Why Some People Are At Risk Of Gout
- Date:
- University of Otago
- Summary:
- Researchers have helped characterize a genetic variant that enables new understanding of why some people are at risk of gout, a painful and debilitating arthritic disease.
University of Otago researchers have helped characterise a genetic variant that enables new understanding of why some people are at risk of gout, a painful and debilitating arthritic disease.
Gout is caused by persistently elevated levels of urate in the blood, which causes severe joint pain and swelling, especially in peoples’ toes, knees, elbows, wrists and fingers. It can be treated using drugs that lower urate levels. But if left untreated, it can cause serious damage to joints, kidneys and quality of life.
PhD student Sarada Ketharnathan together with Associate Professor Julia Horsfield from the Department of Pathology and Professor Tony Merriman from the Department of Biochemistry have recently characterised the genetic variant that lies not inside, but just next to a gene called PDZK1.
This PDZK1 protein product helps excrete urate through the kidney and gut. In this way, PDZK1 controls the amount of serum urate which, when high, form crystals that cause gout.
“We found that the genetic variant doesn’t affect the PDZK1 protein, but causes change in the amount of the PDZK1 gene produced,” Associate Professor Horsfield explains.
“This kind of scientific understanding of disease risk is bringing us into a new age of ‘precision medicine’.”
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What To Think About
If the blood uric acid is high but a person has never had an attack of gout, treatment is rarely needed. But people with extremely elevated levels may need regular testing for signs of kidney damage. And they may need long-term treatment to lower their uric acid levels. Your blood uric acid level may be watched by your doctor until it is lowered to normal levels.
Long-term medicine treatment depends on how high your uric acid levels are and how likely it is that you will have other gout attacks in the future. See Medications to learn more.
After an acute attack of gout, talk with your doctor about the causes of the elevated uric acid levels in your blood. A review of your overall health may reveal diseases, medicines, and habits that could be raising your uric acid levels.
Most doctors will wait several days to weeks after a gout attack is over to begin medicine to lower the high uric acid levels. These medicines can cause uric acid stored elsewhere in the body to begin moving through the bloodstream and could make symptoms worse if treatment begins during a gout attack.
If there is swelling that causes pressure in a large joint such as a knee or ankle, your doctor may relieve the pain and pressure by aspiration. A needle is inserted into the joint and fluid is drawn out with a syringe connected to the needle.
Other Causes Of Hyperuricemia
For most people, the high levels of uric acid are not a problem until middle-age. Something important to make note of is that in addition to eating high-purine foods, other factors slowly compromise the function of the kidneys.
Your poor kidneys are busy trying to eliminate all the other kinds of acid wastes that result from the modern lifestyle. So it becomes even MORE difficult for them to get rid of uric acid quickly enough to keep the levels within the normal range.
Now, before you start feeling like a victim of your kidneys, let me point out that most peoples health choices are not exactly making life easy for their kidneys! Low blood oxygenation from poor breathing habits or poor air quality, chronic dehydration, overly processed foods or genetically modified foods are just a few of the contributing factors that reduce kidney function over time.
With the addition of more and more toxic environmental chemicals making their way into the inner bodily terrain, the kidneys ability to eliminate the uric acid becomes undermined.
If you want to eliminate more uric acid, youve got to adopt some kidney-friendly habits. To learn more about kidney-friendly habits, I go way deep on this subject in my online video program called Kill Your Gout For Good.
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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 .
What To Do During An Attack
You should:
- take any medication you’ve been prescribed as early as possible after you notice an attack this should start to have an effect within two or three days
- rest and raise the limb
- avoid knocking or damaging the affected joint
- keep the joint cool remove surrounding clothing and apply an ice pack, such as a bag of frozen peas wrapped in a towel
- ensure you’re well hydrated
Apply the ice pack to your joint for around 20 minutes. Don’t apply ice directly to your skin and don’t apply it for more than 20 minutes at a time because this could damage the skin.
If necessary, you can keep reapplying an ice pack to your skin during an attack, but you should wait until your skin has returned to a normal temperature first.
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Did We Get Gout All Wrong New Research Debunks Beliefs
Research published in August 2015 in Clinical Rheumatology showed that people prefer to treat gout symptoms as they occur rather than plan a lifetime prevention approach. Bad idea: If gout isnt treated, each attack will last longer, you will have more attacks, and you may eventually suffer irreversible joint damage. You will also be at higher risk for kidney disease or kidney stones. A study published in the BMJ published on October 10, 2018 posits that genetics may play a more important role in the disease development than diet.
