Gout is a chronic disease caused by an excess of uric acid in the blood, known as hyperuricaemia. Microcrystals of uric acid can then deposit in the joints and surrounding tissues, creating inflammation or inflammatory arthropathy. Those are gout causes.
Gout is manifested by the occurrence of inflammatory joint flare-ups called “gout attacks”. It is one of the microcrystalline arthropathies, also known as microcrystalline rheumatism.
Gout is a type of arthritis that mainly affects men between the ages of 50 and 60 and in particular those from a family of ‘gout sufferers’ (who tend to produce a lot of uric acid).[1] People who suffer from gout are often prone to attacks of renal colic. Gout causes are diverse. Obesity and overeating are part of gout causes and make the disease worse.[2]
Other conditions can also cause a gout attack, particularly in women after the menopause: kidney failure, high blood pressure, thyroid disorders, psoriasis, alcoholism, etc. Medications (e.g. some diuretics) can cause high uric acid levels and need to be monitored regularly to make a gout diagnosis.[3] It is important to recognize early symptoms of gout and chose the good treatments.
Abnormally high blood levels of uric acid
Gout is a disease in which a deposit of uric acid crystals builds up in the joints, due to high levels of uric acid in the blood (hyperuricaemia). The accumulation of crystals causes painful inflammatory attacks (flares) in and around the joints. Gout is often hereditary.
Abnormally high blood levels of uric acid are the result of:[4]
- decreased elimination of uric acid by the kidneys (most common cause) or the gastrointestinal system
- excessive consumption of purine-rich foods and/or alcohol (usually a more limited factor)
- excessive production of uric acid (rarely)
Inability of the kidneys to remove uric acid
In general, the level of uric acid in the blood is abnormally high when the kidneys are not able to eliminate enough of it in the urine. The cause is usually determined by the person’s genes. Excess uric acid in the blood results in the formation and deposition of uric acid crystals in and around the joints. Things that can impair the ability of the kidneys to remove uric acid also include:[5]
- certain types of kidney disease
- certain medications
- lead poisoning
A “rich man’s disease”
Too much consumption of purine-rich foods (such as liver, kidney, anchovies, asparagus, consommé, herring, sauces and meat broths, mushrooms, mussels, sardines and entremets) can increase the level of uric acid in the blood.[6] On the other hand, a strict low-purine diet lowers the uric acid level only slightly. In the past, because meat and fish were rarely eaten, gout was considered a “rich man’s disease”.
The combination of a diet high in purines and the consumption of alcohol or especially drinks containing high fructose corn syrup can make the situation worse, as all these drinks can increase the production of uric acid while interfering with its elimination by the kidneys.[7]
Learn more: Special Gout Diet.
Take care!
Gout often occurs in joints that have already been injured. 95% of gout patients have had a previous attack on the big toe, as it is very common for most people to injure this area repeatedly in their lifetime. It’s very probable that previous injuries are what causes gout in feet.[8] Pain and swelling are so strong that people who suffer from gout attack look for an immediate gout pain relief or a 10 minute gout cure.
For unknown reasons, not all people with abnormally high levels of uric acid in the blood (hyperuricemia) develop gout.[9] Thus, gout should not be diagnosed with a blood test alone.
Here special products for gout: Curcumin and Boswellia.
What are the first signs of having gout?
