Who Is Affected By Gout
Gout can affect anyone. It usually occurs earlier in men than women. It generally occurs after menopause in women. Men can be three times more likely than women to get it because they have higher levels of uric acid most of their lives. Women reach these uric acid levels after menopause.
People are more likely to get gout if they have:
- Obesity, or a lot of extra weight.
You are also more likely to develop gout if you:
- Consume a diet high in animal proteins
- Consume a significant amount of alcohol
- Are on water pills .
Risk Factors For Gout
Obesity, excessive weight gain, especially in youth, moderate to heavy alcohol intake, high blood pressure, diabetes, and abnormal kidney function are among the risk factors for developing gout. Certain drugs and diseases can also cause elevated levels of uric acid. Also, there is an increased prevalence of abnormally low thyroid hormone levels in patients with gout.
What Are The Risk Factors For Gout
Risk factors for gout include:
- being male
- taking medications that increase water excretion by the kidneys
- being overweight
- eating a diet with a lot of meat, offal and shellfish
- having kidney disease, high blood pressure, diabetes or abnormal levels of fat and cholesterol in the blood
- drinking a lot of alcohol, especially beer, port or spirits
- going on a crash diet or fasting
- being of Maori or Pacific Islander origin, which can predispose a person to high uric acid levels
Gout is more common in men than in women, and among women it’s more common after menopause. It’s more likely to occur in older people, but can affect anyone.
It can also affect people with certain types of blood disorder and people in treatment for cancer.
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How Do Doctors Diagnose Gout
- This is the most important diagnostic test. It is the ultimate method of being certain of a diagnosis of gouty arthritis, as opposed to other causes such as an infection in the joint.
- A needle is inserted into the joint to withdraw a sample of fluid for testing.
- The fluid is examined under a microscope to see if there are gout crystals or signs of a bacterial infection present. Sometimes other crystals can be found in the joint fluid, such as calcium pyrophosphate, which is caused by an entirely different condition called pseudogout .
- Gouty arthritis is sometimes diagnosed based on the typical clinical presentation without a joint aspiration.
- A doctor may obtain a blood sample to look at cell counts, uric acid levels, kidney function, etc.
- Unfortunately, the level of uric acid in the blood cannot be reliably used to make a diagnosis of gout. It is normal in approximately 10% of people during an acute attack of gouty arthritis. Moreover, uric acid levels are elevated in 5%-8% of the general population, so the presence of an elevated level does not necessarily mean that gout is the cause of an inflamed joint. Interestingly, the uric acid is typically lowered during a flare of inflammatory gouty arthritis. Therefore, the optimal time to measure the uric acid is after a flare has resolved when acute inflammation is not present.
Signs And Symptoms Of Gout
Any joint can be affected by gout, but it usually affects joints towards the ends of the limbs, such as the toes, ankles, knees and fingers.
Signs and symptoms of gout include:
- severe pain in one or more joints
- the joint feeling hot and very tender
- swelling in and around the affected joint
- red, shiny skin over the affected joint
Symptoms develop rapidly over a few hours and typically last three to 10 days. After this time the pain should pass and the joint should return to normal.
Almost everyone with gout will experience further attacks at some point, usually within a year.
Read more about the complications of gout.
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Genes Responsible For Uric Acid Regulation
SLC22A12 gene encodes for the transporter URAT1 present on the apical membrane of renal tubules. SLC2A9 is another gene involved in regulation of UA excretion. It encodes for a transporter protein in the membrane of renal tubules. Polymorphism of both genes results in decreased fractional excretion of UA leading to increased SUA levels. ABCG2 is a gene transporter for UA in the proximal tubular cells of the kidney as well as in the GIT. SLC17A1, SLC17A3 genes are important determinants of SUA levels acting as membrane transporters in the kidenys. Other genes involved in determination of SUA levels include SLC22A11, the glucokinase regulatory protein , Carmil , and near PDZ domain containing 1 genes , .
