Gout Risk Factors | What Causes Uric Acid Buildup

Understanding Gout and Uric Acid Buildup

Gout is a severe and painful form of inflammatory arthritis that occurs when there is a buildup of excess uric acid in the body. Uric acid is a natural byproduct created when the body breaks down purines, which are substances found in human tissues and many foods. Normally, uric acid dissolves in the blood, passes through the kidneys, and is excreted in urine. However, what causes uric acid buildup is typically a combination of the body producing too much uric acid or the kidneys removing too little of it. When this excess uric acid accumulates over time, it can form sharp, needle-like urate crystals in and around the joints, leading to intense inflammation, swelling, and redness.

The Link Between Kidney Function and Gout

The relationship between kidney function and gout is significant. The kidneys play a central role in regulating uric acid levels in the blood. In a recent interview on GoToHealth Media, host Jonathan Marx spoke with Dr. Suneet Grewal, a rheumatologist, and Glenn T, a patient advocate, about the realities of living with gout.

Dr. Grewal clarified a common misconception: while diet plays a role, gout has a strong genetic component and is heavily dependent on how effectively the kidneys excrete uric acid. When a patient has conditions like chronic kidney disease, the kidneys have a harder time filtering out uric acid. This causes the uric acid to back up into the bloodstream, triggering the body to react and leading to painful gout flares.

Identifying Gout Risk Factors

There are several key gout risk factors that can increase a person’s chances of developing this painful condition. According to information from GoutQuestions.com and the National Institute of Arthritis and Musculoskeletal and Skin Diseases, these risk factors include having a family history of gout, increasing age, and being male, though women’s risk increases after menopause. Other significant risk factors involve underlying health conditions such as obesity, high blood pressure, metabolic syndrome, and chronic kidney disease. Lifestyle choices also contribute; consuming a diet high in purine-rich foods like red meat and certain seafood, drinking alcohol, and consuming sugar-sweetened beverages can all elevate uric acid levels. Furthermore, certain medications, such as diuretics and low-dose aspirin, can increase the risk of developing gout.

The Reality of Uncontrollable Gout Pain

When gout is not properly managed, it can lead to uncontrollable gout pain and frequent flares. Uncontrolled gout occurs when a patient continues to experience symptoms, such as two or more flares per year, despite being on gout medication. During the interview with Jonathan Marx, patient advocate Glenn T shared his personal experience with uncontrollable gout pain. He described his first severe flare as horrible, with the joint becoming inflamed, red, and hot. Over time, his gout flares spread to multiple joints, becoming completely unbearable and severely impacting his quality of life. If left uncontrolled, uric acid can deposit in new places in the body, forming hard lumps called tophi under the skin and potentially causing permanent joint damage.

Experiencing Gout in the Hands and Other Joints

While many people associate gout with the big toe, uric acid and joint pain can affect various parts of the body. Gout in the hands is a painful reality for many patients whose condition has progressed. Glenn T noted that his gout flares eventually spread from his toe to his knees, hips, and hands. The intense pain, swelling, and limited range of motion associated with gout in the hands can make daily tasks incredibly difficult. It is crucial for patients experiencing these symptoms to seek medical advice. As Dr. Grewal emphasized, treatment plans must be tailored to the individual, and patients should not ignore the condition due to stigma. Managing uric acid levels is essential to preventing further joint damage and regaining control over one’s health.

Overcoming the Shame of Gout and Seeing Your Physician

Until recently, gout was thought to have been caused by lifestyle factors, including too much red meat and alcohol, which would cause high levels of uric acid leading to gout.

This has led to social shaming and ribbing, discouraging patients from understanding the underlying causes of gout, and blaming their condition on themselves.

We know so much more now. Don’t be ashamed. It’s not your lifestyle. It’s other health conditions and genetics that can determine your likelihood of experiencing gout.

See your doctor if you have questions!

Dr. Suneet Grewal

Cedars-Sinai Medical Center,Los Angeles, CA – Fellowship
Highland Hospital, Oakland, Ca – Residency
St. George’s University, Grenada – Medical School
UC Berkeley, Berkeley, Ca – Undergraduate Studies

Dr. Suneet Grewal is a San Francisco Bay Area native who became fascinated with the field of Rheumatology, while in her second year of residency and joined East Bay Rheumatology Medical Group in 2013. She loves working with a diverse population of people and developing close, long-standing relationships with each of her patients. Dr. Grewal strives to make sure patients understand their medical conditions and therapies, and wants every visit to be informative and comfortable. She enjoys crafting, cycling and spending leisure time with her husband and 2 children.