Gout & GLP1s

FunkyWhales78

FunkyWhales78

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Did anyone else get a gout flare not long after beginning a GLP-1? I woke up during the night with that familiar ache in my right big toe, and by this morning it's really painful. In the past I've found it quite unpleasant, but it's never reached this level, or at least not compared to the stories and information I've come across. It's also been under good control for years. A long time has passed since my last significant flare, and all things considered this episode is on the milder side.

After searching online today, it looks like this might be a known issue, one I somehow overlooked while researching retatrutide. As far as I can tell, losing weight quickly can lead to a short-term rise in uric acid, which may set off a gout attack. Dehydration could play a role too, though I believe I've stayed on top of that.

My sense is that over the long run, dropping weight actually lowers the risk of flares, mainly because of the reduced weight, even though I've had this condition since well before I was carrying extra pounds.

Fortunately, there's some colchicine at the back of my cupboard, so I'm hoping it does the trick quickly and that this turns out to be a one-off or even unrelated.
 
Had you already been taking allopurinol when the flare hit? I share that concern, which is why I'm hesitant about raising how much protein I eat! When a flare comes on, colchicine plus ibuprofen does the job more quickly for me.
 
Yeah, this crossed my mind as well. Before any of this, I'd never once seen a doctor about anything that resembled gout. A few months into tirz, I started noticing a pattern: on weekends where I drank more than I should, my big toe became very tender. Walking hurt. It never reached the extreme cases people describe, where even a sheet brushing the skin is unbearable, but I'd have an odd gait for roughly 5 days. My protein intake was certainly elevated, since I was doing heavy lifting to add mass to loose skin.
 
Gout attacks used to be a regular thing for me. Once I began Reta, the first 2 weeks felt like they were aggravating it, yet after that it cleared up completely. By the time I'd completed 1 month on Reta at 2 mg, I could quit every gout med I was on, and no flare has happened since. Nearly a year has passed now, and I haven't regretted it. Drink more water than you believe is necessary.
 
It's unfortunate that losing weight quickly, even when GLP1s aren't involved, can sometimes set off gout flares.
 
Chili777 said:

Gout attacks used to be a regular thing for me. Once I began Reta, the first 2 weeks felt like they were aggravating it, yet after that it cleared up completely. By the time I'd completed 1 month on Reta at 2 mg, I could quit every gout med I was on, and no flare has happened since. Nearly a year has passed now, and I haven't regretted it. Drink more water than you believe is necessary.
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Are you intending to get your uric acid levels checked through blood work?
 
Hey team, I've dealt with gout for 20 years. Allo isn't part of my routine, but I've been using Reta since April, dropped 27kg, and experienced a few flare ups — 1 of them was really severe and needed 5 days of indomethacin to get through.

If you're eating a solid high protein, lower carb diet while on glps, flares are going to happen. The meats and seafood you rely on for protein will increase your purine intake, which pushes uric acid levels up.

Try finding clean protein that isn't from meat, like whey powders, or other options such as Greek yogurt, eggs, etc.

Increase your daily water and electrolytes to assist kidney flushing, and get bloods plus a uric acid test done as your baseline.

Things will get better as you move further into the process and your body begins repairing itself. In 4 months I went from pre-diabetic to it not even being a concern!

Good luck, embrace the suck and fight thru
 
LastHopeBay said:

Chili777 said:

Gout attacks used to be a regular thing for me. Once I began Reta, the first 2 weeks felt like they were aggravating it, yet after that it cleared up completely. By the time I'd completed 1 month on Reta at 2 mg, I could quit every gout med I was on, and no flare has happened since. Nearly a year has passed now, and I haven't regretted it. Drink more water than you believe is necessary.
Click to expand...
Are you intending to get your uric acid levels checked through blood work?
Click to expand...
Nope. For me, they haven't done much good. Back when I still got it checked, the number never came in above 6.2, even during a flare that hurt like hell. My doctor back then thought it would be way higher. Having dealt with flares for 35 years, I pick up on even the tiniest twinge. The thing is, since that initial month on Reta, I simply haven't had any.
 
LastHopeBay said:

Had you already been taking allopurinol when the flare hit? I share that concern, which is why I'm hesitant about raising how much protein I eat! When a flare comes on, colchicine plus ibuprofen does the job more quickly for me.
Click to expand...

For a long time I refused to consider a once-a-day pill. My doctor, however, told me that relying on colchicine each time a flare appeared could leave my joints damaged. After finally beginning allopurinol, I asked myself why I had waited so long, and since then things have largely been trouble-free.
 
After GLP-1s? Nope, but genetic kidney issues run in my family and those have left me susceptible to gout; mine shows up in the ankles and it is awful. Should you experience more than 2 attacks within under a year, I woudl really urge you to talk to a healthcare provider about allopurinol. The way it works is this, purines are what cause uric acid to accumulate; that means meat, seafood, alcohal, anythign containing yeast. I dug my heels in since I wasnt keen on the thought of taking a pill for the rest of my life. HOW-FREAKING-EVER, I take what is basically the lowest dose and have done so for roughly 10 years now with zero problems.
 
Recent research indicates that gout has a hereditary basis. Avoiding every food high in purines barely changed anything for me. Allopurinol was my treatment for close to 20 years, yet it helped very little, and eventually I developed an allergy to it. I later learned that it only works for roughly 50% of people. In my case, Febuxostat, which was first sold as Uloric, became a real turning point until I began Reta. I keep a bottle of it in my medicine supply just in case, along with Prednisone. Allopurinol is certainly the first-line option for gout, but when flares continue, it's worth asking about Febuxostat.
 
After 24 weeks on Reta and Triz, I went from 151kg down to 109.5kg. Only a single flare happened during that time — it began in the left foot, then shifted to the right foot a week later. Since then, fingers crossed, nothing at all. Back when I carried more weight, these flares came far more often.
 
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