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What Are The Signs And Symptoms Of Gout
Gout flares start suddenly and can last days or weeks. These flares are followed by long periods of remissionweeks, months, or yearswithout symptoms before another flare begins. Gout usually occurs in only one joint at a time. It is often found in the big toe. Along with the big toe, joints that are commonly affected are the lesser toe joints, the ankle, and the knee.
Symptoms in the affected joint may include:
- Pain, usually intense
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Treating A Gout Attack
As is true for many painful conditions, the first-line treatment for a gout attack is taking one of the nonsteroidal anti-inflammatory drugs , such as diclofenac, ibuprofen, or indomethacin. For people who can’t take NSAIDs, a drug called colchicine is an alternative. It’s been used for centuries maybe even longer specifically for gout. The trouble with colchicine is its side effects, especially the copious diarrhea. If neither an NSAID nor colchicine is an option, then gout attacks can be treated with an oral corticosteroid, such as prednisone, or with corticosteroid injections into the joints.
How Are Gout Attacks Prevented
Maintaining adequate fluid intake helps prevent acute gout attacks and decreases the risk of kidney stone formation in people with gout. Alcohol is known to have diuretic effects that can contribute to dehydration and precipitate acute gout attacks. Alcohol can also affect uric acid metabolism and cause hyperuricemia. It causes gout by slowing down the excretion of uric acid from the kidneys as well as by causing dehydration, which precipitates the crystals in the joints.
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Why Am I Getting Gout
More important:
- Why do some people get gout, even when they pay no attention to what goes in their body, and drink from when the are young, are still drinking in their seventies, and never sufferstruggle with gout?
That is the question that one of the hard-charging gout killers came up this week in the TGK Support Group and in my rambling explanation of it, I decided it needed to be a blog post! In our ongoing quest to understand what gout is and what to do about it, this seemed like an important thing to put out there in a bigger way. I copied my reply to this question below, I hope it helps you.
Myth: Once You’ve Got Gout Lifestyle Changes Don’t Really Help
Truth: Lifestyle changes can reduce both the severity and frequency of attacks. For starters, when people lose weight, they often have fewer attacks, says Reveille.
Animal proteins have a higher level of purines, so it’s better to eat vegetable proteins like beans and peas.
In fact, a 2010 review in the rheumatology journal Current Opinion in Rheumatology notes that protein-rich foods such as dairy products, nuts, beans, peas and whole grains are healthy choices for people with gout, reducing the risk of heart disease and possibly lowering the risk of insulin resistance.
Baraf says that he asks patients to abstain from alcohol during the first six months of treatment, until medications have stabilized uric acid levels. After that, he says, it’s fine to drink in moderation.
Dorothy Foltz-Gray is a freelance writer who lives in North Carolina.Remember to go to the AARP home page every day for tips on keeping healthy and sharp, and great deals.
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Ways To Ease A Gout Attack
Knee plays the most crucial role in our body. It is a most important joint because it carries the load of the entire body and helps to walk easily. But, if you feel gout in the knee, so it can create difficulty to walk and run. Due to gout, knee faces some health issues like redness, tenderness, intense pain, swelling on the knee, which may cause damage to the knee. Hence, the patients should take proper care from gout and get expert advice from The Gout Killer.
If you get gout, then you know all too well the unfortunate signs of a gout attack. Some people say gout pain is considered to be the worst pain a person can ever experience . Once the pain of a mind-numbing gout attack starts, all you can think about is how to get rid of it. But here are 4 ways to ease the pain of a gout attack that Ive talked about before, but since gout is new for some people, here it is again.
Myth: Women Aren’t Afflicted By Gout
Truth: Men and women alike can develop the disease, although men are more vulnerable earlier in life. “Gout is 10 times more common in men than in women, until women reach menopause. The incidence of new cases of gout in men and women tends to equal out after age 60 or so,” says Herbert Baraf, M.D., clinical professor of medicine at George Washington University Medical Center in Washington, D.C.
Throbbing pain on the tip of your big toe? You might have gout.
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Treating Gout With Medications
Certain medications reduce the pain and inflammation of gout attacks, such as anti-inflammatory drugs , colchicine, and corticosteroids. Other medications decrease the level of uric acid in the blood and prevent the deposit of uric acid in joints , the kidneys , and in tissue , helping to prevent further attacks and complications. These drugs include allopurinol, febuxostat, lesinurad, and probenicid.