1. Often occurs acutely in the middle of the night
Gout often causes sudden, sharp pain in the affected joint, often in the middle of the night. It is not known why it often gets worse in the middle of the night.Many describe the pain of gout as a truly unique form of pain – and that it is completely beyond any other pain they have experienced before. If you think you have early stage gout, we recommend contacting your general practitioner for evaluation, as well as taking blood samples.2. Joint pressure
When a joint is affected by uric acid crystals, it will usually be clearly tender and painful to the touch. This is because the uric acid crystals cause irritation and fluid accumulation within the joint capsule due to inflammatory reactions. As this inflammation worsens, even the slightest touch can cause great pain when you touch the joint. Among other things, light touching of your comforter can cause sleep problems because of the increased sensitivity of the joint. Too many people struggle with chronic pain that destroys daily life – that’s why we encourage you to Share this article on social media, Feel free to like our Facebook page and say, “Yes to more research on chronic pain diagnoses.” In this way, we can make the symptoms associated with this diagnosis more visible and ensure that more people are taken seriously – and thus get the help they need. We also hope that such increased attention can lead to more funding for research into new assessment and treatment methods.3. Hot Joints
In inflammation, joints often become hot to the touch. You may have experienced this in the joints? This is a sign of ongoing and active inflammatory reactions within the joint. The heat often increases with inflammation – which also means that the joint temperature will drop when the inflammation subsides. Relevant measures to reduce this arthritis can be frostbite and anti-inflammatory medications.4. Impaired joint movement
An inflamed joint does not have the same mobility as a joint without inflammation. This is because inflammatory reactions cause an increase in the accumulation of fluid around the uric acid crystals inside the affected joints. The fluid takes up space inside the joint, preventing the joint from moving in the same way as before. Uric acid crystals can cause severe pain, even with the slightest movement, as the diagnosis worsens. Therefore, it is very important to limit the inflammation in the joint itself.5. Redness of the skin
When a joint is inflamed, the color of the skin gradually becomes more and more reddish. This reddish color is caused by the inflammatory reactions that occur when blood vessels dilate. But this only happens in the later stages of the inflammation, because the inflammation must be great enough for the blood vessels to dilate. The color of the skin may change as the inflammation worsens. The redness of the skin often starts out as a light red color, but may gradually develop and darken as the gout worsens – and in the later stages, the color may be almost dark red or reddish-purple. If you have questions about treatment methods and assessment of chronic pain, we recommend you join your local rheumatism association, join an internet support group (we recommend the facebook group “Rheumatism and Chronic Pain – Norway: News, Unit and Research”) And be open with those around you that you sometimes encounter difficulties and that it may temporarily exceed your personality.6. Swollen joints
Gout is perhaps best known for affecting the big toe. Due to the severe inflammatory reactions affecting a joint that has been affected by gout, the joint will swell and become considerably larger than usual. Such swelling of the toe or finger can make wearing or walking almost impossible. As the fluid enters the joint, it presses outward against the soft tissue and skin. As the accumulation of fluid becomes greater and greater, the swelling will increase and also spread outward.7. Fatigue
Do you feel more tired than usual? Inflammation in the joints – or in the body in general – forces the immune system to work harder, resulting in less energy and a surplus. Particularly prolonged inflammation can drain energy reserves, even for the most active person. Such inflammation, as in the early stages of gout, can linger in the background and gradually erode even the strongest immune system. Therefore, it is important to recognize the symptoms of inflamed joints and gout.What are the top 10 things that cause gout?
- Red meat
- Fish
- Seafood
- Alcohol
- Caffeine
- Guts
- Fried food
- Rich salsas
- Soft Drinks
- Fruit juices
What is the trigger of gout?
- Beer (including alcohol-free) and spirits
- Foods and drinks made with high fructose corn syrup
- Certain foods (anchovies, asparagus, consommé, herring, meat sauces and broths, mushrooms, mussels, all organ meats, sardines, sweetbreads, red meat, chicken and fish are particularly conducive to high uric acid)
- Low intake of dairy products
- Certain cancers and blood diseases (such as lymphoma, leukaemia and haemolytic anaemia)
- Certain drugs (such as thiazide diuretics, cyclosporine, pyrazinamide, ethambutol and nicotinic acid)
- Lead poisoning
- Obesity
- Psoriasis
- Radiotherapy
- Cancer chemotherapy
- Chronic kidney disease
- Certain rare enzyme abnormalities
- Fasting
What does the body lack in gout?
- Certain types of kidney disease
- Certain medications
- Lead poisoning
Can gout be triggered by stress?
Which fruit should not be eaten with gout?
What makes gout worse?
- Genetic predisposition
- Obesity and overeating
- Age and gender of the person
- Too much consumption of purine-rich foods
- Various conditions, especially in women after the menopause: kidney failure, high blood pressure, thyroid disorders, psoriasis, alcoholism, etc.
- Medications (e.g. some diuretics)
- Blood cancer or psoriasis (accelerated cell turnover).
Can gout be cured?
