A gout attack occurs when uric acid levels become too high and the excess comes out of the solution to form crystals in joint spaces. Humans and gorillas are two mammals that don’t produce uricase.
Uricase is an enzyme that breaks down uric acid, so levels don’t become high enough to trigger a gout attack. It just goes to show there are some drawbacks to walking around on two feet and being such advanced beings.
Somewhere along the way humans lost their uricase enzyme and paid for it dearly with gout attacks. Was the trade-off worth it? Some people suffering from a painful gout attack might say no!
Now you know that humans don’t produce uricase, but not all humans get gout. This is because some people are better able to excrete the uric acid they produce through the kidneys — or they simply produce less of it.
Diet is also a factor since uric acid comes from the breakdown of purines, which are found in certain foods. The inability to eliminate excess uric acid is usually a genetic trait, and gout does run in families, although lifestyle is a big issue for many people too.
Who’s at the Highest Risk for Gout?
Gout is more common in certain populations — especially the Hmong people who live in Southeast Asia. They usually get their first gout attacks at a younger age, and their disease is more severe. A group of people called the Maori who live in New Zealand also have a very high incidence of gout, which further shows the importance of genetics.
Men are more likely to get gout than women before a certain age, but after menopause, women catch up with men as their uric acid levels rise after menopause.
Elevated uric acid levels and gout are also linked with medical conditions such as heart disease, high blood pressure, diabetes, thyroid disease, and obesity. If you take some medications, including diuretics, low-dose aspirin, cyclosporine, levodopa, medications used to treat tuberculosis, or niacin, you may be at higher risk for gout.
Factors You Can Control
Binge drinkers are at even the greatest risk of suffering from a gout attack. Eating food high in purines, especially when combined with alcohol, is another risk factor for gout since these foods are broken down to uric acid.
High-protein foods from animal sources usually have the greatest amounts of purines. Eating a big steak and a few beers could be enough to bring on an attack of big toe gout in a susceptible person, and a few painful attacks of big toe gout could quickly turn you into a vegetarian!
Fortunately, not everyone who has a high uric acid level goes on to suffer a gout attack. But if your uric acid levels are high, there’s a one in five chance you’ll have an attack of gout at some point, whether it be big toe gout or gout involving some other joint.
Famous People Who Had Gout
Rumor has it that King Henry VIII of England, Ben Franklin, Sir Isaac Newton, and Thomas Jefferson all had gout. Supposedly, Jefferson was a no-show for meetings focused on writing the Declaration of Independence due to gout flare-ups.
Gout was once referred to as the “disease of kings” because royalty got it a lot. This is probably because they ate so many purine-rich foods and drank too much. Fortunately, you don’t have to follow in their footsteps.
The Bottom Line?
Both genetics and lifestyle play a role in who gets gout. You have control of at least one factor, lifestyle. So limit foods high in purines and stay away from alcohol if you have a history of gout or you could end up with a painful swollen joint from a gout attack.
There are also medications that can help to ward off a gout flare, but some people can lower their uric acid levels through diet and lifestyle changes. Talk to your doctor about this.
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- Eat less meat?
- Drink less alcohol?
- Drink more water?
Follow the usual advice?
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The pain remained as bad as ever?
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