How Does Gout Occur?
Gout is a painful type of arthritis that is getting more common in the Western world.
Anyone can potentially develop gout, although you may be at higher risk of this depending on your health, diet and general lifestyle. Over 8 million Americans have already been diagnosed with it and this number looks set to increase.
That’s a scary thought but it helps to know what factors make you more prone to being affected by gout so you can try to avoid becoming one of them.
Here’s a look at what gout is, why it develops in some people and what you can do to protect against attacks of this nasty condition.
Why Does Gout Affect Some People?
In a nutshell, gout is the result of having too much uric acid in your blood.
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To explain why this problem can affect some people, let’s break down how uric acid is produced and how it’s usually deal with by the body.
Uric acid is a byproduct of purines, which are produced in the body and also extracted from food.
After it’s produced, uric acid is absorbed into your bloodstream and most of it will be filtered by your kidneys so it can leave your body when you urinate.
Some people find that their body produces too much uric acid or doesn’t get rid of the right amount. If this happens to you, you’ll have an unhealthy amount of uric acid in your bloodstream (hyperuricemia). This can lead to gout symptoms but not everyone who has high uric acid in their body goes on to develop gout.
So, how much is too much? A healthy level of uric acid is less than 6.8 mg/dL but if your levels go above this, it can encourage your body to start forming salt crystals known as monosodium urate (MSU) crystals in your joints.
Who is Most Likely to Be Affected By Gout?
In a lot of cases, there’s no obvious reason why gout has developed but these risk factors can increase the chances of it happening:
- If you’re aged 40-50 (it’s not common for children to get gout and young people don’t tend to get it either)
- If you’re male, you’re at higher risk of developing gout but women can be more prone after the menopause
- If there is a family history of gout it can increase your risk factor by around 20 percent
- If you regularly drink alcohol
- If you’re overweight
- If you take certain medications such as diuretics and aspirin
- If you’ve had an organ transplant
- If you have thyroid problems, especially an underactive thyroid gland
- If you have another illness including leukemia, lymphoma and psoriasis
What Are the Symptoms of Gout?
In the first stage of gout, you may have high levels of uric acid but no obvious symptoms.
This can develop into the second stage, whereby MSU crystals form in your joints. This is when symptoms start to show so you’ll probably notice that you’ve got pain, redness, stiffness, swelling and inflammation in certain joints. They may also feel warm and sore.
Attacks of gout usually come on quickly and can flare up in just a few hours. Like many people, you might find that your very first attack happens during the night and wakes you up. It’s more likely to affect only one of your joints to begin with, often one of the big toes.
At its worst, a gout attack can be so uncomfortable that even the feeling of your bed sheets can seem unbearable!
Attacks of gout usually get better within 3 to 10 days, and you’ll go into remission at this point. It can be months or even years before another attack happens. This is the third stage of gout, known as interval or intercritical gout.
Without treatment, future attacks are very likely though and remission periods can get shorter.
There is a fourth stage of gout called tophaceous gout, in which your body produces tophi. These are solid deposits of MSU crystals that build up in your joints, bones and cartilage. Some people will find that these are visible as lumps under the skin. With treatment, you’ll probably never get to this stage and will alternate between stages two and three.
Tophi can potentially start occurring just a few years after gout first develops, although it can also take decades for this to happen. Older people are more likely to have tophi earlier on after developing gout.
Potential Complications of Gout
If gout develops and isn’t treated, it can lead to other health problems. This includes:
- Chronic Uric Acid Interstitial Nephropathy - This happens when uric acid crystals build up in the tubes that carry fluids away from the kidneys. It sounds really serious but fortunately, it’s actually reversible and doesn’t usually cause any damage to the kidneys.
- Kidney failure - An unlucky few people can develop kidney failure if there is a sudden surge in how much uric acid is being produced. Luckily this doesn’t happen a lot! It’s more likely to happen if you have certain cancers (including breast and lung cancers), are receiving chemotherapy for leukemia or lymphoma, have epileptic seizures, or pregnancy eclampsia or preeclampsia.
How is Gout Diagnosed?
Gout can usually be diagnosed based on the symptoms and the areas of the body that it is affecting. If symptoms are in your big toe, doctors will usually be confident that gout is the culprit, for example.
If doctors aren’t sure whether gout is to blame for your symptoms, they can also look at the levels of urate in your blood, do X rays and take fluid samples from affected joints to see whether the results point to gout.
Can Gout Attacks Be Prevented?
Not everyone with gout receives treatment and you may be able to manage the condition through diet and lifestyle.
People with gout are often told to stick to a low purine diet to reduce uric acid levels. Avoiding purine-rich meat and fish is the usual advice but the jury is still out as to whether this actually helps you to ward off gout attacks.
This is because your body produces most of its uric acid by itself so changing your diet probably won’t make a lot of difference by itself.
Lifestyle changes that can help to prevent gout attacks include avoiding alcohol and slimming down if you’re overweight. These can be good moves if you fall into either of these categories.