As many as 6 million adults age 20 and older report having had gout at some time in their lives, according to a National Arthritis Workgroup report that was published in the January 2008 issue of Arthritis and Rheumatism. Gout is a complex form of arthritis that is characterized by sudden, severe attacks of pain, redness and tenderness in the joints. Any joint may be affected, although the joint at the base of the big toe is frequently involved. Gout is caused by the build-up of uric acid in the bloodstream, which is affected by a number of risk factors.
Uric Acid Build-Up
Uric acid is a byproduct of the breakdown of purines. These substances are found naturally in the body, as well as in foods such as anchovies, organ meats, herring, asparagus and mushrooms. Uric acid normally dissolves in the blood and passes through the kidneys into the urine, but it can build up when the body produces too much or the kidneys excrete too little of the substance. When uric acid builds up, sharp urate crystals accumulate in a joint or surrounding tissues, causing pain and swelling, according to the Mayo Clinic.
Family History
According to the National Institute of Arthritis and Musculoskeletal and Skin Disease, 20 percent of people with gout have a family history of the disease.
Age and Gender
Gout occurs more often in men than it does in women, primarily because premenopausal women tend to have lower uric acid levels than men do. After menopause, however, women’s uric acid levels rise and they become more susceptible to gout, reports the Mayo Clinic.
Lifestyle Choices
Alcohol interferes with the removal of uric acid from the body, so drinking excessively (more than one drink a day for women and more than two drinks a day for men) will increase your chances of developing gout. Eating too many purine-rich foods can cause or aggravate gout. According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, excess body weight also increases the risk of developing gout.
Medical Conditions
Certain medical conditions, including untreated high blood pressure, diabetes, high cholesterol and arteriosclerosis (narrowing of the arteries), increase the likelihood of developing gout. Renal insufficiency, or the inability of the kidneys to eliminate waste products, is a common cause of gout in older people. Other medical problems that contribute to high blood levels of uric acid include hypothyroidism, psoriasis, hemolytic anemia and some cancers, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases.
Medications
Taking certain medications can increase the risk of developing gout. Diuretics, which are often prescribed for the treatment of high blood pressure, edema and heart disease, reduce the amount of uric acid secreted in the urine. Low-dose aspirin, niacin, cyclosporine (used to treat autoimmune diseases and to prevent organ rejection in transplant patients) and levodopa (used in the treatment of Parkinson’s disease) increase the risk of developing gout.
Lead Exposure
In some cases, exposure to lead in the environment can cause gout, according to the National Institute of Arthritis and Musculoskeletal and Skin Disease.
About this Author
Marcy Brinkley’s articles about health care and legal issues have appeared in “Texas Health Law Reporter” and the “State Bar of Texas Health Law Section Report.” She holds a bachelor’s degree in nursing, a master’s degree in business administration and a Doctor of Jurisprudence.
