Arthritis Home > Causes of Gout

Sharp crystals that cause inflammation within the joint can result in a person developing gout. These sharp crystals develop from high levels of uric acid in the blood. While there are no one reason why a person might develop high levels of uric acid, there are some factors that can increase a person's risk. Some of the things that can increase this risk include having family members with the disease, being a man, being overweight, and eating too many foods rich in purines.

What Causes Gout?

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 of 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.
A high level of uric acid in the blood is known as hyperuricemia. 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.

What Increases the Risk of Gout?

Although there is no one specific cause of gout, there are a number of factors that can increase a person's chances of developing it. These are known as gout risk factors. Some of these risk factors increase the amount of uric acid produced; others decrease the amount removed from the body. Still others are a combination of these two.
Some risk factors for gout include:
  • Having family members with the disease. Up to 18 percent of people with gout have a family history of it.
  • 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:
    • 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
    • Salicylates, or anti-inflammatory medicines made from salicylic acid, such as aspirin
    • 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
    • Levodopa (Larodopa®), a medicine used to support communication along nerve pathways in the treatment of Parkinson's disease.
Written by/reviewed by:
Last reviewed by: Arthur Schoenstadt, MD
Last updated/reviewed:
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