Gout is caused by an excess of uric acid (urate) in the blood, which leads to the formation of needle-shaped urate crystals in and around the joints. These crystals trigger inflammation, causing the intense pain and swelling characteristic of gout attacks
. The buildup of uric acid can happen due to several reasons:
- Overproduction of uric acid: This can occur from genetic defects affecting purine metabolism or from rapid cell breakdown (e.g., during chemotherapy). Purines, found in certain foods and body tissues, break down into uric acid
- Underexcretion of uric acid: The kidneys may not remove enough uric acid from the body, which is the cause in about 90% of gout cases. This can be due to genetic factors, kidney dysfunction, or medications such as diuretics, low-dose aspirin, and some blood pressure drugs
Several factors increase the risk of developing gout by raising uric acid levels or triggering attacks:
- Diet high in purines (red meat, shellfish, organ meats), alcohol (especially beer), and sugar-sweetened beverages
- Being overweight or obese, metabolic syndrome, high blood pressure, diabetes, kidney disease, and other chronic conditions
- Family history of gout and genetic predisposition
- Age and sex: gout is more common in men, especially between ages 40-60, and in women after menopause
- Certain medications and illnesses that cause dehydration or joint injury can also trigger gout attacks
In summary, gout results from persistent hyperuricemia due to either increased production or decreased excretion of uric acid, combined with lifestyle, genetic, and health factors that promote crystal formation and joint inflammation
