Loop-diuretic Induced Gout

Loop-diuretic Induced Gout

I had no previous episodes of gout. On 13 March 2012 I enjoyed a casino buffet with a friend. I loaded up on proteins: shrimp, fish, and chili. That afternoon I worked around my farm and drank little fluids. I was sweating more than I thought. In the early evening my left big toe felt sore, like I had stubbed it. By mid to late evening I knew I had gout, with a very painful, swollen, throbbing, red big left toe.

I was taking 20-40 mg of furosemide per day, a loop-diuretic, to reduce fluid retention from a weak heart. After some internet research I found out that furosemide could induce gout.

On March 15 2012 I went to see my family doctor. He gave me some indomethacin to take, at 50 mg twice daily. After reading the dangers and side effects of this medication, and after the strong suspicion that lisinopril had given me third degree heart block and caused the implant of an ICD, and furosemide probably caused/helped cause my gout, I decided I could live better with the pain than with another potential side effect of bleeding ulcers. So I toughed it out. The gout was very painful for 3-4 days, then the pain decreased. It was painful to walk on, but I did.

My foot would get better, then worse, as I bumped the toe while working on my farm. I walked the whole time, as crutches banged against my ICD implant near my left armpit, which was not good. I cycled getting better, then worse, then better until 14 May 2012 when I went back to see the doctor to try to finally end the pain. I had read about a NSAID (voltaren gel) that could be rubbed into the toe area to help relieve the pain (I would not have to take it orally and chance getting bleeding ulcers.). I rubbed this medication three times daily into the big toe for a total of 55 applications until 2 June 2012 to finally get the gout episode to end.

So the gout was almost gone, except for a slight joint pain on 2 June 2012. The gout episode lasted about 15 weeks, and was quite bothersome. One should avoid gout if at all possible.

I have now quit taking furosemide because I did not want another bout of gout, plus I wanted to avoid possible damage to my kidneys (creatinine went from 1.5 to 1.9). I also drink more water (I stopped most of the soft drinks and went to mostly water). Further information on what I did with my medications, and why, and the results will be in a future post.

I have not had any more episodes of gout. Now when my toe starts to feel sore, I immediately drink some more water. I have learned.

Google the above title of this article, or "furosemide induced gout," to get references on the subject.

Adrian R. Lawler, Ph.D.,  (C) 2012 --