Will medications for Gout interfere with values of liver function test?

Question

Hi doctor,

I would like to know what does my lab tells you about my current liver function.

I began to struggle with daily gout pain a few months ago and finally gave in to taking the traditional drugs about one and a half months ago. Both Allopurinol and Probenecid caused worrisome impacts on my body. I began to experience flank pain, confused thinking, and fatigue. Around this time, I was also compelled to have my A1C checked because I was struggling with headaches, insomnia, and various degrees of itching after eating. My A1C turned out to be 5.7.

I stopped taking the drugs, and did a lot of research, and was fortunate to find some supplements that seem to be effective at the intersection of both metabolic syndrome and gout. Presently, I have found that Berberine (approximately 1000 mg/day) works. Gout pain is essentially gone, and blood sugar seems to be coming under control with each day, though my caloric intake in unsustainably low. Admittedly, I have taken some Hesperidin, ALA, chromium, NAC, ECGC, nigella sativa oil, or triple strength turmeric occasionally when I was having a momentary concern (not all at once), or even all in a day, but occasionally.

My concern is for my ongoing liver function. Though things seem to be getting better, as the day goes on and I have taken some supplements, I will start to feel pressure in the middle of my back, kidney area, and left flank discomfort. It tends to have gone away by the time I wake up in the morning. On looking at my labs, the markers for liver function have fluctuated, but my primary care doctor never made mention of them. Is there anything you can tell me about what the changes in these ratios say?

Answer 1

Hi,

Welcome to icliniq.com.

I have seen your blood works. (attachment removed to protect patient identity). It is all normal. Usually, during the acute attack of gout, we do not start Allopurinol or uric acid decreasing medications as it can exaggerate the situation. We usually start after the acute situation is treated with drugs like NSAIDs (non-steroidal anti-inflammatory drugs). Allopurinol is started with caution if there is liver disease, kidney disease, diabetes, congestive heart failure, and high blood pressure. Are you pregnant or breastfeeding? Are you receiving chemotherapy drugs? Allopurinol can decrease the number of blood cells in your body that causes blood clot and that help you fight infections, which can make it easier for you to bleed from an injury or get sick when exposed to others who are ill. It can increase liver enzymes to decrease the blood elements. But I have seen your blood works and it is fine.

If someone has kidney stones due to increased uric acid, or recurrent gout episodes, or uric acid deposition on soft tissues that is the time usually Allopurinol is started and continued I think you do not have these problems. You need to decrease your protein intake like less meats, fish, lentils, eggs, and avoid diuretics which are used to treat high blood pressure. Alcohol intake to be reduced as well. You told your HBA1c (glycated hemoglobin) is 5.7 that is pre-diabetes or borderline diabetes, so better check your fasting sugar and sugar after two hours of eating. You need to do exercise even if it is just walking for one hour daily. Stop or reduce carbohydrates especially sugar in tea and sugary juices, bread, rice, pasta, and potatoes. Intermittent fasting can also help in decreasing weight and controlling sugar. Lifestyle modifications can help a lot in your case. Have you done any ultrasound abdomen?

Answer 2

Hi,

Welcome back to icliniq.com.

I was asking about abdominal ultrasound because of the flank pain you mentioned. As I mentioned earlier, sometimes increased uric acid can cause uric acid stones and that can lead to flank pain. You do not need to worry about liver function tests, these are abdominal normal range. As I already discussed the foods you have to avoid to keep control of your gout. You need to decrease your protein content of the food as it can increase uric acid and then exacerbate gout. About the supplements you took for gout I cannot comment much except if it helped you it is fine but keep in mind many of these supplements can lead to harm kidneys and/or liver. You did not mention how you were diagnosed with gout? Was it on clinical grounds only or they tested your joint fluid?

Your weight is quite high and your sugars are high enough to keep you on borderline diabetes. Please check your BP and fasting lipids as well. It looks like all you have is a metabolic syndrome in which insulin resistance occurs and one gains weight with a waist over 40 inches TG (fats, kind of lipid) are high, HDL (good cholesterol) decreases, and uric acid is high as well. The mainstay of treatment for this syndrome is to be active in life and decrease your calories. So as I mentioned earlier low carbohydrates and intermittent fasting will help you. Metabolic syndrome is one of the key risk factors for having heart disease later so you need to change your lifestyle. There is no alternative to this. No medicine is better than lifestyle modifications.

Will medications for Gout interfere with values of liver function test?

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