Pulling The Gout Trigger - What Causes Gout?

What causes gout to happen to some people, and others it doesn't happen at all? People can have high uric acid levels in their blood and never have a gout attack. For those that do get gout, what triggers it? There are risk factors that can trigger gout, making some people more susceptible to it than others. These risks that can cause gout include:

Family history of gout:

It has been found that 40% of people with gout have other family members who also have had it. In families with a history of gout, there is a pattern of 11% - 80%. Additionally, there are forms of hyperuricemia that have a genetic component.

Overeating and alcohol consumption:

Gout is a disease that involves the breakdown of purines in the body. Most of the purine in our bodies is derived from the foods we eat, such as organ meats, seafood, and some vegetables. Although most foods we eat contain purines, this is not what causes the elevated purine levels.

Although eating foods low in purines may seem the way to go, people like more of a variety in the foods they eat, therefore, eating foods low in purines will only decrease the overall uric acid levels in the blood by 1 mg/dl. Suffice it to say, the more intelligent approach would be to eat foods that may contain high purine levels in moderation.

Alcohol - There are three alcoholic beverages that have been connected to the increase of uric acid levels. Beer has the highest concentration of purines, spirits show a moderate risk, and wine in moderation shows no risks at all, according to a study conducted in 2004.

Medications:

Certain medications have been shown to inhibit the kidneys from excreting uric acid from the body. Medications that can cause serum uric acid levels to increase include:

• Aspirin, low-dose


• Cyclosporin - anti rejection drug


• Cytotoxic antineoplastic agents - drugs that fight cancer


• Diuretics (especially thiazides) - a water pill


• Ethambutol - anti TB drug


• Ethanol - An intoxicant


• Levodopa - Used in the treatment of Parkinson's disease


• Nicotinic acid/niacin


• Pyrazinamide - Anti TB drug


• Tacrolimus - Anti rejection drug that suppresses the immune system

Illness and/or hospitalization:

Patients who enter the hospital in an emergency situation are more prone to gout attacks, due to the biochemical changes related to uric acid production.

Lead exposure:

Evidence exists that prolonged exposure to lead can be a trigger for gout. Exposure can be due to the work place, as well as a beloved hobby

Comorbid conditions include:

• Alcohol abuse


• Diabetes mellitus


• Dyslipidemia


• Hypertension


• Obesity


• Renal dysfunction


• Hypothyroidism

There is a relationship between hyperuricemia and insulin resistance, leading to the possibility that hyperuricemia may be related to syndrome X, otherwise known as the metabolic syndrome.

by Barb Hicks, RN