Why We Get Gout


Perhaps surprisingly, one American in 40 has gout, a condition normally associated with the upper classes of a bygone era. In a sense, the real surprise is that is isn’t more common; gout is closely linked with diet, and the food of the upper classes of a bygone era has quite a lot in common with a fairly typical diet now that alcohol, meat, and seafood—foods rich in compounds called purines—are available in quantities undreamt of by even the wealthy a century ago. Now that this sort of lifestyle is within the reach of many people, gout has become the most common form of inflammatory arthritis in men over 40.

However, only about an eighth of gout cases can be directly traced to purine-laden foods. Medications such as immune suppressants and even some over-the-counter drugs such as aspirin can also lead to the buildup of uric acid that causes gout. The disease also often strikes people who have had lead poisoning or otherwise have compromised kidney functioning, or who have a prediabetic condition called metabolic syndrome. There’s a genetic component as well, with people who have a family history of gout being at greater risk themselves.

The gene in question normally produces a protein responsible for getting waste products out of the bloodstream. In its mutated form, it is unable to properly function to remove uric acid, which then builds up and crystallizes, leading to the joint pain and inflammation that are symptomatic of gout. A similar gene mutation affecting a related protein has been implicated in cystic fibrosis. The similarities between the two proteins suggest to researchers similar treatment strategies, and research is ongoing on a way to repair the genetic damage so that the gout-causing protein can work properly.

This is important because as quaint as gout may seem, it can have serious consequences beyond the discomfort. The crystals of uric acid can become lodged in the kidneys, leading to kidney stones. In addition, inflammatory illnesses such as gout have been linked with Alzheimer’s disease. Specifically, the plaques associated with Alzheimer’s cause the creation of inflammatory compounds, meaning gout can be an early warning sign of dementia.

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