instruction: 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 arc checked because I was struggling with headaches insomnia and various degrees of itching after eating my arc turned out to be 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 berine approximately 100mg day works gout pain is essentially gone and blood sugar seems to be coming under control with each day though my caloric intake in unsustainable low admittedly I have taken some hesperidin ala chromium nac ecgc nigella sativa oil or triple strength turmeric occasionally if 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
output: hi I have seen your blood works 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 asteroidal 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 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