I have swelling at the base of 1st toe in both the feet. As such there is no pain or fever but flexibility of the toe is affected resulting in pain at the time of walking. I can not wear shoes because of swelling. I am 66 years old. Orthopedics diagnose it a gouty condition. The uric acid is 5.6 mg/dl. Ra factor and c-reactive protein are negative. X - ray reveals bony growth of the toe. I also tried physiotherapy without any positive result. Can any doctor suggest any treatment?

Dr. R.S. SainiInternal Medicine Specialist13yrs exp

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A high uric acid level can be caused when your body either produces too much uric acid or your kidneys don't eliminate uric acid rapidly enough. A high uric acid level may cause increasingly frequent attacks of gout, or it may never cause problems. A high uric acid level may also cause some people to develop kidney stones or kidney failure. And some people with a high uric acid level also develop high blood pressure, heart disease or chronic kidney disease, but it's often unclear whether this is a direct cause or merely an early warning sign of these conditions. Factors that may cause a high uric acid level in your blood include: Diuretic medications (water pills),Drinking too much alcohol,Genetics (inherited tendencies),hypothyroidism (underactive thyroid),Immune-suppressing drugs,Niacin, or vitamin B-3, obesity,psoriasis, Purine-rich diet ? organ meat, game meat, anchovies, herring, gravy, dried beans, driedpeas, mushrooms and other foods Renal insufficiency ? inability of the kidneys to filter waste Tumor lysis syndrome ? a rapid release of cells into the blood caused by certain cancers or by chemotherapy for those cancers,Also, you may be monitored for high uric acid levels when undergoing chemotherapy or radiation treatment for cancer. Avoid protein diets, avoid more milk products. bad habits , fast food/fat/oily,salty foods. Coffee, smoking, alcohol intake. Non-veg., take whole grain,oats,green veg.,plenty of water in day time, 1 glass of water at night before bed. Take tab. Zyloric 100 mg once a day. Tab. Ulracet sos for pain in joints. 

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