Gout is a form of arthritis in which excess uric acid is deposited in the joints. It then crystallizes and causes painful swelling, often in the feet. This condition, although treatable with medications, typically becomes a lifelong problem. You can develop secondary gout if some type of medication changes your ability to eliminate uric acid. Diuretics, also known as water pills, can cause secondary gout.
Diuretics
By reducing the volume of blood in your body, diuretics help to lower your blood pressure. They essentially force your kidneys to remove extra water from your blood and expel it through urination. There are three kinds of diuretics. The most common, thiazide diuretics, include metolazone, hydrochlorothiazide and chlorothiazide. Potassium-sparing diuretics include triamterene and amiloride. They keep potassium from leaving your body. Loop diuretics include torsemide and furosemide. They prevent sodium absorption.
Secondary Gout
Secondary gout can be especially problematic for older people. More than three quarters of older people who develop gout also take diuretics, according to a story in The New York Times online Health Guide, and diuretics raise blood levels of uric acid. When your uric-acid levels rise, your risk of developing painful crystals in your joints also rises.
Symptoms
When uric-acid crystals form in your joints, they stick like very sharp needles in your nerves. Every movement can cause extreme pain. Your skin in the area of the inflammation will feel hot to the touch and look red. Because the uric-acid crystals tend to form in your feet, primarily the big toes or the heels, walking during an attack can be painful.
Counter Measures
If your physician puts you on water pills, she also should monitor your uric-acid levels with blood tests. She may prescribe other medications, along with the diuretics, to serve as countermeasures. Your doctor may prescribe the same kinds of medicines people with primary gout take. These may include allopurinol, a xanthine-oxidase inhibitor, or probenecid, a drug classified as a sulfonamide derivative. These medicines help your body expel uric acid.
Your doctor may prescribe indomethacin or another nonsteroidal anti-inflammatory drug to reduce the inflammation, which in turn will reduce the pain. Because diuretics increase the level of uric acid in your body, stopping the use of them should stop secondary gout symptoms. However, you should not stop taking a diuretic without consulting your physician.
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