remission medical logo

Fast Facts About Gout

Gout is an inflammatory condition that affects your joints. It’s caused by high levels of urate in your blood, called hyperuricemia. 

Urate (also called uric acid) is the end product of purine metabolism. Purines are chemical compounds that help make up your DNA and RNA, and they’re also found in meat.

Normally, uric acid is excreted through your urine. If it isn’t for whatever reason, it can build up in your body. And it may form crystals and build up in your joints. These crystals cause inflammation, resulting in gout. Large deposits of these acid crystals are called tophi.

Gout can be driven by either or both of the following: genetic and environmental factors contribute to the condition. That is, gout is partly genetic. Said another way, if you have a relative with gout, it may be passed on to you.

The condition involves genes that control what are called urate transporters. Urate transporters regulate urate excretion. As of this date, research has found the strongest link is between gout and the genes solute carrier family 2 member 9 (SLC2A9) and adenosine triphosphate (ATP) binding cassette subfamily G member 2 (ABCG2):

The SLC2A9 gene helps excrete urate in your urine. And the ABCG2 gene creates a protein that’s primarily found in your gut and liver. The protein manages the release of urate into your gut, such that the urate can be excreted from your body.

The heritability (measurement of genetic influence) of gout is thought to be about 65%. Some 20% of people with gout have a relative with the condition. And the risk is higher if it’s a first degree relative, such as a sibling or a parent.

Can genetic testing predict the likelihood of developing gout?

It’s possible to get genetic testing for gout. The test checks for risk alleles, or genetic variations, that are related to risk of gout.

The more risk alleles you have, the more likely you are to develop gout. According to a 2016 study, people with five or more risk alleles have a higher risk of gout than those who have four or less.

A doctor can let you know if you should get genetically tested for gout.

You’re more likely to develop gout if you:

  • Are male
  • Have a relative with gout
  • Are obese
  • Take certain medications, such as diuretics, or medication that helps your body produce urine
  • Consume alcohol
  • Consume high-fructose foods, such as sweetened beverages
  • Consume high-purine foods, such as red meat or organ meat
  • Have poor kidney function
  • Have co-occurring conditions such as diabetes, congestive heart failure, metabolic syndrome, or high blood pressure.

The signs of gout include:

  • Pain in the affected joints (often called “a flare”). For most, the pain affects one specific joint, typically one of the big toes. But it can also appear elsewhere.
  • Intense pain that often starts at night
  • Swollen, stiff, and/or warm joints
  • Pain that persists days or weeks
  • Sudden severe joint pain, especially in your big toe(s)
  • Swelling over a joint
  • Fever

Providers such as our own at Remission Medical can diagnose gout via the following:

  • Medical history. The doctor or NP will ask about your symptoms especially regarding your joints, and will want to dig into your family history and other medical problems.
  • Blood testing that can assess the urate levels in your blood.
  • Synovial fluid analysis that will examine the fluid in your joints, checking for urate crystals.
  • Imaging tests. An ultrasound might be ordered, which can assess the buildup of urate crystals in your joints.