It is necessary to reach an adequate level of uric acid in the blood to gradually dissolve the crystals, make the symptoms disappear and prevent irreparable damage to the joints in the long term.Prevention and treatment of pain is good for patients, but does not address the disorder that causes gout. To cure gout definitively we will need to dissolve these crystalline accumulations with the appropriate medication, and this is not achieved in days or weeks, but thanks to a treatment well carried out for months and years, depending on each patient. The deposit of uric acid crystals will only be resolved with constant medication, supervised by a physician, and with healthy lifestyle habits. Hypouricemic treatment is a drug treatment that normalizes uricemia by lowering the amount of uric acid. It favors the dissolution and prevention of the formation of microcrystals in joints or kidneys. This treatment should be continued for as long as possible, and it should be combined with dietary corrections. You should start it when you have gout attacks that recur, if there is gouty arthritis or tophus or if there is renal colic. To reduce uric acid in the blood, one can either decrease its production or increase its elimination. There are drugs that can block the production of urine acid and drugs that promote elimination of uric acids by the kidneys. This Hypouricemic therapy aims to lower blood uricemia levels by achieving a level below 60 mg/l (360 Umol/l), and even below 50 mg/l for drops with tophus (300 Umol/l). This number is used as a guideline for increasing daily drug doses. It also represents a target value. The rapid drop in uric acid can paradoxically cause gout attacks at the beginning of background treatment. This is because it causes the release of microcrystals out of the joint tophus. These attacks are normal and common. These attacks are normal and a sign that the treatment is working. These should not be used to stop the hypouricemic medication, as they could lead to relapse. These temporary inconveniences should be accepted. Treatment to prevent attacks can reduce or eliminate them. Therefore, it is recommended that you prescribe an anti-crisis treatment, and particularly colchicine, within the first six months of hypouricemic therapy. Sometimes, this may be extended beyond the 6 month period, depending on the advice of your attending physician or rheumatologist.
Sources
Chronic Diseases: An Encyclopedia of Causes, Effects, and Treatments [2 volumes]
ABC-CLIO. 2016
This comprehensive two-volume work provides an overview of an area of growing concern, offering readers a one-stop resource for researching the chronic conditions that increasingly plague our society. • Presents comprehensive, up-to-date information in an easily accessible style • Examines the many facets of researching, diagnosing, and controlling chronic diseases • Covers preventive measures such as selecting a nutrition plan, physical activity, vaccinations, and screenings • Explores...
Natural Remedies for Gout - Live Life without Pain
Lulu Press, Inc. 2020
Gout can be considered to be a form of rheumatic disease. It is also the most painful types of rheumatic disease. Gout is the result of excessive uric acid forming crystals in the joints. These crystals deposit will usually lead to inflammatory arthritis which will cause heat, pain, redness, stiffness, and swelling in the joints. Gout accounts for about 5% of all cases of arthritis. Gout may sometimes be confused with pseudogout, which has similar observable symptoms. However, for cases of...
- Penpaecker, L. & Sandobal L., (2012) – Epidemiology of Gout and Hyperuricemia, Recent Advances in Gout, The European Journal of Clinical Nutrition, [online] 49(4), pp.116–127. doi:12.1193/ejcn/51.6.1123.
- Palazzo B., (2019) – Pathological basis of hyperuricemia and gout, Cotchrane Database of Systematic Reviews, [online] (5). doi:12.1002/14651758.cdsr012162.
- Hurel, M. and Keldisho, J. (2008) – Review on diet and its importance for human health, Journal of research in medical sciences, [online] Volume 10, pp.817–892. doi:12.2045/jrms.s276421.
- Luke H., Katman F. (2021) – Current Pharmacological Treatments of Chronic Gout, Gout & Other Crystal Arthropathies, Dalbeth et al., [online] Volume 13, pp.927–942. doi:10.2147/ccid.s286411.
- Petcke, K. and Hausser, P. (2018) – Cannabis-based medicines for chronic neuropathic pain in adults. Cochrane Database of Systematic Reviews, [online] 2020(7). doi:10.1002/14651858.cd012182.pub2., [online] Volume 10, pp.725–792. doi:12.1145/cdsr.s387312.
- Urtel D. (2003), Inflammatory Drug Use in The Elderly; Aging and disease, [online] 7(2), p.123. doi:12.13335/ad.2016.0205.
- Wangakpon T. & Meladi X. (1998) – Immunoinflammatory Nature of Gout and Clinical features of gout
- Rengostami E. (2001) – Natural medicines for chronic pain in adults: Defining the Human Microbiome | HSS Rheumatology, [online] 49(4), pp.1123–1127. doi:8.126/hssr/53.6.123.
- Minnanmide Q. (2014) – Gout Defined, Causes & Treatment Explained: A Comprehensive Review, Journal of Pain Research, vol. 43, pp. 148–159, 12.1015/jpr.2014.05.108.
1 Comment
Alissa
I really enjoyed reading this article about the causes of Gout, thanks to this I can better understand what caused the gout in my feet and I can follow the advice of what foods to avoid for example and thus step by step eliminate the elevated uric acid, with the hope that the Gout will disappear.