What Causes Gout?
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It is important to know what causes gout if you are to be able to control and avoid future outbreaks. Gout is caused by a buildup of uric acid in your blood which having reached a level whereby the body cannot excrete it as urine then form microscopic crystals in the joints affected by gout. These crystals spark a reaction from the immune system which causes the pain and inflammation associated with the condition.
Uric acid is usually harmless being a waste product that forms when the body breaks down types of acid known as purines. Purines are found naturally in the body, but they are also found in some foods and in alcohol. Two thirds of uric acid is produced by your kidneys. The other third is produced by your digestive system. Uric acid usually dissolves in your blood and passes through your kidneys into your urine so that it can be passed out of your body.
If you produce too much uric acid, or remove too little by way of urination, the uric acid will build up and may cause microscopic crystals to form, usually in a joint, or in the surrounding tissue.
Having established what causes gout it is vital to determine the factors that can increase the amount of uric acid in your blood thus increasing your chances of developing gout. These risk factors fall into one of two categories:
• Lifestyle factors such as diet, job, exercise levels and mental state i.e stress level
• Medical conditions which are known to increase levels of uric acid, such as high blood pressure (hypertension), and poor kidney function.
These risk factors are discussed in more detail below.
Lifestyle –
Gender – Men are three to four times more likely to develop gout than women. This is because their uric acid levels rise during puberty and stay elevated in comparison to females. Gout in women usually occurs during or after the menopause. Women experience a similar, albeit somewhat smaller rise in uric acid levels, which explains why the onset of symptoms occurs later in women than it does in men.
Diet – As we have already surmised some foods that are naturally high in purines. These include:
• beef
• pork
• bacon
• lamb
• seafood
• liver
• kidneys
Alcohol
Alcohol also contains purines. Beer contains the highest level of purines, spirits contain a moderate level, and wine contains the lowest level. In the past it has been wrongly assumed that red wine is particularly bad, however beers are markedly worse than most other alcoholic beverages.
Medication and Medical Conditions
Certain types of medication can increase your uric acid levels, and therefore your risk of developing gout. These include:
• low-dose aspirin – which is often administered to reduce the risk of blood clots
• diuretics – which are used to treat high blood pressure (hypertension) or an abnormal build-up of fluid in your body
• niacin – which is used to treat high cholesterol
• chemotherapy – which is used to treat cancer
• antacids such as allapurinol can actually make gout worse before improving things
• some forms of psoriasis – a condition that causes skin cells to reproduce too rapidly, leading to itchy, sore flaky, and crusty skin
• high blood pressure
• diabetes
• reduced kidney function
• hyperlipidaemia – high fat and cholesterol levels
• vascular disease – when your arteries become thickened, narrowed, or blocked
Family history
Studies have shown that gout can be hereditary and therefore often runs in families. As a rough estimate, approximately 20% of people with gout have a close family member who also has the condition.
Therefore it can be fairly difficult to pin down the exact causes of gout as the triggers can be many and varied. One thing however is obvious, avoiding foods high in purines, keeping hydrated and exercising can reduce the chances of a gout attack.