumatologist only
3. Uric acid of 7.1 is not alarming at all. Some people do have a high uric acid, but it doesnt call for the treatment. Amongst the diet avoid diet in high purines like mutton, sea food, chicken and little bit of pulses. Have more of dairy products as it helps remove the uric acid from the kidneys. You can have tomatoes. They are the best food products with high anti oxidant effect. So no harm in continuing it.
4. But to sum it up, is it really gout? You are right in asking that as gout pain normally never continues beyond 3-4 days. I would like to knew a few more details about your pain....
Where exactly is the location of your pain? Does it get worse on walking or at rest also??ANy associated backache or neck pain???How does it feel in the mornings when you wake up??Were your ESR and CRP checked
Do let me know these queries
I hope the information was useful
REgards
Dr Naval
Is it gout
Detailed Answer:
Good evening
Thank you for writing on health care magic
I have gone through your history. but the management doesnt seem to be going the right way. As per your queries, I would explain to you further
1. Feburic is a safe drug as such, but you need to monitor your liver function tests with it.. But was it the right indication to start in your case? The answer is no. Firstly one doesnt give it in the acute attacks of gout.. It should be avoided as it can only make the gout pain worse. .. Secondly 1st attack of gout is a never an indication for starting drugs like feburic or allopurinol. There has to be more than 3 attacks/year , which justifies us starting the treatment. SO i wont recommend you continue it
2.. You need to consult a Rheumatologist for a proper management of the gout/other causes of your foot pain. There is a big department in Nizams, . In private, Dr Chidambram is also there in XXXXXXX But I am not sure about the location, but consult a rheumatologist only
3. Uric acid of 7.1 is not alarming at all. Some people do have a high uric acid, but it doesnt call for the treatment. Amongst the diet avoid diet in high purines like mutton, sea food, chicken and little bit of pulses. Have more of dairy products as it helps remove the uric acid from the kidneys. You can have tomatoes. They are the best food products with high anti oxidant effect. So no harm in continuing it.
4. But to sum it up, is it really gout? You are right in asking that as gout pain normally never continues beyond 3-4 days. I would like to knew a few more details about your pain....
Where exactly is the location of your pain? Does it get worse on walking or at rest also??ANy associated backache or neck pain???How does it feel in the mornings when you wake up??Were your ESR and CRP checked
Do let me know these queries
I hope the information was useful
REgards
Dr Naval
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks a lot sir for your response..Following are my answers..
1.Pain starts slightly beneath the little toe towards what they call foot bone..
2.As such pain is not severe by itself but if press my foot with hand I feel good amount of pain beneath the little toe..
3.The pain very slightly increase when I run on treadmill..I do run because I was told regular exercise decreases uric acid and ofcourse for good health..
2.I haven't got my ESR or CRP checked yet..
My doctor told me to get uric acid checked every 6 weeks and asked me to use feburic tablet based on the result..but now I am concerned whether to use it or not..Could you please advise me on what should be my next step..I am also worried if it further shoots up if I don't use the tablet based on past experience(when I posted you the question first I kept it simple but below is the exact history)
1.In May my uric acid was 6.8 so doctor gave feburic tablet
2.I used it for a month and with proper diet it went down to 3.5
3.I stopped tablet for a month and also had non vegetarian occasionally and my uric acid went to 7.1
3.Again for a month I used tablet with diet and it came down to 3.5
4.The next two months with good exercise, reasonably good diet(No red meat but occasionally chicken) and my uric acid today is 8.1
So I am concerned if I don't use tablet for next 1 month uric acid would further shoot up.So could you please advise me on my next step
1.Pain starts slightly beneath the little toe towards what they call foot bone..
2.As such pain is not severe by itself but if press my foot with hand I feel good amount of pain beneath the little toe..
3.The pain very slightly increase when I run on treadmill..I do run because I was told regular exercise decreases uric acid and ofcourse for good health..
2.I haven't got my ESR or CRP checked yet..
My doctor told me to get uric acid checked every 6 weeks and asked me to use feburic tablet based on the result..but now I am concerned whether to use it or not..Could you please advise me on what should be my next step..I am also worried if it further shoots up if I don't use the tablet based on past experience(when I posted you the question first I kept it simple but below is the exact history)
1.In May my uric acid was 6.8 so doctor gave feburic tablet
2.I used it for a month and with proper diet it went down to 3.5
3.I stopped tablet for a month and also had non vegetarian occasionally and my uric acid went to 7.1
3.Again for a month I used tablet with diet and it came down to 3.5
4.The next two months with good exercise, reasonably good diet(No red meat but occasionally chicken) and my uric acid today is 8.1
So I am concerned if I don't use tablet for next 1 month uric acid would further shoot up.So could you please advise me on my next step
Brief Answer:
Foot pain
Detailed Answer:
Good evening
Well, the sort of pain which is persisting behind the toe may not be all due to uric acid. It can be due to other reasons like a ligament injury or some bone injury, but since the site collaborated with the Gout hence your medications were started. Never the less, I am not ruling out the gout as it difficult to say without examining, but you should evaluate it further maybe with an X ray or MRI of the foot. Cause the gout pain will remain through out the day and night but you have symptoms only on activity which favors against it.
