Gout is a form of arthritis. High uric acid blood levels causes pieces of the urate crystals to leak into the tissues and joints and produce pain, swelling and inflammation. An attack of gout is usually sudden and severe, causing pain that is most frequently associated with the big toe. Gout can also be recurrent, occurring in the joints of the fingers, wrists, knees and ankles. Recurrent gout sufferers may wonder how these attacks can be prevented. The website Gout.com, sponsored by Takeda Pharmaceuticals, notes that certain triggers commonly flare a gout attack.
Dehydration
Uric acid can crystallize, similar to the calcium and struvite deposits that are so commonly associated with kidney stones. The best way to prevent kidney stones is to stay hydrated. When it comes to the uric acid that is produced in the body from the breakdown of old cells or the uric acid consumed from the intake of purine-dense foods, it too must be flushed from the body. Lab Tests Online notes that gout attacks can occur because the uric acid is not sufficiently removed from the body. Gout flare-up can sometimes be prevented if proper hydration is in place.
Diet
Uric acid is the byproduct of purine breakdown in the body. The sources of purines in the body include the breakdown of cells and diet. Takeda Pharmaceuticals notes that some dietary sources that are high in purines and thus contribute to high levels of uric acid. Foods that are high in purines include anchovies, fish eggs, sardines, herring, mackerel, organ meats such as liver and sweetbreads, minced meat and meat extracts, scallops and mussels, game meats like goose, duck and partridge as well as broth, boullion and gravy. Yeasts in the form of baker’s and brewer’s supplements, according to Drugs.com, are also purine-rich.
Infection, Injury and Surgery
Any scenario that causes tissues to be broken down more rapidly than their byproducts can be dispersed by the body can theoretically cause a gout flare-up. Infection, injury and surgery can lead to tissue destruction. Tissues are composed of cells. Purines can be formed within the body as a result of cell death. High cell turnover leads to high purine and uric acid concentrations. In susceptible individuals, notes Takeda Pharmaceuticals, infection, injury and surgery may trigger a gout flare-up.
Lead Poisoning
The debate on the link between lead exposure and uric acid levels has taken place over a quarter of a century, notes a study outlined in a 2002 article in the "American Journal of Medicine." Bone levels of lead tend to persist for years after initial exposure and the study showed that people with gout had higher levels of lead removed with chelation therapy. Higher levels of lead removal also resulted in increased urinary excretion of uric acid and lowered blood serum levels of urate. No conclusions were specifically drawn about lead and gout, but the trial did correlate the two.
Weight Loss
Being overweight is a risk factor for high uric acid in the blood and increases the potential of gout attacks. The National Institute of Arthritis and Musculoskeletal and Skin Diseases notes that increased body mass imparts increased tissue breakdown, higher levels of circulating purines and thus hyperuricemia. Additionally, rapid weight loss using fad low-carbohydrate diets, starve the body of necessary carbohydrate sources that assist in fat burning. When the body cannot properly burn fat it creates ketones. As these molecules accumulate, ketosis can result and an increase in uric acid will develop in the blood.
Medications
Some medications can increase the levels of uric acid in your body. Taking these medications when other concomitant factors such as diet, major weight loss or a general susceptibility to gout such as family history is in play, these medications may trigger a gout attack. The MedlinePlus encyclopedia lists these medications as aspirin, theophylline, ephedrine, cisplatin, diazoxide, diuretics, ethambutol, levadopa, methyldopa, nicotinic acid and phenothyazides. These drugs treat a variety of conditions including asthma and Parkinson’s disease and work as smoking cessation and chemotherapeutic agents. Caffeine, alcohol and vitamin C and niacin are noted by MedlinePlus to increase uric acid levels as well.
References
- Takeda Pharmaceuticals: What Triggers a Gout Attack?
- Lab Tests Online: Gout
- "American Journal of Medicine"; Environmental lead exposure and urate excretion in the general population; N.A. Shadick; 2002
- Drugs.com: Low Purine Diet
- National Institute of Arthritis and Musculoskeletal and Skin Diseases: Gout
