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Are you one of the unfortunate people who have had a gout attack? You’re in good company. Around 2% of the population has a gout attack at some point in their life – and the numbers are on the rise – but that doesn’t explain why gout happened to “pick you.” Certain people are more susceptible to gout and you’ll soon find out why. Before discussing gout risk factors, it’s important to understand why gout happens in the first place.
What Causes a Gout Attack?
Gout attacks occur when uric acid levels become too high. Uric acid is a breakdown product of compounds called purines found in cells and in our diet. Uric acid is normally eliminated through the kidneys, but some people are not very effective uric acid excretors, and they develop high uric acid levels as a result. As uric acid levels increase, uric acid crystals start to form and deposit in tendons, joints and other tissues. This causes an inflammatory response that leads to the pain and swelling of gout.
Some animals produce an enzyme called uricase that breaks down uric acid so it doesn’t accumulate and lead to a gout attack, but humans and gorillas missed out when the uricase enzyme was passed around, and they have more problems breaking it down. Sources say that primitive humans once had the uricase enzyme and lost it. Now they pay dearly for it by being more susceptible to gout attacks.
Now you know that humans don’t produce uricase, you may wonder why all humans don’t get gout? As mentioned, some people eliminate uric acid better through their kidneys – or they simply produce less of it. Diet plays a role too. Uric acid is produced by the breakdown of purines from food sources and this adds to the uric acid load your body has to deal with. The inability to eliminate excess uric acid is usually a genetic trait. This explains why gout runs in families although lifestyle is an issue for many people too.
Who’s at Highest Risk for Gout?
Gout is more common in certain populations – especially the Hmong people who live in Southeast Asia. They get their first gout attacks at a young age, and their disease is more severe. A group of people called the Maori who live in New Zealand also have a very high incidence of gout, which shows the role genetics plays.
Men got the short end of the stick when it comes to susceptibility to gout. Men are more likely to get gout than women before women reach middle age, but after menopause, females play “catch up” as their uric acid levels rise after menopause. There’s more than one reason to lead a healthy lifestyle when you have gout. Elevated uric acid levels and gout are linked with other medical conditions such as heart disease, high blood pressure, diabetes, thyroid disease and obesity. If you take certain medications, including diuretics, low-dose aspirin, cyclosporine, levodopa, medications used to treat tuberculosis, or niacin, you may be at higher risk for gout.
Factors You Can Control
You can’t control all of your risk factors for gout but some you can – like your diet and how much alcohol you drink. Even as little as one alcoholic drink a day raises the risk of gout. That’s because alcohol contains purines with beer containing the highest levels. Eating food high in purines, especially when combined with alcohol, is a risk factor for gout, since these foods are broken down to uric acid. High protein foods from animal sources are usually highest in purines, especially organ meats, red meat and some types of seafood. Eating a big steak and a few beers could be enough to bring on an attack of big toe gout in some people, and a few painful attacks of big toe gout could quickly turn you into a vegetarian!
Fortunately, not everyone who has a high uric acid level goes on to suffer a gout attack. But if your uric acid levels are high, there’s a one in five chance you’ll have an attack of gout at some point, whether it be big toe gout or gout involving some other joint.
Famous People Who Had Gout
Rumor has it that King Henry VIII of England, Ben Franklin, Sir Isaac Newton and Thomas Jefferson all had gout. Supposedly, Jefferson was a no-show for meetings focused around writing the Declaration of Independence due to gout flare-ups. Gout was once referred to as the “disease of kings”, because royalty got it a lot. This is probably because they ate so many purine-rich foods and drank too much. Fortunately, you don’t have to follow in their footsteps.
The Bottom Line?
Both genetics and lifestyle play a role in who gets gout. You have control of at least one factor, lifestyle. So reduce foods high in purines from your diet as much as you can, and stay away from alcohol if you have a history of gout. There are also medications that can help to ward off a gout flare, but some people can lower their uric acid levels through diet and lifestyle changes. Talk to your doctor about this.
If you’d like more information on using diet and supplements to prevent gout attacks, we’ve written an Amazon Kindle ebook to help you make dietary changes that will help you reduce the frequency of gout attacks and reduce the risk of other health problems linked with gout.