“Gout uric acid?”
I am 19 years old with morbid obesity bmi 55, mild sleep apnea, gastroesophageal reflux (treatment with famotidine 40MG * 2), fatty liver infiltration, and chronic gout for 3 years now. My rheumatologist has prescribed Kineret in 3-5 days each attack of gout and colchicine 1mg daily). My rheumatologist also recommended zyloric 100mg but I had chest pain, very dizziness, and headache and so he told me to take febuxostat 40mg with the cardiologist as I do not have a cardiovascular problem. But I would like to know more about the safety of the drug due to my age. Would it be better to precede a large weight loss with bariatric surgery and then administer it? Cardiovascular deaths were in people without a previous history of cardiovascular disease or severely?
Examination: (Glucose) 91mg/dl (Urea) . . . . . . . . . . . . . . . . . . . . 27.8 mg/dL (Creatinine) . . . . . . . . . . . . . 0.78 mg/dL (Uric Acid) . . . . . . . . . . . . . 10.4 mg/dL (Triglycerides) . . . . . . . . . 273 mg/dL (Total Cholesterol) . . . . . . 215 mg/dL HDL . . . . . . . . . . . . . . . . . 38.9 mg/dL LDL . . . . . . . . . . . . . . . . . 122 mg/dL SGOT (AST) . . . . . . . . . . . . . . . . . . . . . 32.2 U/L SGPT (ALT) . . . . . . . . . . . . . . . . . . . . . 114.2 U/L (ALP) . . . . . . . . . 181 IU/L CPK . . . . . . . . . . . . . . . . . . . . . . . . . . . 47.8 U/L CK-MB . . . . . . . . . . . . . . . . . . . . . . . . . 13.1 U/L (Ferritin) . . . . . . . . . . . . . . . . 155.3 ng/mL (CRP) . . . . . . . . . 13.2 μg/mL UA Urine 716.10 mg/24h (Vol Ur 24HR) . . . 4250.0 ml
Examination: (Glucose) 91mg/dl (Urea) . . . . . . . . . . . . . . . . . . . . 27.8 mg/dL (Creatinine) . . . . . . . . . . . . . 0.78 mg/dL (Uric Acid) . . . . . . . . . . . . . 10.4 mg/dL (Triglycerides) . . . . . . . . . 273 mg/dL (Total Cholesterol) . . . . . . 215 mg/dL HDL . . . . . . . . . . . . . . . . . 38.9 mg/dL LDL . . . . . . . . . . . . . . . . . 122 mg/dL SGOT (AST) . . . . . . . . . . . . . . . . . . . . . 32.2 U/L SGPT (ALT) . . . . . . . . . . . . . . . . . . . . . 114.2 U/L (ALP) . . . . . . . . . 181 IU/L CPK . . . . . . . . . . . . . . . . . . . . . . . . . . . 47.8 U/L CK-MB . . . . . . . . . . . . . . . . . . . . . . . . . 13.1 U/L (Ferritin) . . . . . . . . . . . . . . . . 155.3 ng/mL (CRP) . . . . . . . . . 13.2 μg/mL UA Urine 716.10 mg/24h (Vol Ur 24HR) . . . 4250.0 ml
Male | 19 years old
Complaint duration: 29/03/2003
Medications: Peptan40x2, kineret
Conditions: Gout
3 Answers
I would trust your Rheumatologist
We always try to make what we call a “crystal confirmed” diagnosis, where we aspirate inflammatory synovial fluid from the involved joint and look to identify uric acid crystals under polarized microscopy
The goal of treatment is to lower uric acid to 6.0 units or lower
Options in your case include
1) Allopurinol
2) Febuxostat (Uloric)
3) Pegloticase ( Krystexxa )
Poorly controlled gout can be linked to hypertension, chronic kidney disease, metabolic syndrome and other comorbidities
I wish you well!
We always try to make what we call a “crystal confirmed” diagnosis, where we aspirate inflammatory synovial fluid from the involved joint and look to identify uric acid crystals under polarized microscopy
The goal of treatment is to lower uric acid to 6.0 units or lower
Options in your case include
1) Allopurinol
2) Febuxostat (Uloric)
3) Pegloticase ( Krystexxa )
Poorly controlled gout can be linked to hypertension, chronic kidney disease, metabolic syndrome and other comorbidities
I wish you well!
My recommendation is to go online to: https://obesitymedicine.org/find-obesity-treatment/ and find a bariatric physician who understands the metabolism and can help you lose the weight. Fatty liver makes it hard to lose weight, so you need to find ways to improve the metabolism and burn the peripheral fat as well as the visceral fat and the fat in your liver to get your body's engine working the way it needs to, A good bariatric physician will not only help you lose the weight, but will go stride for stride with you to keep it off.
Sorry but this is a question for a rheumatologist. I am a gastroenterologist.
