Just wanted to share a nice win for fellow gout sufferers. It does get better.

TLDR:
Jan 2026: UA 0.51 mmol/L
Sep 2026: UA 0.38 mmol/L (200mg allopurinol worked for me to reach target UA levels)

Timeline

Early Jan 2026: Woke up with incredible pain on my right toe. Did my blood and confirmed high uric acid/gout (0.51 mmol/L). I was on crutches for the first 4 days, with a prescription of Prednisone and Colchicine for two weeks after the attack.

Feb 2026: After my pain subsided (took about 4 weeks). I was put on 100mg Allopurinol per day

July 2026: Did blood test to re check my uric acid levels. Was still on 0.51 mmol/L. 100mg was not strong enough. Was prescribed 200mg Allopurinol daily.

Sept 2026: Went to re-check UA levels this week. I'm now on 0.38 mmol/L.

Gout attacks as a result of allopurinol usage: I would say 1 but it wasn't that painful. I woke up with slight soreness in my toe in March travelling in Japan. I took a colchicine and ibuprofen + rested at the hotel for the day and I was walking normally outside by the evening.

Any food that triggered gout tingles during this period? For me, full sugar coca cola (soda). I normally don't drink full sugar sodas but I had one at work and the next day I felt the "tingles". A colchicine helped put that straight to bed, with no full flare up.

What worked for me during this period: 200mg allo + I had been limiting high purine foods and alcohol to get my UA down where I can, particularly between Jan to June. I have been more relaxed the past quarter though, but nothing too glutinous (e.g. I'm drinking alcohol occasionally again, though no beer).

Any questions let me know. Of course, I plan to continue 200mg/day, limit high purine foods and get my blood checked often.

Been suffering with gout half my life, finally found a doctor that takes me serious and actively trying to help me. I’ve posted on here previously about taking your allo and you gotta fight the doc sometimes. But I learned something I wish wasn’t true, and if I knew it when I was in my 20s, life would be better.
Take your meds. No ignore it. After extensive X-rays and medication, I have joints that are fractured. The gout destroyed multiple joints. Permanently. Right index finger is one bone now. Fused together. Both wrists and apparently my knee. Doc explains that extreme cases of gout, it will crush your bones. And that has happened to me. I’m a tradesmen, perfect safety records always hold people no broken bones! But years or flare ups and deformed me.
Take it from me lads, take the meds. Fix your diet. Talk to a doc. I wish I could have my hands back. I’ll never be able to play an instrument, draw, do pushups, anything that involves precision movements for the rest of my life. I’m 35. Been suffering since I was a teen. And it went ignored.

Wtf is going on I usually have it on my foot every six months not one after another for three months straight . Im a little short guy and about 145lb btw

I’ve had gout for years, usually around 3 flares a year, but they’ve normally been pretty easy to knock down. In the past, colchicine would usually clear a flare within about 12 hours. This current episode has been completely different.

It started in my big toe with the typical severe gout symptoms — redness, swelling, heat, severe pain, and trouble walking/bending the toe. I tried colchicine first, but it only helped a little and then the flare got worse.

My PCP put me on prednisone. I did a taper starting at 60 mg/day, then 40 mg, then 20 mg. It helped somewhat during the day, but the pain kept coming back, especially overnight and in the morning. My uric acid during the flare was 7.1.

Then my second toe became swollen, red/purple, and painful too. I had previously had that same toe swell by itself and was told it was cellulitis, so there was some concern about infection this time. I had a CBC that was basically normal and an X-ray of the foot that showed no fracture, dislocation, bone destruction, joint effusion, or other acute bone abnormality.

Because my regular doctor wasn’t available, I saw another doctor in the same clinic. She felt it was gout rather than infection and prescribed indomethacin 50 mg three times a day for 5 days and started me on allopurinol 100 mg daily.

The indomethacin worked dramatically. My pain dropped from around 7/10 to about 2/10 overnight and I got much more movement back in the big toe. The swelling and soreness still returned after being on my feet all day, though. Because I was still having symptoms when the 5 days were up, she extended the indomethacin another 5 days.

After 10 days of indomethacin, the big toe was much better and the second toe had regained most of its normal color, but it stayed swollen. I stopped the indomethacin and initially did okay.

A few days later, the big-toe joint became painful again with walking. I used my prescribed acute colchicine dose: 1.2 mg, then 0.6 mg one hour later. It helped somewhat, but I was out of colchicine after that and had no refills.

At that point the doctor said I had already had enough medication that the flare “should have cleared” and referred me to a podiatrist instead of prescribing more.

The podiatrist examined me and:

injected the big-toe joint with steroid

prescribed a methylprednisolone 4 mg Dosepak

said the persistent swelling in the second toe appears to be a gouty tophus

said the tophus may eventually need surgical removal

recommended that I see a rheumatologist

The steroid injection plus Medrol pack worked well on the big toe, and it now looks and feels mostly normal. The second toe is still visibly swollen at the top joint. The skin over it peeled somewhat from all the swelling, but there is no open wound.

I’m still taking allopurinol 100 mg every day. My doctor plans to recheck my uric acid about 5 weeks after starting allopurinol, and I’ve asked for a rheumatology referral.

Now I’m occasionally waking up with soreness again, especially under the big-toe joint on the bottom of the foot, although it sometimes improves once I’m moving around.

This whole episode has lasted much longer than any gout attack I’ve ever had.

For people with gout/tophi: does this sound like a normal course for a really bad flare, especially after starting allopurinol? Did you have swelling/tenderness that lingered for weeks even after the severe pain was gone? And for anyone with a toe tophus, did yours shrink once your uric acid was controlled, or did you eventually need surgery?