Gout is a common and complex form of arthritis that can affect anyone. A very recent study was completed with unexpected results. The study, led by researchers from the University of Otago, New Zealand, analyzed the genetic information of an astounding 2.6 million people, including 120,295 individuals with gout.
This was the largest genetic study of the condition, providing unprecedented insights into its underlying causes. The findings are published in Nature Genetics. One of the most striking findings was that inherited genetics is a major factor in determining who develops gout. This new information may provide a great deal of guidance for future treatments and could change the understating of how/why gout occurs.
An excess of uric acid in the body is called hyperuricemia. It’s characterized by sudden severe attacks of pain, swelling, redness and tenderness in one or more joints, most often in the joint at the base of the big toe – one of the metatarsophalangeal joints. But it can also develop elsewhere at the front of the foot or in the ankles, knees, elbows, wrists, or fingers.
If other members of your family have had gout, you’re more likely to develop the disease. Gout occurs more often in men, primarily because women tend to have lower uric acid levels. After menopause, however, women’s uric acid levels approach those of men. Men are also more likely to develop gout earlier, usually between the ages of 30 and 50. Certain diseases and conditions increase the risk of gout – these include untreated high blood pressure, diabetes, obesity, metabolic syndrome, and heart and kidney diseases. If you’re overweight, your body produces more uric acid, and your kidneys have a more difficult time eliminating uric acid.
Gout occurs when urate crystals accumulate in your joint, causing the inflammation and intense pain of a gout attack. Urate crystals can form when you have high levels of uric acid in your blood. Normally, uric acid dissolves in your blood and passes through your kidneys into your urine. But sometimes either your body produces too much uric acid, or your kidneys excrete too little uric acid. When this happens, uric acid can build up, forming sharp, needlelike urate crystals in a joint or surrounding tissue that cause pain, inflammation and swelling.
Your body produces uric acid when it breaks down purines – substances that are found naturally in your body. Purines are also found in certain foods including red meat and organ meats like liver. Purine-rich seafood includes anchovies, sardines, mussels, scallops, trout and tuna. Alcoholic beverages, especially beer, and drinks sweetened with fruit sugar (fructose) promote higher levels of uric acid.Certain medications like low-dose aspirin and some medications used to control hypertension, including thiazide diuretics, angiotensin-converting enzyme (ACE) inhibitors and beta blockers, testosterone, and xylitol. ED medication sildenafil, heartburn drug omeprazole, drugs containing salicylate, also can increase uric acid levels.
The signs and symptoms of gout almost always occur suddenly and often at night. They include: (A) Intense joint pain – the pain is likely to be most severe within the first four to twelve hours after it begins. (B) Lingering discomfort – after the most severe pain subsides, some joint discomfort may last from a few days to a few weeks. Later attacks are likely to last longer and affect more joints. (C) Inflammation and redness – the affected joint or joints become swollen, tender, warm and red. (D) Limited range of motion – as Gout progresses, you may not be able to move your joint normally. Gout can be acute, with symptoms that come on suddenly, or gout can be chronic, with more frequent flares and lasting symptoms.
If you experience sudden, intense pain in a joint, call your doctor. Gout that goes untreated can lead to worsening pain and joint damage. Seek medical care immediately especially if you have a fever and a joint is hot and inflamed, which can be a sign of infection. A joint infection and gout can cause similar symptoms; the doctor may also look for bacteria in an aspirated joint fluid sample to rule out a bacterial cause. Untreated gout can progress, causing permanent damage to the joints and kidney damage/stones. Your physician may order blood tests and an ultrasound scan and/or CT scan to locate uric acid crystals around affected joints or within growths. X-rays cannot detect these signs, but your physician may use an X-ray to rule out other causes of the symptoms. Your physician may prescribe medications that can help with the pain/swelling, regulate blood uric acid levels, prevent future flares, and reduce the risk of complications, such as kidney stones and acid crystals forming white growths in the affected areas, called “tophi” – a swollen, bulbous growth on your joints just under your skin.
- YOU and Your Doctor Are Your Medical Team – May 2025 - April 30, 2025
- YOU and Your Doctor Are Your Medical Team – April 2025 - March 30, 2025
- YOU and Your Doctor Are Your Medical Team – March 2025 - February 27, 2025
