1. Gout most commonly attack the big toe.

2. Asymptomatic high uric acid level is not an indication for allopurinol

3. During attack, we usually prescribe NSAID or Colchicine to stop the pain then we review the lifestyle, food etc for optimizing gout..

4. We DO NOT start allopurinol during attack

5. If u're taking allopurinol but an gout attack as well, DO NOT stop the drug during the attack.

6. Why we do not simply start allopurinol is because it has severe side effects such as hypersensitivity, bone marrow suppresion, aplastic anemia etc..

7. Advice for all gout patients:
- Optimize weight
- modify diet
- exercise
- reduce alcohol intake
- maintain fluid intake
- treat your other medical prob such as hypertension, hyperlipidemia

8. Avoid high purine content food such as red meat, liver, kidney, asparagus, meat extracts (eg Bovril) etc..