@recoveryrheumtampa: There's a second reason this window catches people, and it has nothing to do with the drug. Gout is one of the few conditions where the treatment itself can set off an attack. Starting a urate-lowering medication drops uric acid fast, and that rapid drop can mobilise crystals that were sitting quietly in a joint. This is why flare prophylaxis exists and why we start those drugs slowly. A GLP-1 creates a version of the same problem from the other direction. The uric acid moves quickly, and moving quickly is the thing joints object to. So if you have gout and you're starting a GLP-1, that's worth raising before you begin, not after the first attack. There are reasonable ways to plan for it. What almost nobody does is have the conversation in advance, because almost nobody knows there's a conversation to have. #glp1 #gout #uricacid #glp #johncartermd

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