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Paul from Calgary asks: I have Gout. I take allopurinol and indomethacin; I also take ibuprofen when I have exceeded my daily indomethacin intake. I experience Gout attacks daily. Is there something I can take that would work better?

A few things to consider for gout. 1) It is best not to mix different anti-inflammatories (NSAIDs) at the same time. Once you have maxed your dose on one anti-inflammatory, you are maxed on all of them. It is not a time to switch to another one. 2) If gout is not controlled on allopurinol, it probably means the dose of allopurinol is not right and needs to be adjusted. Watch our recent video for more on this exact topic. 3) If your gout is not controlled on allopurinol and you are having daily attacks, it is possible this is not gout. Reviewing your symptoms with your doctor or rheumatology team may be worthwhile to ensure you are on the right treatment for the right diagnosis.

Andy from Alberta asks: Can Gout happen outside of joints?

Gout is a common inflammatory arthritis that is most commonly known for causing acute painful red hot swollen joints that resolve over 5-7 days. While that is typical, that picture can change over time if you continue to have gout flares with poorly controlled uric acid levels in your body. Gout can also cause tophi, lumps of uric acid crystals which can deposit outside of joints. While they are not necessarily painful themselves, they can deposit in awkward locations and cause pain and inconvenience as a result (e.g. elbow, fingers, toes, ears). By treating the underlying cause of gout – lowering uric acid – these tophi can also dissolve and go away. Read more about gout here!

Bernie from Calgary asks: I had gout in my left knee in mid-December last year. The Doctor took the fluid out and gave 10mg of Prednisone daily until the uric acid is cleared from my blood. The last three monthly blood tests shown my uric acid is still 650 and I am gaining weight in my trunk and thinning legs. I tried last week to stop taking Prednisone and to take instead Allopurinol. Unfortunately, I began having pain in my knee. What should I do?

Chronic gout is treated using a uric acid lowering medication, such as allopurinol. These medications are the only way to lower uric acid and in doing so, reduce the frequency, duration, and intensity of gout attacks. Prednisone does not lower uric acid, but it does reduce inflammation, including the inflammation from a gout attack. In other words, often the treatment for gout requires a two pronged approach. For the long term, a uric acid lowering agent is needed to prevent attacks. In the short term, a medication to treat attacks when they happen is needed, such oral prednisone, an anti-inflammatory, colchicine or a cortisone injection into the affected joint.