A Buildup of Uric Acid in the Blood
Gout is caused by a buildup of uric acid—a substance that occurs when your body breaks down purines (substances that are found naturally in the body, as well as in foods high in protein)—in the blood. There are 2 main factors that cause you to have too much uric acid:
- Your body makes too much uric acid. When your body produces high levels of uric acid, it’s called hyperuricemia. Hyperuricemia can make it more likely that you develop gout, but not everyone with hyperuricemia will develop gout. It just makes you more at risk of developing gout.
- Your body has a hard time getting rid of uric acid. In some cases, uric acid levels may be normal, but your body might have a difficult time eliminating the uric acid through your urine.
Regardless of what causes you to have too much uric acid in the blood, it can cause a cascade of events that can lead to the pain associated with gout. The excess uric acid can accumulate into uric acid crystals in a joint—most often in your big toe. These uric acid crystals are sharp and needle-like, and when they build up in your joint and surrounding soft tissues, it can be incredibly painful. Tophi (chalky deposits of uric acid under the skin of the affected joint) can form, too, but that’s more commonly seen in chronic gout.
The buildup of uric acid crystals can also lead to inflammation in the affected joint.
This cascade of events can happen whether you’re having your first gout attack or with chronic gout (when you can have flare ups of gout attacks).
Gout Risk Factors
In addition to the causes of gout, there are numerous risk factors that may make it more likely that you’ll develop hyperuricemia or gout. Researchers know that the more risk factors you have, the more likely you are to develop gout.
- Age: Gout is more common in adults than children.
- Alcohol use: Drinking alcohol can lead to hyperuricemia because alcohol can interfere with the removal of uric acid from your body.
- Being overweight or obese
- Certain medications: Certain medications—for example, diuretics (medications taken to get rid of excess fluid in your body)—may decrease the amount of uric acid passed through your urine. Other medications such as aspirin can affect uric acid levels, too.
- Eating a high-purine diet: Foods high in purines, such as organ meats (eg, liver) and shellfish (eg, shrimp), can lead to hyperuricemia and gout.
- Gender: Gout is more common in men—particularly men between 40 and 50 years old—than women.
- Genetics: If you have a family member with gout, you’re more likely to get it, too.
- Lead exposure
- Other health conditions: Some researchers think that health conditions such as renal insufficiency (kidney failure), hypothyroidism, and high blood pressure can contribute to high levels of uric acid.
Gout Causes Conclusion
Too much uric acid in the blood—whether your body makes too much uric acid or it has a hard time getting rid of it—can cause gout. And having a combination of the risk factors mentioned above can make it more likely that you’ll develop hyperuricemia and gout. If you have some of these risk factors, don’t be afraid to ask your doctor any questions you have about your likelihood of developing gout.