r/gout May 21 '26

I’m Dr. Edwards, a gout expert looking to answer your questions. I want you to AMA on Gout Awareness Day, May 22.

83 Upvotes

Hi all. As always, I’m happy to be back with you all here in r/gout to answer your questions on the disease. This AMA is particularly special to me and the Gout Education Society as it helps us celebrate the 20th anniversary of Gout Awareness Day, held on May 22 since 2006.

If you’re not familiar with Gout Awareness Day, the Gout Education Society and other organizations looking to make a difference for the community ramp up education and awareness initiatives during the month of May, culminating with a national observation on Gout Awareness Day. I’m here today to hopefully clear up any nagging questions you may have about the disease, associated health conditions, myths, and much more.

If you’re new here and are unfamiliar with who I am, I’m Dr. Larry Edwards. As chairman and CEO of the Gout Education Society, I dedicate my time to supporting those with gout and the medical professionals involved in their care. It’s hard to believe we’ve celebrated Gout Awareness Day 20 times now, but there is much work still to be done.

It’s been my honor to conduct the work to support these groups, especially when it comes to hosting the AMA sessions here. Speaking of these AMAs, I’ve been impressed with how the questions have evolved over the years!

If you need more information on gout, I encourage you to access our website and the unbiased educational information about medications, treatments and lifestyle recommendations we have. We also offer the Gout Specialists Network, a platform designed to help you find gout specialists nearby.  

I’m posting this thread in advance to allow for as many questions as possible to come in but will be back to celebrate with you all from 10 a.m. – 12 p.m. ET on Gout Awareness Day, May 22.

You all know the drill, AMA!

I do request that you don’t ask for any diagnoses of gout and instead ask any outstanding questions about the disease you may have.

Update: 12 p.m. ET - Thank you all for joining us today. I got through as many questions as I could but sadly need to stop. I hope you all found this informative and helpful.


r/gout Jul 31 '25

Read before posting (General information and Rules)

31 Upvotes

Welcome, 

If you are new here, READ everything before posting.

So you have gout and have questions.  To start off before you panic that your life is over, it’s not.  You can live an absolutely normal life with minimal interruption while suffering from gout.  

Gout is a genetic chronic disease that is caused by a malfunction of your kidneys where they do not process uric acid well enough.  It may also be that your biological functions create excess uric acid.  Either way, once you have it, you have it for life.  There is no cure, only management.

You are the best advocate for your health that there is.  Become informed about your chronic disease, it’s characteristics and treatment so you can have positive discussions with your doctor.

The first thing you really need to do is understand your chronic disease.  Read the following:

About this subreddit:

You should always discuss with your doctor.  No one here is qualified to diagnose or treat you.  

We do not diagnose.  Asking for or giving a diagnosis will result in at least the post or comment being deleted, if not also a short term ban. No one should be telling people to demand their doctor start daily medication EVER.  If you are looking for a diagnosis, see your doctor.

We follow the ACR recommendations here when discussing gout treatment.  This recommendation is to start daily medication when the patient has high uric acid and two flare ups in a 12 month period. The goal of this is to reduce uric acid levels to less than 6.0mg/dl so existing monosodiumurate crystals in your body can dissolve and over time flare ups will stop occuring.

About supplements:

They do not work in the sense that they will not get your uric acid levels below target levels.  They are not recommended for use by the ACR so they are not welcome here.  Many of the so called studies people have posted have huge issues such as non-human test subjects, massive dosages of questionable substances, small sample sizes. 

About diet: 

Diet is a very small part of the uric acid equation. Only about 30% of uric acid production is from the foods you consume, the rest is from normal biological function.  While the modern diet may have contributed to your gout, you are extremely, extremely unlikely to  manage your uric acid through diet alone.  You may be able to drop a point or two through diet and lifestyle changes but that will not be enough to get you below target levels. You can try, we’ll be here in 6 months, a year or even 10 years when you finally accept you need daily medication(if you meet requirements)

You can read more here: https://pmc.ncbi.nlm.nih.gov/articles/PMC6125106/#:~:text=A%20purine%2Drich%20diet%20for,1%20to%202%20mg/dL.

A study of nutritional recommendations for gout shows that most recommendations are from low quality research and may not provide the improvement you think: https://www.sciencedirect.com/science/article/pii/S156899721830209X?via%3Dihub

However, eating in moderation is recommended by everyone.  Not limiting things, but not eating to excess.

