Which doctors are considered gout specialists?

Gout patients will need to see a number of specialists in their lifetime. For the first time that you experience a gout attack, you may be seeing a general practitioner first. They’ll prescribe you drugs to help relieve the pain but then after that, they may have you undergo a test to find out whether you have gout.

Depending on your doctor, they may have you do any of these tests to ensure you get the right diagnosis:

Joint fluid test – This is a test where the doctor will draw fluid from the affected joint using a needle. They will then examine the fluid under a microscope to check for urate crystals.

Blood test – A blood test will measure the amount of uric acid and creatinine in your blood. This is not as accurate as other tests as some people can have elevated uric acid levels but never experience a gout attack while others have gout but don’t have high uric acid levels in their blood.

X-ray imaging – This is when your doctor will use an X-ray to determine what caused the inflammation in your joint.

Ultrasound – A musculoskeletal ultrasound is another test that can determine whether there is urate crystal build up in the affected joint.

Dual energy CT scan – The most expensive test of all is the DUAL energy CT scan. This method can spot urate crystals in the joint even if it is not inflamed.

After the initial diagnosis, your doctor may prescribe medicines to help with your gout. There are two types of gout medications: one is for treating gout attacks and the other is for preventing it. The medication for preventing gout is prescribed based on the gout patient’s situation as it can fall into two types: either their body makes too much uric acid or they cannot get rid of it efficiently.

Treatments for gout attacks include NSAIDs, Colchicine and Corticosteroids. Meanwhile, medication for prevention include Allopurinol, Febuxostat, Probenecid, and Pegloticase.

Your doctor may then refer you to a specialist who can give you advice on how to better manage your symptoms. This specialist is called a rheumatologist. The unfortunate thing is that not enough gout patients see this specialist. Sometimes, they never see one at all in their lifetime. Only when they’ve exhausted all their treatment options are, they referred to a rheumatologist, and oftentimes, it’s already too late and gout already

As a gout patient, you should be aware with the options of specialists you can see. Sometimes, a general physician is not enough to help with your condition. A rheumatologist can get to the root cause of the problem and treat your gout more effectively. This is because they specialize in arthritis and rheumatic illnesses –and gout is a form of arthritis.

It’s been shown that gout patients who see a rheumatologist are:

  • More likely to get diagnosed via a synovial fluid analysis
  • More likely to detect serum urate levels
  • Less likely to need NSAIDs
  • More likely to receive higher doses of colchicine
  • More likely to receive interarticular cortisone injections
  • More likely to recommend prophylaxis with allopurinol

 

This means with a rheumatologist; you get a more accurate diagnosis and effective treatment for your gout. The condition is already challenging to manage by itself. By receiving care from the right specialist, you save yourself a lot of pain and hassle.

In addition to a rheumatologist, you may also need to see other specialists who can help with your condition. This includes a dietitian, an orthopedist, a cardiologist, and a podiatrist. Let’s take a look at what their roles will be in your journey to managing your gout. It’s important that you are aware who these specialists are and which one to approach depending on your situation.

Dietitian – Part of reducing your gout symptoms is eliminating foods that trigger a flare. These are high purine foods which turn into uric acid in the body. To avoid this, you will need the help of a dietitian. They will craft a diet plan for you –one where you’re able to avoid high purine foods while still meeting your daily requirements for carbs, fat, and protein.

Diets can be tricky especially when you have food corporations and marketers who will literally spend millions of dollars to make sure you buy their product, regardless if it’s healthy or not. Your dietitian will also teach you how to shop smarter at the grocery, so you avoid products that disguise themselves as healthy.

Lastly, your dietitian will keep track of your progress and setbacks, making modifications along the way until you settle on a diet plan that’s more sustainable.

Orthopedist – In the rare case that your gout develops into tophi, you will need an orthopedist who will perform the task of removing those chalky nodules in your joint. They specialize in bone, joint, ligaments, tendons, and muscle disorders.

Cardiologist – Heart disease is a complication that’s associated with gout disease so it’s important to always check on your heart health. A cardiologist will check for any risk of heart disease. They will also give you tips on how to prevent heart damage.

Even if you don’t think you have a heart problem, it’s important that you see a cardiologist anyway. Health should be looked at holistically and just because you’re feeling pain in one area it doesn’t mean other parts aren’t affected. Knowing that gout increases your risk for heart disease means that you should also make this area of your health a priority.

Podiatrist – A podiatrist is someone who specializes in health conditions that affect the feet and lower legs. Like orthopedists, they too can perform surgery on your foot if necessary. Although they can help diagnose conditions like gout, they might not be able to prescribe you the medicine that you need. If they find out that you do have gout, they may refer you to a rheumatologist who can better give you a course of treatment.

What was the first specialist referred to you by your doctor? Share your thoughts in the comments below.

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    3 replies to "Gout and Specialists"

    • Francois

      Hi Spiro

      I live in Windhoek, Namibia – you might want to google that, most people in Canada have never heard of us.

      Anyway – I stumbled over your website after browsing the web for help.

      I have suffered from gout now for almost 16 years, after getting it for the 1st time when I was 35 yrs old. Biggest reason was mostly diet and unhealthy living – I used to eat plenty of meat and lots of sugar.

      I have never adapted to taking allopurinol and have only tried to deal with it through diet & lifestyle, but with limited success.

      The problem is that in the past when I have tried to go onto allopurinol, I have struggled with a severe attack almost immediately………I have also balked at the idea of taking it for life.

      I had a severe attack again a week ago……one of those where I had to get out my crutches. So I am back again at trying out allopurinol…..what would you suggest?

      By the way – I’ve just purchased your book (kindle version) on Amazon and will look to incorporate it into my current diet.

      Kind Regards

      • Spiro Koulouris

        HI Francois!

        Thank you for your email and welcome to our community!

        Yes it’s rough, best you seek your doctor’s advice and see where your uric acid levels are at.

        Many gout sufferers have no choice, they can’t control gout with diet only, they have to take medication to control it long term.

        I am one of them cause I have a genetic disposition that I was born with. I have minor thalassemia which my doctor says could be the reason I developed gout so early.

        But I only take 100 mg daily of allopurinol and control it well with diet.

        See what your doctor recommends but you can live a healthy life with allopurinol if you continue to eat well.

        Many gout sufferers think that taking medication is a free pass to eat whatever they want but end up having their doctors increasing their allopurinol dosage every few years.

        So if you are taking a low dose and eating right, you’ll be fine and can live a long healthy life.

        For gout diet here is a quick summary:

        Try eating 80% of your daily calories as complex carbohydrates such as fresh vegetables, legumes, some fruit, 100% whole grain breads, pastas and rice. Eat mostly beans for protein.

        10% of your daily calories can be protein such as chicken breast, turkey, fish, lean red beef and lamb. Avoid pork, processed meats like sausages and hot dogs, avoid all seafood as well like lobster, shrimp and crab for example.

        Finally, eat 10% of your daily calories as fat like milk, cheese, yogurt, butter, eggs and so on.

        Drink only water, herbal teas and coffee.

        Avoid processed foods like snack bars, cookies, cereals etc…

        Do not fry your food. Only boil it or bake it in the oven. BBQ meat is fine too. Cook only with 100% extra virgin olive oil. Do not use corn oil, vegetable oil, canola or other types of oil that are toxic to your health.

        Good luck!

    • Anthony

      I had asked to see a specialist (rheumatologist) for my gout from my primary physician, but they stated they can address any issues with gout and prescribe the same medications necessary to control my gout as would a rheumatologist would diagnose and prescribe.

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