Causes and Risk Factors

A Buildup of Uric Acid

Most people with gout have too much uric acid in their blood, a condition called hyperuricemia. Uric acid is a substance that results from the breakdown of purines which are a part of all human tissue and found in many foods. Needle-like crystals of uric acid can build up in the connective tissue, in the joint space between two bones, or both. If too many uric acid crystals form as a result of hyperuricemia, gout can develop.

Risk Factors

These risk factors are associated with gout.

  • Genetics. Many people with gout have a family history of the disease.
  • Gender and age. Gout is more common in men than in women and more common in adults than in children.
  • Weight. Being overweight increases the risk of developing gout because there is more tissue available for turnover or breakdown, which leads to excess uric acid production.
  • Alcohol consumption. Drinking too much alcohol can lead to a buildup of uric acid because alcohol interferes with the removal of uric acid from the body.
  • Diet. Eating too many foods that are rich in purines such as liver, dried beans and peas, anchovies and gravies, can cause or aggravate gout in some people.
  • Lead exposure. In some cases, exposure to lead in the environment can cause gout.
  • Other health problems. Renal insufficiency, or the inability of the kidneys to eliminate waste products, is a common cause of gout in older people. Other medical problems that contribute to high blood levels of uric acid include
    • high blood pressure
    • hypothyroidism (underactive thyroid gland)
    • conditions that cause an excessively rapid turnover of cells, such as psoriasis, hemolytic anemia, or some cancers
    • Kelley-Seegmiller syndrome or Lesch-Nyhan syndrome, two rare conditions in which the enzyme that helps control uric acid levels either is not present or is found in insufficient quantities.
  • Medications. A number of medications may put people at risk for developing hyperuricemia and gout. They include

    • diuretics, which are taken to eliminate excess fluid from the body in conditions like hypertension, edema, and heart disease, and which decrease the amount of uric acid passed in the urine
    • salicylate-containing drugs, such as aspirin
    • niacin, a vitamin also known as nicotinic acid
    • cyclosporine, a medication that suppresses the body’s immune system (the system that protects the body from infection and disease). This medication is used in the treatment of some autoimmune diseases and to prevent the body’s rejection of transplanted organs.
    • levodopa, a medicine used in the treatment of Parkinson’s disease.