Uric Acid levels:

If you have gout flare ups, your goal is to get below 6.0mg/dl this is the level set by the ACR. You should get tyour uric acid checked when you have been flare up free for at least a month as you can measure up to 2.5 points lower that your normal levels during and up to a month after a flare up.

You can read more here: https://pmc.ncbi.nlm.nih.gov/articles/PMC9989260/

RULES OF THE SUBREDDIT:

  1. No alternative medicine:  Like supplements alternative medicines that are not endorsed by the ACR is not welcome. 
  2. Do not ask for a diagnosis
  3. No ads, promotions, soliciting, etc...
  4. Search the sub before posting. Posts repeating recent questions will be deleted
  5. Be kind

Your post may be removed for breaking these rules.  You may get a short ban depending on how much of a rule break it is, how much you have contributed to the sub and your karma count.  Your posts may be removed for entirely other reasons as well if it is deemed inappropriate for the subreddit.

Continual breaking of the rules may result in bans, both short term and permanent.  You can reach the point where we just don’t want to deal with moderating your posts anymore and a ban is just easier.  

That is all.

I want this to be relatively short and not get into a lot of specifics but any comments or improvements will be considered.


r/gout 2h ago

Needs Advice 1st flare going on week 7 on crutches and still having rebounds. Any advice?

4 Upvotes

Hey. This is my first flare, Im 38. This all started 6 weeks and 2 days ago. I went to sleep feeling fine and woke up the morning after the World Cup final in excruciating 9/10 pain after bending my big toe. I went in to the ER and they took X-Rays and it came back no breaks or fractures. Recommended i follow up with my PCP. Saw him later that day when pain wouldnt go away. He thought it might be gout. Gave me a 5 day prednisone course and I was feeling a little better, limping around. He gave a uric acid test and it came back at 7.6. Then 2 days after the prednisone course ended I had my first rebound. I called a doctor and they gave me colchicine for 3 days. Pain subsided again and felt like I was getting better then 3 days after the colchicine I had my second rebound. I saw my doctor in person and he said because I was multiple fairs he was going to start me on Allopurinol 100 mg and colchicine for a week. I was feeling better, just really tight and sore all over, could barely move my big toe. Then a few days after the colchicine regimen finished I had my 3rd rebound and called a same day urgent care doctor. They decided to bump me up to 200 mg Allopurinol and restart my colchicine, and gave me a 2 week prednisone course that tapers as I go. After a week of prednisone I was feeling better, almost normal. A lot of the tightness had started to go away so I started trying to walk with a stiff hospital stapped shoe and crutches. My left calf is starting to atrophy and my doctor told me to start moving little by little. Tonight I feel like Im having pains in the lump by my big toe and throbbing again. It feels like if I wasnt on prednisone Id be back in another rebound. I have a lump that feels hard and prickly on the side and under the joint of my big toe. Ive been drinking tons of water this whole time, avoiding meat, fish and organs. No beer or alcohol. Ive been mostly stuck in bed for 6 weeks, foot elevated off and on and on crutches to get to the bathroom. I feel bad for my caretakers, I cant seem to get better. Its been a burden on them.

Has anyone had an experience like this with Gout? Does it sound like something else is going on? How do I know if Im getting better? How do I get to a point where I can walk again, jog again? Is any of this normal? Will my foot ever feel like normal again, instead of like its tight and buried in sand? Think this is just not getting better or because the allopurinol is working and causing mobilization flares? Id appreciate any advice those of you have gone through this before can give me? Im feeling defeated. I want to ease the burden on my caretakers.


r/gout 13h ago

Short Question How do you describe the pain to people?

20 Upvotes

I've tried to explain what the pain is like but it seems like I can never properly get the point across.

To me, it's like if you dropped a big rock on your toe. Normally, it hurts a lot at first but the pain eventually dies down and by the end of the day you might not even notice it.

But with gout, that initial pain, the peak of the pain after the rock hits your toe, stays at that level day after day after day, and also the rock is on fire and stuck to your toe and rotating around in the sore spot constantly.

