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Rheumatology

Got gout?

Got Gout: What’s your uric acid?

Ingrid M. Hall, MD
Oaklawn Medical Group-Rheumatology

Gout is one of the most common types of inflammatory arthritis among men and postmenopausal women. In simple terms, gout is caused by uric acid crystals (monosodium urate) depositing in one or more joints and causing inflammation. Patients with gout experience “gout attacks,” which are associated with increased pain, swelling, and redness in the affected joint. Patients with gout remember their gout attacks. Patients are not able to use their affected joints without incredible pain and some may even be forced to call off of work if the gout attack is prolonged and severe.

What are the risk factors for gout?
There are multiple reasons why a patient may develop gout. Some risk factors for gout include high uric acid levels, family history of gout, obesity, chronic kidney disease, diabetes mellitus, high cholesterol, high blood pressure, eating the wrong foods, drinking too much alcohol (three or more servings in a 24-hour period), eating a lot of fructose (“sugar”) in the diet, and taking certain medications (e.g. diuretics -”water pills”).

The importance of uric acid
Studies have shown that the uric acid level of less than 6.0 mg/dL is recommended to prevent uric acid crystals forming in the body. When the uric acid levels are significantly elevated, then the uric acid starts to form the uric acid crystals, which can deposit in the joints and lead to that dreaded gout flare. Not every patient with high uric acid levels has gout. However, the higher the uric acid levels, the more likely a patient is to develop gout. Similarly to how diabetic patients should know their last hemoglobin A1C, patients with gout should know their last uric acid level.

So I have gout, so what?
Recurrent gout attacks lead to arthritis in the affected joint and may cause decreased quality of life. For patients with established gout and more than 2 gout attacks in a year, ideally the uric acid levels should be lower than 6.0 mg/dl. Patients should know who is managing their gout and what medications are available to effectively treat gout.

Patients with gout should avoid red meat, seafood, alcohol overuse, high fructose corn syrup, sweet juices, sweet fruit with high fructose, and caffeine overconsumption (four or more cups of coffee in a day). These foods can trigger a gout attack.

Gout is associated with increased risk of cardiovascular disease. Patients with gout and high blood pressure, high cholesterol, or diabetes mellitus, should regularly follow up with their healthcare provider.

If you have poorly controlled gout with recurrent gout attacks, it may be time to ask your healthcare provider if it’s time for you to see a rheumatologist. Rheumatologists are physicians that have experience in the treatment of gout and may be a resource to your healthcare provider.