Causes of Gout

While there are no specific causes of gout, there are some factors that can increase a person's risk of developing the disease. Some of the things that can increase a person's risk of developing gout include having family members with the disease, being a man, being overweight, and eating too many foods rich in purines.

 

Causes of Gout: An Overview

Gout is caused when the levels of uric acid become so high that crystals form inside the joint. These urate crystals cause inflammation. This combination of urate crystals in the joint and inflammation result in the signs and symptoms of gout.
 

Understanding Uric Acid and How It Causes Gout

Uric acid is a substance that forms from the breakdown purines. Purines are part of all human tissue, and are also found in many foods. Normally, when uric acid forms, it dissolves in the blood and passes through the kidneys and out of the body in urine. Some uric acid also passes out the body through the intestines. But for a variety of reasons, uric acid can build up in the blood. Generally this occurs when:
 
  • The body increases the amount of uric acid it makes
  • The kidneys (or intestines) do not get rid of enough uric acid
  • A combination of these two things occurs.
     
High levels of uric acid in the blood is known as hyperurecemia. Most people with hyperuricemia do not develop gout. But in some people, this uric acid can become so concentrated that crystals (known as urate crystals) can form in the joint and cause inflammation. The higher the uric acid levels in the blood, the greater the chance of developing gout.
 

Causes of Gout: What Increases Your Risk?

Although there is no one specific cause of gout, there are a number of factors that increase a person's chances of developing gout. These are known as gout risk factors. Some of these risk factors increase the amount or uric acid produced; others decrease the amount removed the body; and still others are a combination of these two. Some gout risk factors include:
 
  • Having family members with the disease. Up to 18 percent of people with gout have a family history of the disease.
     
  • Being a man.
     
  • Being overweight. This is because there is more tissue available for turnover or breakdown, which leads to excess uric acid production.
     
  • Drinking too much alcohol, since alcohol not only increases the amount of uric acid made, but also interferes with the removal of uric acid from the body.
     
  • Eating too many foods rich in purines (see Gout Diet for foods high in purines).
     
  • Having an enzyme defect that makes it hard for the body to break down purines. This can include conditions such as glucose-6-phosphatase deficiency and fructose-1-phosphate deficiency.
     
  • Having any of the following conditions:

 

o Diuretics (also known as water pills), which are taken to eliminate excess fluid from the body in people with conditions like high blood pressure and congestive heart failure, and which decrease the amount of uric acid passed in the urine
 
o Salicylates, or anti-inflammatory medicines made from salicylic acid, such as aspirin
 
o Niacin (nicotinic acid, Niaspan®, Niacor®, Nicolar®)
 
o Cyclosporine (Gengraf®, Neoral®, Sandimmune®), a medicine used to suppress the body's immune system (the system that protects the body from infection and disease) and control the body's rejection of transplanted organs
 
o Levodopa (Larodopa®), a medicine used to support communication along nerve pathways in the treatment of Parkinson's disease.
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Written by/reviewed by: Arthur Schoenstadt, MD
Last reviewed by: Arthur Schoenstadt, MD