Can gout patients adjust their medication dosage independently? It is not recommended; please follow medical advice.

As someone who's been through it, my advice is: absolutely do not adjust your medication on your own; this is something you must leave to your doctor.

To give you an analogy, treating gout is like fighting a war, and there are two scenarios:

One scenario is when the enemy (gout) has already reached your doorstep (an acute attack, with joints red, swollen, and painful). At this point, the doctor will prescribe "firefighting" medications, such as colchicine or painkillers. These drugs are meant to quickly extinguish this "fire." Even with these medications, the dosage and duration of use must strictly follow medical advice, as overuse can lead to significant side effects.

The other scenario is long-term "city defense construction," which is what we commonly refer to as uric acid-lowering therapy, involving medications like allopurinol or febuxostat. This is the key to fundamentally treating gout. Its purpose is not pain relief, but to lower the uric acid level in the body to a safe range, allowing already formed urate crystals to slowly dissolve, thereby preventing future attacks.

So, why can't you adjust the dosage of uric acid-lowering medication yourself?

1. Increasing the dosage too aggressively can actually trigger gout: If the uric acid level in your body drops too quickly, stable crystals in your joints might break off and detach, which can, in turn, trigger a severe pain attack. Doctors typically start with a small dose to allow your body to gradually adapt. Then, based on follow-up blood uric acid levels, they incrementally increase the dosage. This is a process that requires careful pacing. If you increase the medication based on your own feelings, you can easily make things worse.

2. Feeling no pain and then reducing or stopping medication will undo all progress: Lowering uric acid is a long process. No pain doesn't mean your uric acid has reached the target level, nor does it mean the crystals in your joints are gone. As soon as you stop the medication, uric acid levels will quickly rebound, all your hard-won progress will be wasted, and the next attack might be even more severe. This is like boiling a kettle of water: if you turn off the heat at 80 degrees, it will quickly cool down and never reach boiling point.

3. Everyone's "optimal dosage" is different: The dosage you need depends on your uric acid level, liver and kidney function, presence of other diseases, and so on. Doctors need to conduct regular blood tests, like a detective, to find the most suitable and safest dosage for you that also brings your uric acid to target levels. This "code" can only be deciphered through scientific examination; you can't guess it blindly on your own.

Therefore, the most worry-free and safest approach is to completely entrust the medication adjustment to your doctor. Your task is to honestly take your medication on time, manage your diet, exercise regularly, and then regularly visit the hospital for follow-up blood uric acid tests. This allows the doctor to adjust your subsequent treatment plan based on your "report card." Only by doing so can you truly control gout and live a normal life.