Gout and Corticosteriods

I have been fighting a gout flare for two days. I am a retired RN, and I am not an advocate of taking "maintenance" medications available for gout. I can usually keep the gout at bay with proper diet, rest and lots of water! Cherry juice is also useful. But, one of the biggest triggers for gout is stress, and I have had more than my share of that over the last two months. I finally lost the battle.

These are my normal feet, and the lower picture is the appearance of my right foot today...

This morning the pain became so intense that i finally contacted my internist to ask for something for relief. She called in a Prednisone dose pack. Now, I have taken this drug for bronchitis attacks, but have never heard of it being used to quench the effects of gout.

I am happy to report that less than ten hours later I have marked improvement in the pain and symptoms which were plaguing me this morning. Amazing. I did some research, and found the following report on the world wide web. If you are a person who has occasional severe gout flares, you will find this very interesting information.

IMMEDIATE GOUT TREATMENT

Corticosteroids may be used for fast gout treatment if NSAIDS (including indomethacin) and colchicine fail to deliver gout pain relief, or patients are unable to tolerate them because of other medical conditions. Corticosteroids are also more likely to be used if more than one joint is affected and for the elderly.

Corticosteroids work as anti inflammatory hormones. They are the strongest anti inflammatory medication but are used very cautiously. Prednisone is the most commonly prescribed corticosteroid for fast relief. Other prescribed steroids include prednisolone, triamcinolone, corticotrophin (ACTH).

Prednisone decreases gout pain and inflammation by halting the white blood cells’ (neutrophils) attack on the inflamed location. It usually works within a few hours. Only the lowest dosage of prednisone is used, and as infrequently as possible, because prednisone and other corticosteroids suppress the immune system.

Dosage Orally as a tablet. 20-60mg mg initially, followed by tapered down dosages. Or, in some cases, such as emergency gout pain relief, prednisone, triamcinolone or corticotrophin are injected into the attack site(s) if there are two or less. The dose is based on the size of the affected joint (s) and the extent of the inflammation.

Your doctor may prescribe prednisone tablets for emergency treatment when travelling. If you are taking corticosteroids, make sure you follow the doctor's instructions accurately, or any other gout drug for that matter.

Possible side effects include Colds and fevers; slow wound healing; increased levels of blood sugar; increased appetite and weight gain; poor sleep; heart failure; higher blood pressure, diarrhea; headache; nausea; and others. Side effects are very likely, the longer you take corticosteroids - one reason why they are are not long term treatment. Maximum is probably 30 days.

If you’re taking prednisone or any other corticosteroid, any noticed side effect should be immediately reported to your doctor.

Corticotrophin (ACTH) Corticotrophin may be used as an immediate treatment instead of prednisone or the others. Corticotrophin stimulates your body to produce corticosteroids. It may be beneficial for elderly patients, who can't take steroids.

Possible side effects include vomiting; appetite loss or increase; diarrhea; constipation; sleep disorders and others.

As I have said, less than ten hours later I feel much better and am on the mend.
I have got to find a way to deal with my current stressors in order to stave off future attacks, but right now I am just thankful for the immediate relief provided by the steroids.

My foot is still swollen, somewhat reddened and sore, but much better. If you are suffering from gout, check with your physician. Proper diet, stress relief and proper hydration should be the first line of defense, but when all else fails, medication may be the answer.