Causes
The pain and swelling of a gout attack are caused by uric acid crystals
building up in the joint and leading to inflammation. The body normally
forms uric acid when breaking down cells and proteins, releasing it into the
bloodstream. The uric acid usually stays dissolved in the blood and ends up
being flushed out by the kidneys. If there's too much uric acid in the blood,
called hyperuricemia, or if the kidneys can't get rid of it quickly enough,
it may begin to form crystals that collect in the joints and even the kidneys,
skin, and other soft tissues. Although most people with gout have hyperuricemia,
about 3 in 10 turn out to have normal uric acid levels during an actual attack.
Meanwhile, hyperuricemia by itself doesn't mean that a person will develop gout
- less than 1 in 5 people with high uric acid end up with gout.
Certain high-protein foods can make the body produce too much uric acid,
triggering gout. Beverages such as tea, coffee, cocoa, and especially alcohol
in any form lead to extra water loss from the body, which can cause an attack.
Certain medications can hamper the kidneys' ability to clear out uric acid,
including aspirin* and diuretics or "water pills"
commonly given to control high blood pressure. Finally, sudden changes in diet
and weight gain or loss can also lead to gout.