What are the causes of gout? Needless to say, gout is a no laughing matter. Ask anyone who has ever suffered from a gout attack and they’ll tell you that in no uncertain terms. A gout flare-up can happen anytime, but the symptoms are most likely to strike at night. How painful is a gout attack? Some people liken the pain of gout to childbirth, so severe is the discomfort of this menacing health problem that was once referred to as the disease of kings, so common was it in royalty. Have you ever wondered what causes gout?

The Problem of High Uric Acid Levels

The majority of people with gout have high levels of uric acid in their bloodstream. Uric acid forms when your body breaks down purines, compounds found in certain foods and inside cells. Purines are released from inside cells when they die. There are two reasons why people have a high uric acid level. They either produce too much uric acid or their kidneys don’t eliminate uric acid in their urine as well as they should. Sometimes it’s a combination of these two factors. Either way, uric acid levels build up in the bloodstream.

Why is this a problem? If uric acid levels are too high, uric can enter the synovial fluid that lubricates joints and cluster together to form crystals. Immune cells see these crystals as “foreign” and try to destroy them. This leads an inflammatory response that causes the familiar pain, redness, heat and swelling of gout. Basically, the pain comes not from the uric acid crystals themselves but the way your immune system responds to them.

Why Are Some People More Predisposed to Gout?

There seems to be a genetic component to gout. A significant number of people with high uric acid levels who go on to have a gout attack have a family history of the disease. Men are more likely to have a gout attack than females until women go through menopause. Then things “even up” and women get it about as often as men.

Some medications put people at greater risk for gout including diuretics, aspirin, some immune-suppressing medications and levodopa, a drug used to treat Parkinson’s disease. Overindulging in alcohol also increases the risk of gout and an indulgent diet that leads to weight gain also increases the risk. That’s why gout was so common among royalty. Think about the “rich” diet they ate.

Kidney disease also raises the risk for gout since diseased kidneys can’t eliminate uric acid as easily. Other medical conditions that put people at higher risk for gout include an underactive thyroid gland, high blood pressure, diabetes, heart disease and some types of anemia and cancer.

Causes of Gout: The Role of Diet

Cells release purines when they die. These purines are broken down to uric acid. You also get purines through diet, especially certain foods like game meats, some types of fish, organ meats, asparagus and dried beans to name a few. Generally meat is higher in purines than plant-based foods. Limiting foods that are high in purines is one way to help prevent gout attacks. There are also certain foods that can help lower your risk for gout.

The Bottom Line?

Now that you know what causes gout, take a closer look at your family history, medications, medical history and your diet and see if you have any of these risk factors. Fortunately, lifestyle changes such as losing weight and adopting a gout-friendly diet can help you lower your uric acid level and reduce your risk for gout. It's a change worth making.