Pain in big toe

General cycling advice ( NOT technical ! )
mikeymo
Posts: 1151
Joined: 27 Sep 2016, 6:23pm

Re: Pain in big toe

Postby mikeymo » 26 Jun 2020, 3:47pm

Proofer wrote:Seen the GP and she said it was gout (no sign of infection) and gave me some pills, looking back on it I think it was down to dehydration on that first run.


Friend of mine (keen cyclist) had high blood pressure. Doctor prescribed diuretics. Diuretics caused dehydration, thus gout.
Hilarious, pithy, or philosophical signature.

Jdsk
Posts: 862
Joined: 5 Mar 2019, 5:42pm

Re: Pain in big toe

Postby Jdsk » 26 Jun 2020, 4:02pm

One very commonly used family of diuretics, thiazides, have a direct effect on urate metabolism that doesn't depend on dehydration.
https://en.wikipedia.org/wiki/Thiazide#Contraindications

Jonathan

Proofer
Posts: 11
Joined: 16 Mar 2018, 3:50pm

Re: Pain in big toe

Postby Proofer » 27 Jun 2020, 2:24pm

I take blood thinner (Apixaban) so normal NSAIDs aren't suitable so I'm on Colchicine.
The odd thing is the first attack was June 15th and I was walking quite a lot after that (2 or 3 miles at a time) with no problems, I knew it wasn't right just put it down to an injury but when I went cycling it came back.

Jdsk
Posts: 862
Joined: 5 Mar 2019, 5:42pm

Re: Pain in big toe

Postby Jdsk » 27 Jun 2020, 2:27pm

Interesting drug. We used to think we knew how it worked, but it's got more complicated:
https://en.wikipedia.org/wiki/Colchicine#Mechanism_of_action

Jonathan

Jdsk
Posts: 862
Joined: 5 Mar 2019, 5:42pm

Re: Pain in big toe

Postby Jdsk » 27 Jun 2020, 2:34pm

And there's a lot that isn't known about gout, despite its description since ancient times. And its repeated portrayal in literature.
https://en.wikipedia.org/wiki/Gout#History
Proofer wrote:The odd thing is the first attack was June 15th and I was walking quite a lot after that (2 or 3 miles at a time) with no problems, I knew it wasn't right just put it down to an injury but when I went cycling it came back.

It's pretty clear that both physical stress and wear and tear interact with the metabolic disturbance. But it's hard to explain in any detail what happens in individual sufferers.
https://en.wikipedia.org/wiki/Gout#Pathophysiology

Jonathan

User avatar
Audax67
Posts: 4746
Joined: 25 Aug 2011, 9:02am
Location: Alsace, France
Contact:

Re: Pain in big toe

Postby Audax67 » 27 Jun 2020, 3:38pm

Proofer wrote:Seen the GP and she said it was gout (no sign of infection) and gave me some pills, looking back on it I think it was down to dehydration on that first run.


I'm pretty bad at drinking enough myself, and have had horrible cramp on occasion both during and after rides. Post-ride lately I've started making myself up a pint of Isostar with a half-teaspoon of bicarb to kill the acidity. It has pretty well got rid of the post-ride problems. Last one I had, I added a ball of vanilla ice-cream. Highly recommended.
Have we got time for another cuppa?

User avatar
NUKe
Posts: 3874
Joined: 23 Apr 2007, 11:07pm
Location: Suffolk

Re: Pain in big toe

Postby NUKe » 27 Jun 2020, 4:13pm

Proofer wrote:Seen the GP and she said it was gout (no sign of infection) and gave me some pills, looking back on it I think it was down to dehydration on that first run.


Quinine is good for gout, if you feel it coming on It, I find you can usually head it off with a tonic water best leave the gin out though as alcohol can aggravate it. The pills the doctor gave me worked when it was severe. But I fInd managing it with Indian tonic water works well
NUKe
_____________________________________

Jdsk
Posts: 862
Joined: 5 Mar 2019, 5:42pm

Re: Pain in big toe

Postby Jdsk » 27 Jun 2020, 4:24pm

NUKe wrote:Quinine is good for gout...

What's the evidence for that, please?

Thanks

...

There's a known interaction between colchicine and quinidine.
https://academic.oup.com/rheumatology/article/57/suppl_1/i4/4762112

I've never seen anything similar for quinine, but I'd probably abstain.

Jonathan

User avatar
TimeTraveller
Posts: 34
Joined: 7 Mar 2019, 8:49pm

Re: Pain in big toe

Postby TimeTraveller » 29 Jun 2020, 8:58am

Gout.... I get a flair up about twice a year, its a right pain in the wheels as I can't even get my shoe on.
I think I may be aggravating the issue now days as I'm running on a low carb Keto lifestyle which has a lot of fat and protein in it and as I've been told this can increase in uric acid.. hence flair ups.
I'm on Meloxicam plus pain relief but that I don't believe helps :(
What I tend to do now when I notice the joints beginning to cause pain is increase my fruit, lots of cherries and berries and also pure cherry and cranberry juices when I can find them (nothing else in it).
Still takes a while to ease down but I'd rather not add more chemicals to the mix.. Just getting over a bout that has had me unable to get the shoe on for the first week, now on week two and finding things easing off..

User avatar
NUKe
Posts: 3874
Joined: 23 Apr 2007, 11:07pm
Location: Suffolk

Re: Pain in big toe

Postby NUKe » 29 Jun 2020, 4:13pm

Jdsk wrote:
NUKe wrote:Quinine is good for gout...

What's the evidence for that, please?

Thanks

...

There's a known interaction between colchicine and quinidine.
https://academic.oup.com/rheumatology/article/57/suppl_1/i4/4762112

I've never seen anything similar for quinine, but I'd probably abstain.

Jonathan

The only evidence I have was a doctor that told me and the fact that the medicine I was prescribed Contained it. apart from that it works for me.
NUKe

_____________________________________