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Gout Diet / Gout Foods To Eat
Which gout foods to avoid, and which of the gout foods to take advantage of is a constant source of confusion for most people struggling with this intensely painful disease. The source of this confusion comes in part from the media, and from the medical community. A better way to categorize gout foods would be by using the designations of detrimental, neutral, or therapeutic. But this method is far from the current reality of how gout symptoms are dealt with today.
The fact that medical doctors are shackled by their malpractice insurance companies directing them to prescribe drugs as treatment for gout instead of nutritional advice, is the first part of the problem. The second part of the problem is that medical doctors are required to have no training in diet or nutrition, so they are the wrong people to ask about which gout foods to eat.There are so many recipes available to kill gout if you want to get one of them, so get the suggestions of experts who can give you the proper solution over gout. Actually, gout can affect the joints of the body and if you will not get treatment to remove it, so it can increase day by day and make difficult to live. The Gout Killer is the best place to know recipes for gout here you can find recipes which remove out gout from the body.
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What Is Gout What Causes It
Gout is a painful arthritic condition that causes soreness, pain, and redness in joints. The pain can be sudden and severe. Sometimes, sufferers wake up in the middle of the night with sensations like their joints are on fire.
The suffering that gout triggers is caused by the buildup of uric acid in joints .
The suffering that gout triggers is caused by the buildup of uric acid in joints .
There is normally some uric acid that comes out through your urine and is a normal metabolic byproduct of purine, a component in a variety of foods but mainly animal products. But if youre consuming more than your body can handle, excess amounts of this acid crystallizes in joints resulting in pain and discomfort caused by the inflammation.
Its recommended that you see a doctor if you experience sudden intense pain in your joints because gout can lead to even worse pain and damage to the joints.
Also Check: How To Get Rid Of Gout In Toes
Is Diet The Only Determining Factor For Developing Gout
To be certain, the food that you eat plays a huge role in how much uric acid builds up in your body.
But there are two other variables that contribute to uric acid buildup. One is the amount of uric acid that your body generates, which is not under your control .
The other variable is the health of your kidneys. These organs are responsible for processing and readying uric acid for excretion. If youre kidneys are damaged or unhealthy, they may not be able to process uric acid efficiently. Diabetics often have damaged kidneys, so its no wonder they tend to have higher uric acid levels.
So Why Do You Keep Getting Recurring Attacks
The condition we call gout is caused by the appearance of microscopic crystals in your joints. These are needle-like in character and usually form in your big toe most of the time, although you can get gout in any part of your body, e.g. your ankle, side of your foot, knee, finger, hand, elbow, etc.
The crystals appear when the conditions are right for their formation. This is usually when you have high uric acid levels in your bloodstream. Now, uric acid is just a natural byproduct of your bodys metabolization and is produced when chemical compounds called purines breakdown as part of that process.
But as well as existing in our bodies, purines also exist naturally in our foods. And some foods have higher concentrations of purines than others. Unfortunately, the foods with the high and very high levels are exactly the foods that we all love, e.g. red meat, game, kidneys, liver, seafood, poultry, yeast products, legumes, etc.
However, not everyone who eats a typical western diet keeps getting gout, or indeed, ever gets it. So why is this?
The thing is that the kidneys usually process the uric acid formed in the body and excrete the excess out of your system through urine with a little via the stools. When the kidneys are operating efficiently, there are no high uric acid levels in the blood.
So what are the factors that increase your risk of having high uric acid and thus of your getting gout?
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How Does Uric Acid Become Elevated
Generally speaking, uric acid becomes elevated by one of two means. Either the body is producing too much uric acid, or it is not eliminating enough of it, or both.
The body produces uric acid as a normal part of its every day functioning. However, the problem of producing too much uric acid is actually extremely rare. In those rare cases, the excess production could be coming from abnormal genetics, but this so unlikely it should be considered negligible.
Most often the excess production is coming about as a result of bad lifestyle habits. But this really doesnt even matter, because the vast majority of cases of hyperuricemia are from the 2nd cause . . . not enough elimination.
When I say elimination, think kidneys, bladder, and toilet! Your body has an eliminatory system that includes peeing, pooping, sneezing, exhaling, etc. Uric acid is primarily excreted via the kidneys and bladder in your urine. And when your kidneys are not functioning well, they cannot eliminate uric acid as fast as your body is producing it. Hence, hyperuricemia!