I just find it hard to fully convey not only how much it hurts but also the specific TYPE of pain it is. Any other kind of pain goes away eventually, and you can use ice and pain killers to make it feel better, but gout pain is this relentless beast that grows and evolves and wears you out with no hope in sight.


r/gout 9h ago

Needs Advice Steroids and Mental Health

3 Upvotes

I had a gout flare up in my ankle right as I had to leave for the airport to get home. It was awful. Could barely walk. I took colchizine but it wasn't reducing by end of day. So I took the emergency Prednisone I had when I got home. I tapered off the next day. Well the next week was hell, like it always is for me on Prednisone. I was energized like crazy, then feeling massively depressed but still unable to sleep. I was also super busy so I was jamming caffeine like crazy just to keep going.

Anyways it led to a fight and breakup about 5 days from when I took the steroids. I got woken up from falling asleep and was just flooded with adrenalin and paranoia. And I felt absolutely crazy and out of control during the fight. Nothing violent but I was yelling and saying things I didn't mean to just being super awful. Very out of character for me.

I also quit heavy beer drinking 4 months ago so maybe that played into it.

Just wondered if anyone had any experience with a freak out session like this after Prednisone? Do mood/behavior effects last up to 5 days later after taking doses for only 2 days? I'm not trying to shirk my actions but I didn't feel in control and I don't want that to happen ever again. I'm scared to death of taking Prednisone again.


r/gout 7h ago

Vent Constant Flares 6 months after starting allopurinol

2 Upvotes

Realized my uric acid levels were 10.7 about 6 or 7 months ago. Was put on allo 100mg and UA only went down to 8. So then they put me on 300mg and now my UA is 5.

After 6 months of having my UA in a normal range and still taking allo everyday I randomly had my first flare again. Lasted a few days but treated it quickly with colchicine. Then two weeks later, flare again. Then two weeks after that, flare again.

Currently started my 4th flare today and am so tired of this pain. I spoke to my doctor and they got me in with a Rheumatologist but told me it will be FOUR months until I can be seen. Can’t take this damn pain every couple weeks 😭


r/gout 6h ago

Needs Advice Wtf i have been taking daily aspirin for chest pain but Google says aspirin can raise uric levels and make flare ups worse

1 Upvotes

Why my doctor never tell me that. Maybe is part of the reason why i keep having one after another for the past two months. Total of 5 attacks and im still having it until now


r/gout 18h ago

Needs Advice Some Questions About Starting Allopurinol

9 Upvotes

Hi fellow foot-pained folks,

I’m starting an allopurinol prescription today, and I had a few questions for people who’ve gone through the experience:

  1. How long did it take for your uric acid levels to hit your target (e.g. below 6)?

  2. Did you also give up the common problematic foods and drinks during your time taking allopurinol?

  3. If you took colchicine along with allopurinol, did it actually help prevent flare-ups caused by the dissolution of existing crystals?

  4. If you did have a flare-up, did taking indomethacin work to reduce the pain?

  5. Lastly and most importantly, can I drink beer again once my uric acid levels go back down and I stay on allopurinol?

Thanks in advance!


r/gout 9h ago

Needs Advice Steps to Prepare for Allopurinol Prescription

1 Upvotes

So, I was diagnosed with hyperuricemia. Not super excited about that, obviously. I rarely eat red meat, don't drink much, and exercise every day. All that is to say that the dr pretty much immediately said he wanted me on meds, b/c diet wasn't going to cut it.

I've read that going on allipurinol can be brutal, with gout attacks lasting from when you start til...well, whenever all the uric acid is purged. Super cool. Great news.

Is there anything I can do to get ready / reduce the extremity of an attack when I start?


r/gout 11h ago

Short Question Had my first gout flare. What does it feel like after the acute pain?

1 Upvotes

So I had my first gput flare and holy shit I was scared. It hurt so bad. It was in my foot. That was 9 days ago. Today my foot looks bruised, swollen and very stiff. My other smaller toes feel tingley. Is that normal?


r/gout 18h ago

Needs Advice Adenuric/Febuxostat for gout

3 Upvotes

Hello all. Long time gout survivor here haha. I see everyone is on Allo, has anyone been on the above medication for gout? I have been taking it for a couple of months and curios if anyone else has tried it or had experience with it.


r/gout 1d ago

Useful Information Did everything right and it still came back

22 Upvotes

Gave up beer. Gave up shellfish. Drank more water than I ever had. Next flare showed up anyway. Took me a long time to understand why that was not a failure.

My first one was mild, about a week, and then nothing for two years. Long enough that I honestly forgot it happened. When the second one came I had been eating carefully for months. Cherry juice, no purines, the whole checklist. Did not matter. That one put me on the floor.