What Are Risk Factors For Gout
There are many risk factors for gout. Having high blood pressure is a risk factor for gout. Gout is more common after surgery, trauma, and dehydration. Certain medications such as diuretics , which treat high blood pressure, that raise the level of uric acid in the bloodstream are risks for gout. Surprisingly, medications that lower the level of uric acid in the bloodstream, such as allopurinol , can also initially cause a flare of gout. This is because anything that raises or lowers the uric acid level can cause a gout flare by causing uric acid crystals to deposit in a joint. Low-dose aspirin can precipitate gout attacks. The treatment of certain types of cancer can cause gout because of high levels of uric acid released when the cancer cells are destroyed. Degenerative arthritis also makes affected joints more likely to be the site of a gouty attack.
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Causes & Risk Factors
While natural gout remedies do help to relieve the pain and discomfort, for true healing its important to address the underlying causes of gout and address any risk factors you may have to prevent future gout attacks.
Gout Risk factors
Consuming moderate to high levels of purine-rich foods including beef, seafood, alcohol, legumes, certain vegetables and fructose is a leading cause of gout.
When obese, more uric acid is produced and the kidneys may have a difficult time eliminating the excess.
3. High Blood Pressure:
Natural high blood pressure remedies can help bring your numbers into the normal range. Partner these treatments with regular exercise and stress-relieving activities for the best results.
Stay hydrated by drinking a minimum of eight glasses of water each day. During the summer months or when exercising, be sure to drink more.
5. High Levels of Triglycerides:
Work to reduce your triglycerides by losing weight, avoiding sugary foods, reducing alcohol, and replacing unhealthy fats with healthy ones.
Follow a diabetic diet plan and exercise regularly to lower your A1C numbers naturally.
7. Metabolic Syndrome:
Incorporate burst training and essential oils into your daily routine while following a diet for metabolic syndrome to reduce your chances of gout.
8. Heart Disease:
9. Kidney Disease:
12. Trauma or Surgery:
Diagnosis And Management Of Gout
JOEL R. PITTMAN, PHARM. D., and MICHAEL H. BROSS, M.D., University of Mississippi Medical Center, Jackson, Mississippi
Am Fam Physician. 1999 Apr 1 59:1799-1806.
Gout is a disease resulting from the deposition of urate crystals caused by the overproduction or underexcretion of uric acid. The disease is often, but not always, associated with elevated serum uric acid levels. Clinical manifestations include acute and chronic arthritis, tophi, interstitial renal disease and uric acid nephrolithiasis. The diagnosis is based on the identification of uric acid crystals in joints, tissues or body fluids. Treatment goals include termination of the acute attack, prevention of recurrent attacks and prevention of complications associated with the deposition of urate crystals in tissues. Pharmacologic management remains the mainstay of treatment. Acute attacks may be terminated with the use of nonsteroidal anti-inflammatory agents, colchicine or intra-articular injections of corticosteroids. Probenecid, sulfinpyrazone and allopurinol can be used to prevent recurrent attacks. Obesity, alcohol intake and certain foods and medications can contribute to hyperuricemia. These potentially exacerbating factors should be identified and modified.
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Gout Versus Rheumatoid Arthritis
Patients confuse these two conditions and cannot diagnose them on their own. Both gout and rheumatoid arthritis cause redness, pain in joints, and swelling. Moreover, both of them cause disability and discomfort.
That is why you have to analyze the symptoms closely to differentiate them. The safest option for you is to have an appointment with a physician. He will help you best by diagnosing the signs.
In the case of rheumatoid arthritis, the pain may be severe, moderate, and mild. The joint parts can become stiffer due to this condition. Moreover, these affected parts will become swollen, red, and painful.
How Can I Treat My Foot Gout
Gout is easily treated. The main goal of treatment is to lower the uric acid levels in your body, decrease pain and other symptoms, and prevent further attacks or flare-ups.