As for the uric acid levels, some people do have a high uric acid levels from birth but doesnt mean you need treatment for it. This is an entity called asymptomatic hyperuricemia, that is the uric acid remains high but there are no symptoms. ONly reason for starting febuxostat is: Uric acid > 10, or kidney stones due to uric acid or recurrent gout attacks.
SO i wont recommend you tablets at this stage, rather just keep a watch on it and control your diet and keep regular on exercises. If it shoots up or you get another attack of gout, we need to treat it or else we can wait. DO monitor your cholesterol , blood sugars and blood pressure along with it.
Consult a rheumatologist around you in your next visit , as it will be more useful
Do let me know for more queries. Would be happy to help out
REgards
Dr Naval
Foot pain
Detailed Answer:
Good evening
Well, the sort of pain which is persisting behind the toe may not be all due to uric acid. It can be due to other reasons like a ligament injury or some bone injury, but since the site collaborated with the Gout hence your medications were started. Never the less, I am not ruling out the gout as it difficult to say without examining, but you should evaluate it further maybe with an X ray or MRI of the foot. Cause the gout pain will remain through out the day and night but you have symptoms only on activity which favors against it.
As for the uric acid levels, some people do have a high uric acid levels from birth but doesnt mean you need treatment for it. This is an entity called asymptomatic hyperuricemia, that is the uric acid remains high but there are no symptoms. ONly reason for starting febuxostat is: Uric acid > 10, or kidney stones due to uric acid or recurrent gout attacks.
SO i wont recommend you tablets at this stage, rather just keep a watch on it and control your diet and keep regular on exercises. If it shoots up or you get another attack of gout, we need to treat it or else we can wait. DO monitor your cholesterol , blood sugars and blood pressure along with it.
Consult a rheumatologist around you in your next visit , as it will be more useful
Do let me know for more queries. Would be happy to help out
REgards
Dr Naval
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks sir that was very helpful I will consult rheumatologist before deciding on medicine.Also I had tested my Bp(120/80),blood sugar(95/105),cholesterol(total around 170) which all seem normal although I am personally slightly concerned on fasting blood sugar being 95(as it is close to cut off value of 100)..I have couple of doubts on my diet..
1.Can I eat potato,green leafy vegetables,corn,cheese,sandwich,milk,bread..
2.Will MRI scan or X-Ray reveal if the pain is because of gout
3.I used furic 40mg sometime back,just want to know if component/dosage of feburic 40mg is exactly same as furic 40mg...
1.Can I eat potato,green leafy vegetables,corn,cheese,sandwich,milk,bread..
2.Will MRI scan or X-Ray reveal if the pain is because of gout
3.I used furic 40mg sometime back,just want to know if component/dosage of feburic 40mg is exactly same as furic 40mg...
Brief Answer:
Further course
Detailed Answer:
Good morning
Sorry for the late reply. Had a long shift
As per your queries:
1. You can have all those foods. They are healthy and a part of daily diet which you can continue without any issue
2. I dont think the pain is due to gout in your case as it has been present since a long time. But since it is persisting, A MRI would be of good value as it will help us know the exact reason and we can cut down on your unnecessary medications
3. The content of the medicine is Febuxostat. You can check for the same, but at this point I would suggest your stop the drug and monitor your symptoms along with uric acid levels
Hope the information was sufficient
Do let me know for more queries
REgards
Dr Naval
Further course
Detailed Answer:
Good morning
Sorry for the late reply. Had a long shift
As per your queries:
1. You can have all those foods. They are healthy and a part of daily diet which you can continue without any issue
2. I dont think the pain is due to gout in your case as it has been present since a long time. But since it is persisting, A MRI would be of good value as it will help us know the exact reason and we can cut down on your unnecessary medications
3. The content of the medicine is Febuxostat. You can check for the same, but at this point I would suggest your stop the drug and monitor your symptoms along with uric acid levels
Hope the information was sufficient
Do let me know for more queries
REgards
Dr Naval
Note: For further information on diet changes to reduce allergy symptoms or to boost your immunity, Ask here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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