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What causes Gout Flare Ups in Big Toe?

Gout, a form of arthritis, is a disorder in which deposits of uric acid crystals build up in the joints as a result of high concentrations of uric acid in the blood (hyperuricaemia). The crystal accumulations cause flare-ups (crises) of painful inflammation in and around the joints. Gout usually affects the big toe, but can occur in any joint.

As we have seen, anyone at any age can suffer from gout but men and adult are more at risk. There are several factors that increase the likelihood of suffering from it:

  • Having high levels of uric acid in the blood (above 6.8 mg/dl).
  • Being obese or overweight.
  • Taking certain drugs:
    – Diuretics (some types more than others), as they reduce the amount of uric acid that passes in the urine, favouring its deposit in the form of crystals.
    – Medicines containing a substance called salicylate. For example, aspirin.
    – A vitamin called niacin (nicotinic acid).
    – Cyclosporine, which is a medicine that blocks the immune system. It is used to treat some autoimmune diseases and to prevent organ rejection after transplantation.
    – Levodopa, which is a drug used in the treatment of Parkinson’s disease.
    – Some drugs used for the treatment of tuberculosis (tuberculostatics).
  • Eating a diet rich in foods or substances that increase uric acid levels (foods rich in purines). These include some seafood, oily fish, red meat, beer (alcoholic and non-alcoholic), alcoholic beverages and soft drinks.
  • Exposure to lead.
  • Having any of the following diseases:
    – Kidney failure.
    – High blood pressure.
    – Excess cholesterol and triglycerides in the blood (hyperlipidaemia).
    – Hypothyroidism (slowing of thyroid gland function).
    – Diabetes.
    – Medical problems that cause cells to reproduce and be eliminated more quickly than usual, such as psoriasis, haemolytic anaemia and some types of cancer.
    – Rare diseases in which the body does not properly regulate the concentration of uric acid in the blood due to enzyme deficiencies.
  • Drinking alcohol.
  • Having relatives with the disease, i.e. the genetic factor plays a role.

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