New doctors explain why gout hurts so much

Gout is a treatable form of arthritis that causes intense pain when uric acid crystals build up in the joints. Dr. Rhea Rogers, a board-certified physician, explained that the condition occurs when the body produces too much uric acid or cannot remove it fast enough. The Centers for Disease Control and Prevention identifies gout as a painful type of arthritis that typically affects one joint at a time. Most people recognize the condition by a red, throbbing big toe, a specific presentation that Rogers calls podagra.

The pain associated with gout is often described as severe. Gerontologist Sam Cradduck noted that her daughter, who has suffered from the condition twice, compared the sensation to having a shard of glass in her foot. Cradduck added that even walking near her daughter's foot caused her pain. Both Cradduck and Rogers explained that the crystals themselves do not cause the pain. Instead, the immune system reacts to the crystals as if they were foreign objects. Rogers said this immune response triggers a strong inflammatory reaction in the joint.

Gout can also serve as an indicator for other underlying health conditions. Rogers stated that a buildup of uric acid often signals metabolic disease. Many patients with gout also have insulin resistance, diabetes, or cardiovascular issues. Uric acid reduces nitric oxide, a substance that helps arteries relax. Rogers explained that this is the same mechanism involved in atherosclerosis, which is the hardening of the arteries. This connection makes it important for doctors to recognize and treat the condition early.

Men are more likely to develop gout than women, largely due to hormonal differences. Rogers said estradiol is protective against the condition. Premenopausal women have higher levels of estradiol, which provides this protection. Men have lower levels of estradiol, which they produce by converting testosterone. As men age, their testosterone levels drop and they often carry more visceral fat. For women, the risk increases after menopause. Rogers said that when estradiol levels drop after menopause, the gap between men and women in gout risk closes.

Diet and lifestyle play a role in managing the condition. Aging well coach Katherine Ambrose noted that gout has historically been called the disease of kings because it was linked to rich foods and alcohol. Aging expert Amy O'Rourke said that what people put into their bodies is a major factor. She observed that men often do not seek treatment as quickly as women. O'Rourke advised that partners and family members should encourage men to see a doctor if they suspect gout.

Doctors have several options for treating patients. Rogers said some physicians prescribe allopurinol to lower uric acid levels. She also mentioned that a combination of vitamin C, quercetin, and luteolin can naturally lower uric acid. Sugary foods and drinks are quick ways to raise fructose. Rogers explained that high fructose levels push insulin up and cause the body to hold onto uric acid. Patients should consult a health care provider for specific medical advice.

The Alliance for Gout Awareness provides more information for those interested in learning more. The information from the Aging Untold program is for educational purposes only. It does not replace professional medical advice. Individuals should always seek the advice of a doctor or other qualified health provider regarding a medical condition.