Gout - Symptoms

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Family History/Genetics

A family history of gout is present in close to 20% of patients with this condition. Three genetic locations have been associated with the body's uric acid handling and gout. Some people with a family history of gout have a defective protein (enzyme) that interferes with the way the body breaks down purines.

Obesity

Researchers report a clear link between body weight and uric acid levels. In one Japanese study, overweight people had two to more than three times the rate of hyperuricemia as those who maintained a healthy weight. Children who are obese may have a higher risk for gout in adulthood.

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Medications

Thiazide diuretics are "water pills" used to control hypertension. The drugs are strongly linked to the development of gout. A large percentage of patients who develop gout at an older age report the use of diuretics.

Several other medications can increase uric acid levels and raise your risk for gout. These include:

• Aspirin -- low doses of aspirin reduce uric acid excretion and increase the chance for hyperuricemia. This may be a problem for older people who take baby aspirin (81 mg) to protect against heart disease.
• Niacin (used to treat cholesterol problems)
• Pyrazinamide (used to treat tuberculosis)

Alcohol

Drinking excessive amounts of alcohol can raise your risk of gout. Beer is the kind of alcohol most strongly linked with gout, followed by spirits. Moderate wine consumption does not appear to increase the risk of developing gout.

Alcohol use is highly associated with gout in younger adults. Binge drinking particularly increases uric acid levels. Alcohol appears to play less of a role among elderly patients, especially among women with gout.

Alcohol increases uric acid levels in the following three ways:

• Providing an additional dietary source of purines (the compounds from which uric acid is formed)
• Intensifying the body's production of uric acid
• Interfering with the kidneys' ability to excrete uric acid

Lead Exposure

Chronic occupational exposure to lead is associated with build-up of uric acid and a high incidence of gout.

Organ Transplants

Kidney transplantation poses a high risk for renal insufficiency and gout. In addition, other transplantation procedures, such as heart and liver, increase the risk of gout. The procedure itself poses a risk of gout, as does the medication (cyclosporine) used to prevent rejection of the transplanted organ. Cyclosporine also interacts with indomethacin, a common gout treatment.

Other Illnesses

Treatment of several other conditions can cause significant elevations of uric acid in the blood, and therefore a gout attack. These conditions include:

• Leukemia
• Lymphoma
• Psoriasis

Review Date: 01/04/2011
Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org).