Thank you. You were helpful last time! My Uric acid is staying at around 10+ last three months 10.6 today. I have constant low grade gout. Some huge tophi on feet, bilaterally, ankle bone left, top of foot left, right finger and elbow. Rheumatologist gave me a surgical referral. Allergic to allopurinol, no Uloric due to cardiac issues and black box warning. Oncologist said no to pegloticase (metastatic breast cancer.) I have stage 3 CKD, one kidney creatinine 1.3.

I’m pretty great about diet. I also take sodium citrate for kidney stones very regularly. Tried Tart Cherry juice ( more pain.) Drink a gallon of water a day plus IV hydration - helps with kidneys.

Nothing is helping, I’m miserable. I am not dead yet however! Any further advice?