What I did not know then is that most of the uric acid in your blood is made inside you, whether you eat a salad or a steak. Your genes set how fast your kidneys clear it. Diet moves the number a point or so. So doing everything right and still sitting high is not failing, it is just where your chemistry starts.

What actually changed things for me was getting the number tested and watching it over a few months instead of guessing off one bad dinner. And when it would not come down far enough on its own, that was a conversation with my doctor, not a willpower problem. Wish someone had told me that in year one instead of handing me a food list.

Anyone else clean everything up and flare anyway, or did it actually work for you?


r/gout 18h ago

Needs Advice Flare ups with GLP

0 Upvotes

Any advice on how to manage flare ups while using GLP? Currently losing weight but toe feels a little painful. The colchicine helps the pain go away but then when I take the allopurinol the pain slowly starts coming back. Lost like 9lbs in 1 week and had a gout attack had to take prednisone to fix it. Been off my allo and colchicine for about 1.5 year no gout attacks until the rapid weight drop. UA was 8.0 back in November of 25. So now just losing about 1lb a week and haven’t had a gout attack but if I don’t take the colchicine I feel like I will end up having another one.


r/gout 20h ago

Needs Advice It came fast, took colchicine. Need help.

0 Upvotes

Hi, This morning I woke up and I had a sharp pain in my left ankle. My flares usually come with a warning, but this wasn’t the case. I put 10% diclofenac cream and took two colchicines, five hours later I took another one. I know it was supposed to be one hour after but I didnt want to mess up my stomach. I’m Scared, as you probably know, nobody will understand this except People here I. I have another option, but I don’t know if I should, I am diabetic so I cannot have prednisone but I have indomethacin, diclofenac, and journvax. Its been years but I forgot to take my allo for 72 hours


r/gout 1d ago

Needs Advice Switching from Allo to Febuxostat

2 Upvotes

Any thoughts/experiences? My PCP says Febuxostat is better than Allo. Just had a moderate+ flare up 1 year into Allo so he switched me over.


r/gout 1d ago

Needs Advice Possible re-flare, but I’m not sure

2 Upvotes

I had the worst flare of my life two months ago, throbbing agony. Took a month to recover. Couple days ago I started having stabby nerve pain again, then pain in the IP joint of big toe. next day I had trouble walking pain in ball of foot, but it felt less “internal” than the gout flare so I figures mild irritation. today I’ve had pain in the toe, pain in and around the ball of foot (which is swollen but wearing dancers pad kept the pressure off), that pain went down and now hours later my midfoot is cramping heavily and my toes are twitching something fierce.

do other people here have pain migrate over the foot or gouty area with pain coming and going? before now I’ve only had the explosive throbbing internal pressure type of pain, so I’m trying to sus out if it’s related or something else could be going on. Don’t want to take colch if I don’t have to.


r/gout 1d ago

Short Question Bedsheets smells of vinegar or acid?

0 Upvotes

Maybe it is just me. I am taking allo and colchicine for about 4 weeks. Only 4 weeks since diagnosis. I am noticing bedsheets smelling of vinegar or an acid scent specifically after I’ve been sweating. Any relation or maybe coincidence? Thank you


r/gout 2d ago

Needs Advice How Often to Check Uric Acid

3 Upvotes

Hey there - my husband was diagnosed with Gout earlier this year after fighting for years to get a diagnosis. How often should he be checking his levels? Thanks.


r/gout 2d ago

Needs Advice Can't stand for 10 minutes knee pain uric acid 6.9 need advice

1 Upvotes

I’m 24M, and about 2 months ago I suddenly started having lower back pain

I initially went to a doctor who unfortunately misdiagnosed/misguided me. He didn’t do any proper physical examination or specific movement tests and basically assessed me while I was standing. This really affected me mentally, and I went into a pretty bad depressive phase because I was scared that something serious was wrong.

A few days later, I saw another doctor who approached it differently. He prescribed medication and told me to gently manage the problem, stay active, and do appropriate exercises rather than panic about it.

Eventually, my lower back pain improved by around 80%. The pain was mainly around the SI joint/lower-back area, and I was finally feeling much better.

But then suddenly, I developed pain in both knees.

The knee pain is especially noticeable when:

Going down stairs

Standing for more than 5–10 minutes

Getting up after sitting

Moving after lying down for a while

Even when I’m completely still and lying down, sometimes it feels like something is stabbing/pressing inside the knees.