If you only experience one episode of foot gout, your doctor may recommend a non-steroidal anti-inflammatory drug other than aspirin, such as ibuprofen or naproxen.
Aspirin is not used to treat gout because if can interfere with the excretion of uric acid crystals in your urine. Doctors have several ways to treat your gout, including:
- Anti-inflammatory medications or injections to reduce pain, swelling, and inflammation
- Corticosteroid injection into affected joint to reduce inflammation
- Suggesting a change in diet to eliminate or reduce intake of foods and beverages that are high in purines and protein because protein can increase your uric acid level
- Encouraging the patient to drink plenty of fluids each day, especially water
- Explaining the importance of avoiding alcoholic beverages
- Requiring you to stay off your feet
- Cold compresses
It is very important that you talk to a doctor if you are experiencing foot gout symptoms or a flare-up.
Symptoms will generally subside within three to ten days with treatment. If the problem is left untreated, or if gout continues to occur with treatment, the uric acid buildup can eventually cause arthritic damage to your joint.
In severe cases, your doctor may recommend surgically removing the uric acid crystals from your joint.
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Decreased Excretion Of Uric Acid
Two thirds of urate excretion occurs in the kidneys while the rest is excreted through the gastrointestinal tract . Reduced secretory function of the transporter ABCG2 leads to decreased excretion of uric acid through the GIT resulting in rise of serum levels of uric acid and enhanced renal excretion .
Joints Affected By Gout
Gout can affect any joint, but some joints are more likely to be affected than others. Joints commonly affected include the big toe, the foots instep, heel, ankle, and knee.2 Less often, gout affects the elbow, wrist, fingertips, or spine.2–7
Gout is acute, painful swelling in the joints from uric acid buildup. Common areas include the foot and big toe.
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What Does The Future Hold For Gout
Active research is ongoing in a variety of fields related to gout and hyperuricemia. Scientists have found that high animal protein slightly increased the risk for gout. New drugs are being developed that may be more versatile and safe in treating the elevated uric acid levels in patients with chronic gout.
How Do You Get Gout
There are a few risk factors that increase your chances of getting gout or of triggering a gout attack. They include:
- Diet high in purines, including red meat, organ meats, and seafood
- Drinking a lot of sugary beverages
- Alcohol consumption
- Medical issues such as high blood pressure, kidney disease, and diabetes
- Medications diuretics and low-dose aspirin
- Family history of gout
- A recent surgery or injury
One of the first places gout attacks is the great toealthough it can be just about any joint. Certain foods like red meat, seafood, sugary beverages, and even beer can help set it off. Gout attacks can become chronic and lead to destruction of the joint, so its important to avoid risk factors and manage attacks as they occur. Dr. Schwartz
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How Will Gout Affect Me
Attacks can vary from person to person. Some people only have an attack every few years, while others have attacks every few months.
Without medication attacks tend to happen more often and other joints can become affected.
Having high urate levels and gout for a long time can lead to other health problems, including:
- narrowing of the arteries – which can lead to an increased risk of stroke or heart attacks or other heart problems
- osteoarthritis, which occurs when the urate crystals and hard tophi cause joint damage.
- an increased risk of developing kidney disease or worsening of the condition if you already have it
- kidney stones
- an increased risk of some cancers, especially prostate cancer
- mental health problems, including depression
- underactive thyroid
- erectile dysfunction in men.
If you take medication to lower your urate levels, and have a healthy diet and lifestyle, most of the damage and complications caused by gout can be stopped.
Treatments for gout are incredibly successful. There are two main parts to treating gout, which are:
- treating the acute attack
- treatments to prevent future attacks.
How Is Foot Gout Diagnosed
If you are experiencing sudden bouts of intense pain in your joints, or if you feel you are experiencing the symptoms of foot gout, you should see your doctor immediately. Early detection can improve your chances of catching the gout during its early stages and successfully treating the condition.
