Gout and uric acid
When uric acid levels in the blood rise above 6 mg/dl, or 360 μmol/l, this can lead to the formation of uric acid crystals. These crystals can build up in tissues, joints or the kidneys and lead to inflamed joints, swelling and severe pain, which occurs in "flares". This is known as gout.
Getting your uric acid levels below 6mg/dl
is the most important step in avoiding gout.
What is gout?
Gout is a type of arthritis – the main symptom is the painful inflammation of one or more joints. This is caused by the formation of uric acid crystals in the joints when a person has uric acid levels above 6 mg/dl, or 360 μmol/l . Gout can develop over many years due to a number of reasons, including genetics or a purine-rich diet. Purines are a type of chemical compound that are found in food and drink and are broken down to form uric acid. They are part of a normal diet, but foods with high concentrations of purines are linked to an increased risk of gout. Foods rich in purine include beer, red meat and shellfish such as shrimp and mussels.
The early stages of the disease are characterised by an increase in uric acid levels in the blood to above 6 mg/dl, or 360 μmol/l, known as "hyperuricaemia"; signs and symptoms of gout first occur several years later. Gout is a multisystemic disease, which means that it can affect many different parts of the body such as the joints, tendons, skin and ear cartilage. This is due to increased uric acid levels in the blood. Gout is a chronic disease, meaning it requires lifelong treatment.
What is hyperuricaemia?
Hyperuricaemia is characterised by elevated levels of uric acid in the blood. This may or may not cause symptoms. Uric acid levels above 6 mg/dl, or 360 μmol/l, may lead to the formation of uric acid crystals; these can accumulate in tissues, joints or the kidneys and lead to inflamed joints, swelling and severe pain, which occurs in flares. This is called symptomatic hyperuricaemia, or gout.
If no signs or symptoms of uric acid crystal build-up such as gout or uric acid kidney disease occur, this is called "asymptomatic hyperuricaemia".
How common is gout?
The number of people with gout is increasing in western countries. About 1 to 2 % of women and 3 to 6 % of men have the disease, and the trend is rising. Prevalence rises up to 10% in men and 6% in women more than 80 years old.
What are risk factors?
Most patients develop gout between the age of 30 and 60.
Men (approx. 80 %) are more frequently affected. Women tend to have lower uric acid levels, but they rise after the menopause.
High levels of meat and seafood consumption are associated with an increased risk of gout, whereas dairy products are linked to a decreased risk. A moderate intake of purine-rich vegetables such as peas, beans, lentils, spinach, mushrooms, and cauliflower are not associated with a higher risk of gout.
Obesity and overweight are associated with the increased production and decreased elimination of uric acid. Obese or overweight patients are therefore advised to do regular exercise and change their diet.
Some medications such as thiazide diuretics (used to treat high blood pressure) and acetylsalicylic acid (aspirin) can increase uric acid levels in the blood. Please consult your doctor or pharmacist regarding medications that may have an effect on your levels of uric acid.
Family history of gout
You are more likely to have gout if you have a family history of the disease.