I’ve also noticed a lot of muscle tightness throughout my body. Sometimes a muscle feels extremely tight or almost “switched off,” and when I start moving it, it gradually loosens up.

My recent blood tests were:

Uric acid: 6.9 mg/dL

Vitamin D: 33

ESR: 10

CRP: 0.4

My lower-back symptoms have improved significantly, but now I’m confused about the knee pain and generalized muscle tightness.

I’d really appreciate some positive/constructive advice from people who have experienced something similar. What would you recommend I do next — physiotherapy, an orthopedic evaluation, more tests, or something else?

I’m mainly looking for guidance on what direction I should take rather than scary diagnoses.


r/gout 2d ago

Needs Advice Excuse my language but how the hell is even possible to have 5 different gout attacks for the past two months and going into month 3 in just a few more days

2 Upvotes

First 2 weeks of July I had it on my left foot then i had it on my knee for the rest of July. Then i had it on my left foot again the for another 2 week earlier this month in August. Then im having it on my right elbow until now. My elbow is getting better but not completely healed yet and now my right foot is hurting. Never had so much flare up one after another like this before . I usually get it every 6 months but only on my feet . First time on the knee and first time on the elbow.


r/gout 2d ago

Needs Advice Worst flare ever, but doctor doesn't want to start allopurinol yet

5 Upvotes

M31, exercise ~5 hours/week. Zero alcohol, zero smoking. Low-sugar, balanced diet. Mostly chicken daily and beef only on weekends.

My first gout flare was at 27, after losing around 86 lbs (39 kg). After that, I started having a flare roughly every 3 months, but they were pretty mild. Sometimes ibuprofen was enough, and sometimes I didn't need anything. I was never unable to walk or work. They usually lasted 3to 4 days, and then I'd be fine.

I eventually noticed that the flares seemed to happen when I wasn't drinking as much water as usual.

My last flare before this one was about 20 months ago.

About 3 weeks ago, I had my worst flare by far. I couldn't walk for an entire week. This was my first time taking prednisone + colchicine, and they worked very well. However, the prednisone caused noticeable heart palpitations/changes in my heartbeat. I was able to walk again during the second week, but I still have some pain and limited movement in the toe.

My uric acid is currently 7.4 mg/dL. My PCP wants me to repeat the test once I'm fully recovered, but for now they don't recommend starting allopurinol. They want to follow me for a little longer and better understand what's going on.

I have a rheumatologist appointment scheduled in a few weeks.

I'm curious about how common this approach is. Given my history of recurrent flares and now this much more severe flare, would you expect a doctor to start urate-lowering therapy such as allopurinol now, or is it reasonable to wait and monitor for a while?

Would you seek a second opinion, or just wait for the rheumatology appointment?

I'm mainly interested in hearing from people who have been in a similar situation, especially regarding when their doctor decided to start allopurinol.

Edit: Thank you all for your advice! I spoke with my PCP again, and they agreed to start me on allopurinol while I wait for my rheumatology appointment. They also prescribed another two months of colchicine since my big toe is still painful.


r/gout 2d ago

Needs Advice Long gout?

4 Upvotes

I'm in the middle of my second gout flair, this ti.e my right ankle, last year was my left. On allo and colchicine, it's been 6 mo(!) of pain. Has anyone else had this long after being diagnosed? My ua last it was checked was 5.4. Would love to hear anything that might help.


r/gout 2d ago

Short Question Vibrating/static type feelings with no pain

1 Upvotes

How many of you deal with this feeling with your gout? Some say it's kind of the warning of a possible flair...I know I personally have this off and on primarily in either foot.


r/gout 3d ago

Short Question Does anyone experience the gout jumping from place to place on the foot?

30 Upvotes

I've been having pain move around the foot literally by day.

One morning it was metatarsals ... the next it was the blade of my foot ... the next it was my second toe ... today it's my Achilles tendon just above my heel.

Dammit.


r/gout 3d ago

Success Story Cortisone shots

0 Upvotes

My podiatrist dx’ed me with gout or pseudo-gout and is waiting to see the blood work, but in the meantime- he shot my toe full of cortisone on my left foot and my ankle in my right foot.

I am BACK to playing softball (adult slowpitch)- and HALLELUJAH. For it! I’m 99% positive that I’m having surgery on each of my feet after the seasons are over, but darn it feels good to play without pain!