Your doctor will perform a number of tests on you and ask questions about your family history, medical history, personal habits, and diet. He or she may also perform a joint fluid test. During this test, a needle is used to draw fluid from your affected joint for analysis. Your doctor may also order a blood test to measure your uric acid levels.
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What Is The Main Cause Of Gout
When uric acid builds up, it causes gout. It is normal to have some uric acid in your blood, but people with gout create too much of it. Or their kidneys cant get rid of it very well.
Certain foods are high in a natural chemical called purine, which is broken down into uric acid in your body. Ditto with fructose, the sugar in sweetened drinks.
When uric acid levels get too high, sharp, needle-like crystals form. They get into the joint or surrounding tissue. This causes inflammation, pain, redness, and swelling.
What Are The Mortality Rates Among Canadians With Or Without Gout And Other Crystal Arthropathies
Between 20072008 and 20162017, age-standardized all-cause mortality rates decreased among females with diagnosed gout and other crystal arthropathies , and among males with diagnosed gout and other crystal arthropathies .
Over the surveillance period, the age-standardized all-cause mortality rate ratios were relatively stable ranging from 1.9 to 2.2 for females and from 1.3 to 1.4 for males. While rate ratios were similar among females and males, they showed an increase in mortality risk among those with diagnosed gout and other crystal arthropathies.
Figure 4: Age-standardizedFootnote e all-cause mortality rates and rate ratios among Canadians aged 20 years and older with and without diagnosed gout and other crystal arthropathies, Canada,Footnote f from 20072008 to 20162017
- Footnote e
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Why Do I Have Gout
Gout is caused by a build-up of uric acid in your blood, a condition called hyperuricemia. When a persons uric acid levels rise, so does the risk of a gout flare-up.
Uric acid is always present in our blood, and it is eliminated when we urinate. When someone has gout, the uric acid builds up and crystallizes within the joints.
Foot gout can also be attributed to heredity. The National Institute of Arthritis and Musculoskeletal and Skin Diseases conducted a study showing that 18 percent of people who develop gout have a family history of the condition.
Numerous other medical conditions also increase the risk of developing gout. These conditions include:
Other risk factors for developing gout include:
- Alcohol consumption
- Consumption of foods rich in purine
- Exposure to lead in the environment
- Being male
When you drink alcohol, you increase the concentration of uric acid in your body. When this happens, you increase your risk of developing gout. Abusing alcohol can also affect other parts of your body, including your kidneys, which are responsible for eliminating uric acid.
Certain medications such as aspirin, diuretics, and levodopa can also interfere with your bodys ability to remove uric acid, causing a build-up.
What Are Gout Treatments And Home Remedies
When gout is mild, infrequent, and uncomplicated, it can be treated with diet and lifestyle changes. However, studies have shown that even the most rigorous diet does not lower the serum uric acid enough to control severe gout, and therefore medications are generally necessary. When attacks are frequent, uric acid kidney stones have occurred, tophi are present, or there is evidence of joint damage from gout attacks, medications are typically used to lower the uric acid blood level.
Medications for the treatment of gout generally fall into one of three categories: uric-acid-lowering medications, prophylactic medications , and rescue medications to provide immediate relief from gout pain.
Urate-lowering medications are the primary treatment for gout. These medications decrease the total amount of uric acid in the body and lower the serum uric acid level. For most patients, the goal of uric-acid-lowering medication is to achieve a serum uric acid level of less than 6 mg/dl. These medications also are effective treatments to decrease the size of tophi, with the ultimate goal of eradicating them. Uric-acid-lowering medications include allopurinol , , probenecid, and pegloticase .
Gout home remedies
Home remedies for an acute gout attack include drinking plenty of water. Over-the-counter NSAIDs , such as ibuprofen and naproxen sodium , can be used when there are no contra-indications, such as decreased kidney function or stomach ulcers.
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