Gout: Causes

What causes gout?

Gout is caused by a metabolic disorder called hyperuricemia. Hyperuricemia is an excessive amount of uric acid in the blood. Uric acid is produced by the breakdown of waste products called purines. Hyperuricemia occurs when there is an overproduction of uric acid by the body or when the kidneys fail to effectively eliminate uric acid through urination.

Excess uric acid can build up and form crystals in and around joints, resulting in gout symptoms, such as inflammation, pain, redness, stiffness, and heat in and around joints. In fact, gout can be diagnosed by examining synovial fluid from the affected joint under a microscope to see if it contains the characteristic uric acid crystals.

Although hyperuricemia is a cause of gout, it is not the same as gout. You may have hyperuricemia and not have gout.

Gout triggers

The following triggers can increase uric acid levels, which may lead to hyperuricemia and gout:

• Cancer chemotherapy

• Certain medications, such as diuretics, immunosuppressants (such as cyclosporine), and aspirin

• Dehydration

• Foods and beverages containing high levels of purines, including sweetbreads, game meats, alcohol, certain fish and shellfish, and organ meats such as liver and kidney

• Joint injuries and infections

• Severe infection or illness

• Sudden weight loss

• Surgery

What are the risk factors for gout?

Research has identified several risk factors that can make you more prone to develop gout. Certain factors can be managed with lifestyle changes; whereas, some risk factors cannot be controlled, such as your family history and certain preexisting diseases.

General risk factors for gout

Well-accepted risk factors for gout include:

• Cancer chemotherapy

• Certain medications, such as diuretics, immunosuppressants (such as cyclosporine), and aspirin

• Dehydration

• Diet containing high levels of purines, including sweetbreads, game meats, alcohol, certain fish and shellfish, and organ meats such as liver and kidney

• Family history of gout

• Female gender past menopause

• Male gender older than age 40

• Obesity

Diseases and disorders that increase the risk of gout

Certain diseases, disorders and conditions can increase the risk of gout including:

• Cardiovascular disease (due to atherosclerosis, or hardening of the arteries, or other causes)

• Diabetes (chronic disease that affects your body’s ability to use sugar for energy)

• Hypertension (high blood pressure)

• Hypothyroidism (underactive thyroid)

• Kidney disease (including any type of kidney problem, such as kidney stones, kidney failure, and kidney anomalies)

• Leukemia (cancer of the blood or bone marrow)

• Sickle cell anemia (inherited disease characterized by abnormally shaped red blood cells that impair the delivery of oxygenated blood throughout the body)

Reducing your risk of gout flares or attacks

If you have recurring gout flares, your health care provider may suggest these lifestyle changes to help prevent the occurrence of future flares:

• Decreasing your consumption of high-purine foods and beverages, such as sweetbreads, game meats, alcohol, certain fish and shellfish, and organ meats such as liver and kidney

• Increasing your water intake

• Participating in a regular exercise program

• Reducing excessive stress