Gout Causes & Risks

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• QWhat causes gout?

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  A Dr. Michael Roizen, MD , Internal Medicine, answered

  Gout comes on when your body either makes too much or excretes (in your urine) too little uric acid -- a byproduct of purine (a chemical that's in almost all human tissues and some foods). It's those uric acid molecules that cause trouble when they get together and form sharp, pointy crystals that lodge in joints and tissue.

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• QWhat are tophi?

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  A Dr. William J. Martin, MD , Rheumatology, answered on behalf of UCLA Health

  If gout is left untreated, tophi (masses of solid uric acid) begin to form in the affected areas. From the initial attack, it can take three to 42 years for a visible tophus to appear. The average is about 11.6 years. The rate of formation depends primarily on the concentration of uric acid.
• QWhat foods increase the risk of gout?

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  A Dr. Audrey K. Chun, MD , Geriatric Medicine, answered on behalf of The Mount Sinai Health System

  Women who drink fructose-rich beverages such as sugar-sweetened sodas and orange juice are at increased risk for gout, say researchers writing in the "Journal of the American Medical Association." Compared with women who consumed less than one serving of sugar-sweetened soda per month, those who consumed one serving per day were 1.74 times more likely to develop gout and those who consumed two or more servings per day had a 2.4 times higher risk.
  
  In addition, compared with women who consumed less than a glass (6 ounces) of orange juice per month, those who consumed one serving per day were 1.41 times more likely to develop gout, and those who consumed two or more servings per day had a 2.4 times greater risk. The risk of gout in these women over 22 years was about 1%; drinking two or more servings of sugar-sweetened soda per day raised the risk to about 2.4%.
• QWhat increases my risk of developing gout?

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  A Portsmouth Regional Hospital answered

  Many people with gout have a family history of the condition. Although gout is more common in men than women, post-menopausal women are more prone than younger women to developing this form of arthritis. The following factors may also increase your risk of developing gout:
  

  • kidney disease, diabetes, certain types of cancer, high blood pressure, hypothyroidism
  • alcohol consumption and diets rich in high-purine foods such as sardines, liver, organ meats, and asparagus
  • obesity
  • lead poisoning
  • prescription drugs such as diuretics or antirejection drugs, or aspirin in large or regular doses
• QWhat medications can increase my risk of developing gout?

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  A Portsmouth Regional Hospital answered

  Medications used to treat hypertension called thiazide diuretics may cause increased levels of uric acid in the blood. Aspirin in large doses can also reduce the effectiveness of drugs used to treat gout. Talk to your doctor about any medications you are currently taking to avoid any complications.

• QCan damage to my joints caused by gout be reversed?

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  A Portsmouth Regional Hospital answered

  Unfortunately, damage to your joints cannot be reversed. However, with treatment, any additional damage to the joints can be prevented. In some cases, surgery may be used to remove large deposits of tophi (uric crystal) from under the skin. If you believe you have symptoms of gout, talk to your doctor right away.

• QHow is obesity linked to gout?

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  A Dr. William L. Wilson, MD , Family Medicine, answered

  The link between obesity--especially central obesity, and gout is primarily through excessive fructose consumption, especially in the form of sucrose (sugar) and high fructose corn syrup. If you consume more than 25 grams of fructose a day, some of this fructose is converted to uric acid. Even if you don't develop gout, elevated uric acid irritates the lining of your blood vessels causing a condition called endothelial dysfunction, the first step leading to heart attacks and strokes. Uric acid also blocks the production of nitrous oxide, a gas that allows your blood vessels to relax. Thus high uric acid also contributes to high blood pressure. To learn more about the adverse effects of excessive fructose, I recommend that you read "The Sugar Fix" by Richard Johnson, MD. The bottom line--sugar and high fructose corn syrup are likely chronic toxins and you should do everything possible to eliminate them from your diet, especially if you are dealing with obesity.

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• QWho is most at risk for developing gout?

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  A Portsmouth Regional Hospital answered

  Men have a higher risk of developing gout. Gout is also more prevalent in men age 40 and over and in women age 50 and over. In many cases, people who develop gout have a family history of the condition.

• QWhat can trigger a gout attack?

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  A Portsmouth Regional Hospital answered

  Eating foods rich in purines, such as anchovies, mushrooms, or asparagus, and drinking large amounts of alcohol can increase levels of uric acid in your blood, triggering an attack. A sudden injury to a joint, stress, illness, or surgery may also result in an attack. Some medications used to treat kidney stones can also provoke an episode.
• QWhich foods are most linked to gout?

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  A Portsmouth Regional Hospital answered

  Foods high in protein are often naturally high in purines. High-purine foods include:

  • organ meats such as liver, kidneys, sweetbreads;
  • certain seafood, such as mackerel, mussels, scallops, herring, sardines, and anchovies;
  • some vegetables, such as asparagus and dried peas and beans, as well as mushrooms;
  • meat-based broths or gravies.

  Limiting the amount of high-purine foods you eat is one way to manage your risk of gout, as well as additional flare ups. Alcohol is also connected to gout, and should be limited;