In addition to an inherited abnormality in handling uric acid, other risk factors for developing gout include obesity, excessive weight gain, especially in youth, moderate to heavy alcohol intake, high blood pressure, and abnormal kidney function. Certain drugs, such as thiazide diuretics (hydrochlorothiazide [Dyazide]), low dose aspirin, niacin, cyclosporine, tuberculosis medications (pyrazinamide and ethambutol), and others can also cause elevated uric acid levels in the blood and lead to gout. Furthermore, certain diseases lead to excessive production of uric acid in the body. Examples of these diseases include leukemias, lymphomas, and hemoglobin disorders.
Interestingly, a recent study demonstrated an increased prevalence of abnormally low thyroid hormone levels (hypothyroidism) in patients with gout.
In patients at risk of developing gout, certain conditions can precipitate acute attacks of gout. These conditions include dehydration, injury to the joint, fever, excessive dining, heavy alcohol intake, and recent surgery. Gout attacks triggered by recent surgery are probably related to changes in the body fluid balance as patients temporarily discontinue normal oral fluid intake in preparation for and after the surgery.
You're more likely to develop gout if you have high levels of uric acid in your body. Factors that increase the uric acid level in your body include :
- Lifestyle factors. Choices you make in your everyday life may increase your risk of gout. Excessive alcohol use generally more than two drinks a day for men and more than one for women increases the risk of gout.
- Medical conditions. Certain diseases and conditions make it more likely that you'll develop gout. These include untreated high blood pressure (hypertension) and chronic conditions, such as diabetes, high levels of fat and cholesterol in the blood (hyperlipidemia), and narrowing of the arteries (arteriosclerosis).
- Certain medications. The use of thiazide diuretics commonly used to treat hypertension and low dose aspirin also can increase uric acid levels. So can the use of anti rejection drugs prescribed for people who have undergone an organ transplant.
- Family history of gout. If other members of your family have had gout, you're more likely to develop the disease.
- Age and sex. Gout occurs more often in men than it does in women, primarily because women tend to have lower uric acid levels than men do. After menopause, however, women's uric acid levels approach those of men. Men also are more likely to develop gout earlier usually between the ages of 40 and 50 whereas women generally develop signs and symptoms after menopause.
