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information from the National Institutes of Health
What Is Gout?
Gout is a painful condition that occurs when the bodily waste product uric acid
is deposited as needle-like crystals in the joints and/or soft tissues. In the joints,
these uric acid crystals cause inflammatory arthritis, which in turn leads to intermittent
swelling, redness, heat, pain, and stiffness in the joints.
In many people, gout initially affects the joints of the big toe (a condition called
podagra). But many other joints and areas around the joints can be affected in addition
to or instead of the big toe. These include the insteps, ankles, heels, knees, wrists,
fingers, and elbows. Chalky deposits of uric acid, also known as tophi, can appear
as lumps under the skin that surrounds the joints and covers the rim of the ear.
Uric acid crystals can also collect in the kidneys and cause kidney stones.
What is Uric Acid
Uric acid is a substance that results from the breakdown of purines. A normal part
of all human tissue, purines are found in many foods. Normally, uric acid is dissolved
in the blood and passed through the kidneys into the urine, where it is eliminated.
If there is an increase in the production of uric acid or if the kidneys do not
eliminate enough uric acid from the body, levels of it build up in the blood (a
condition called hyperuricemia). Hyperuricemia also may result when a person eats
too many high-purine foods, such as liver, dried beans and peas, anchovies, and
gravies. Hyperuricemia is not a disease, and by itself it is not dangerous. However,
if excess uric acid crystals form as a result of hyperuricemia, gout can develop.
The crystals form and accumulate in the joint, causing inflammation.
What Causes Gout?
A number of risk factors are associated with hyperuricemia and gout. They include:
•Genetics. Many people with gout have a family history of the disease. Estimates
range from 20 to 80 percent.
•Gender and age. It is more common in men than in women and more common in adults
than in children.
•Weight. Being overweight increases the risk of developing hyperuricemia and gout
because there is more tissue available for turnover or breakdown, which leads to
excess uric acid production.
•Alcohol consumption. Drinking too much alcohol can lead to hyperuricemia, because
alcohol interferes with the removal of uric acid from the body.
•Diet. Eating too many foods that are rich in purines can cause or aggravate gout
in some people.
•Lead exposure. In some cases, exposure to lead in the environment can cause gout.
•Other health problems. Renal insufficiency, or the inability of the kidneys to
eliminate waste products, is a common cause of gout in older people. Other medical
problems that contribute to high blood levels of uric acid include:
(underactive thyroid gland)
that cause an excessively rapid turnover of cells, such as psoriasis, hemolytic
anemia, or some cancers
syndrome or Lesch-Nyhan syndrome, two rare conditions in which the enzyme that helps
control uric acid levels either is not present or is found in insufficient quantities.
•Medications. A number of medications may put people at risk for developing hyperuricemia
What Can People With Gout Do to Stay Healthy?
Fortunately, gout can be controlled. People with gout can decrease the severity
of attacks and reduce their risk of future attacks by taking their medications as
prescribed. Acute gout is best controlled if medications are taken at the first
sign of pain or inflammation. Other steps you can take to stay healthy and minimize
gout’s effect on your life include the following:
•Tell your doctor about all the medicines and vitamins you take. He or she can tell
you if any of them increase your risk of hyperuricemia.
•Drink plenty of nonalcoholic fluids, especially water. Nonalcoholic fluids help
remove uric acid from the body. Alcohol, on the other hand, can raise the levels
of uric acid in your blood.
•Exercise regularly and maintain a healthy body weight. Lose weight if you are overweight,
but avoid low-carbohydrate diets that are designed for quick weight loss. When carbohydrate
intake is insufficient, your body can’t completely burn its own fat. As a consequence,
substances called ketones form and are released into the bloodstream, resulting
in a condition called ketosis. After a short time, ketosis can increase the level
of uric acid in your blood.
•Avoid foods that are high in purines.
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