Finding Relief From Painful Gout with Prescription Colchicine

Did you know that gout is a form of arthritis? According to the Arthritis Foundation  gout is an inflammatory arthritis that develops when there is a high level of uric acid in the blood stream. About 4% of American adults experience gout.

There are three stages of gout:

Asymptomatic hyperuricemia – This is the phase when the patient feels no symptoms but due to the high level in their blood the uric acid is starting to form crystals in the joints. 

Acute gout – This is a gout ‘attack’, when the patient feels the pain of the gout.  Gout attacks usually happen in the evening and can last up to 12 hours, with symptoms lasting anywhere from a few days to over a week.   

Interval gout – Up to 84% of those people who have a gout attack will have another attack within three years. In between the attacks there will still be inflammation which damages the joints, but no severe pain.

Chronic gout – When uric acid levels remain high over several years and attacks are more frequent, joint damage can occur. In fact chronic gout can lead to impaired and even lost mobility.

What are the Symptoms of Gout?

While the inflammation of gout can occur in other body joints such as knees or ankles, the majority of patients who experience a gout attack will feel the pain and swelling in the joint at the base of the big toe.

What Causes Gout?

Gout doesn’t occur all at once or as the result of a sudden change.   Diets high in high-purine foods (see below), excessive alcohol use, dehydration, fasting, and other factors over time will raise the level of uric acid in the blood stream. Uric acid is normally formed when the body processes purines, and the uric acid is then usually eliminated by the kidneys.  Unfortunately if there is too much uric acid in the body the kidneys simply can’t process it all, so it builds up leading to what is known as hyperuricemia, and eventually the precipitation of sharp, needlelike urate crystals in the joints.

There are also some medical triggers of gout.  Certain medications such as cyclosporine, chemotherapy, and thiazide diuretics used for high blood pressure may trigger gout attacks.  At times certain infections, joint injury and even sudden severe illnesses, trauma or surgery may also trigger gout attacks.

Obesity, untreated high blood pressure, diabetes, kidney disease and family history of gout also increase your risk of developing the condition.

Gout occurs more often in men, who tend to have higher uric acid levels than women. It is worth noting however that after menopause, women’s uric acid levels approach those of men. That is why men are likely to develop gout between the ages of 30 and 50, whereas women generally do not until after menopause.

How is Gout Treated with Colchicine?

Prescription Colchicine reduces the painful swelling associated with gout and works to reduce the buildup of uric acid crystals in the joint. 

It is important to note that prescription Colchicine is not a pain medication and is not to be used as a pain reliever. Colchicine does not cure gout. It helps treat and prevent gout attacks.

It is also used off label for primary biliary cirrhosis, pericarditis and familial Mediterranean fever.

Prescription Colchicine is taken immediately at the beginning of a gout attack.  The common dose is 1.2 mg (2 tablets) at the start of an attack followed by 0.6 mg (1 tablet) an hour later. However, your doctor will recommend your course of treatment and recommend when you should repeat the medication should you experience another gout attack.  Doses should not be increased or decreased without specific directions from your doctor.

Colchicine is also often prescribed to be taken on a daily basis in order to prevent gout recurrence.

Colchicine can decrease the absorption of vitamin B12 (cyanocobalmin, methylcobalmin) which can sometimes lead to anemia. If you are taking colchicine long term talk to your doctor about vitamin B12 supplementation.

What Foods to Avoid While Taking Colchicine

Unless your doctor says otherwise, it is a good idea to avoid eating grapefruit or drinking grapefruit juice while taking prescription Colchicine, as it may actually increase the amount of the medication in your blood stream.   

Healthy Living Tips for Patients with Gout

As noted earlier in this article, consumption of foods that are high in purines may trigger gout attacks and should, therefore, be avoided or reduced.  Foods that are high in purines and should be avoided include:

• alcoholic beverages, esp. beer
• some meats, such as bacon, turkey, veal, venison
• organ meats (liver, kidneys, sweetbreads)
• some fish, seafood and shellfish, including anchovies, sardines, herring, mussels, codfish, scallops, trout and haddock

Moderate purine foods which should be reduced include

• meats, such as beef, chicken, duck, pork and ham
• shellfish, such as crab, lobster, oysters and shrimp
• sugary sodas, cereals, candies and bakery goods sweetened with fructose

What should you consume to help reduce uric acid?

• Vegetables
• Water
• Whole grain foods
• Low fat dairy products
• Vitamin C supplements (500-1,000 mg/daily) (Source: Arthritis Foundation)
• cherries

DID YOU KNOW?

Researchers have found that people who suffer from gout are at an increased risk for atrial fibrillation (A.Fib). (Source: Arthritis Foundation) Learn more about A.fib and what medications are used to treat it.