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Diseases > Gout > Diagnosis | Gout

Diagnosis | Gout

What is Gout?

Most people don’t know this but gout is a type of arthritis.  In fact, it is the most common type of inflammatory arthritis affecting men.

What causes Gout?

Gout is a result of high levels of uric acid in the blood. But, for uric acid to cause gout it has to form crystals.

Think of it like this: most of us have jars of honey in our kitchen cupboards. Have you ever noticed when the jar of honey is getting low that the honey starts to become hard at the bottom? This is because the sugar in the honey crystallizes. If you pop that jar of honey into the microwave the crystals melt away. You can think of gout like this as well – uric acid, like the sugar in honey, crystallizes. When it crystallizes inside your joint – presto – you can get an attack of gout.

You might be wondering, where does the uric acid come from? There are 2 sources:

  1. Your body naturally makes uric acid every day.
  2. Your diet (especially meats, fish, seafood, and alcoholic beverages).

Your body gets rid of uric acid by flushing it out in the urine. In healthy people, the body keeps levels of uric acid in balance. In other words, the amount of uric acid being made is about the same as the amount being lost.

Uric Acid Sink

You can think of it like this: Imagine you go into your kitchen and turn on the tap to fill the sink with water. You don’t want the sink to overflow, so you pull the drain to let some of the water out. If the amount of water coming out of the tap is the same as the amount going down the drain, there will be a constant level of water in the sink. But if the drain gets plugged, the level of water in the sink will start to rise. Eventually, the water will spill over onto the floor and make a mess – and nobody likes to clean up a mess!

Your body does the same thing with uric acid: it is constantly making uric acid and getting it from the foods you eat. The body normally keeps the level of uric acid steady by getting rid of it in the urine. But if the kidneys can’t keep up, levels will build-up in the blood. As the levels build up high enough they reach a point where the uric acid can start to form crystals. If crystals form, the body’s immune system attacks the crystals, causing the joint to become red, hot, swollen and sore.

There are several reasons why levels of uric acid can build-up in the blood. The most common reason is that the kidneys don’t get rid of uric acid fast enough. This can happen naturally as we get older. Other people (with normal kidneys) just have a hard time getting rid of uric acid.  This can run in families.  Another reason is related to your diet. You may have heard gout described as “the disease of kings.” That’s because a long time ago, it was thought that gout was the result of eating a diet that was rich in meats and alcohol (which is actually true). Animal foods and alcoholic beverages are a rich source of uric acid. Sweetened drinks (soft drinks, sodas, and fruit juices) containing high-fructose corn syrup can also play a role. These drinks make it harder for the kidneys to eliminate uric acid.

Finally, certain medications can interfere with the kidneys’ ability to get rid of uric acid. The most common type is “water pills” (diuretics). These medicines are often used to treat high blood pressure or lower leg swelling.

Who gets Gout?

It is estimated that gout affects between 3 and 5 people in every 1000. That means that in a city of a million people, you could expect between 3000 and 5000 people to have gout. You can see that it’s not all that uncommon: you might know someone else who has it. Some famous people who have or have had gout include actor Jared Leto, major league baseball player David Wells, and King Henry VIII of England.

Gout is most likely to affect men in their 40s or 50s. Gout almost never occurs in women until after they reach the menopause or if they have a kidney problem.

Gout often runs in families. In other words, it is thought that your genes play a role in who gets gout. Men who have family members affected by gout have a higher chance of having gout themselves. This usually involves a genetic problem with the kidneys and how they handle uric acid.

There are other factors that can increase a person’s chances of developing gout:

  • Kidney problems
  • High blood pressure
  • High cholesterol
  • Diabetes or insulin resistance
  • Thyroid disease
  • Obesity

Read more – Symptoms of Gout