What Causes Gout
Gout develops when uric acid crystals accumulate in joints, triggering an inflammatory response. While elevated uric acid is necessary, genetics play a major role—many people with high uric acid never develop gout.
Uric Acid Formation
Uric acid is produced from purine metabolism. Purines come from foods and are produced by the body. Kidneys normally excrete uric acid, but in gout, either excessive uric acid production or inadequate excretion occurs.
Hyperuricemia (elevated uric acid) is the foundation, but not all hyperuricemic individuals develop gout.
Dietary Triggers
High-purine foods increase uric acid:
- Red meat and organ meats
- Certain seafood (shellfish, anchovies, sardines)
- High-fructose corn syrup and sugary beverages
- Excessive alcohol, particularly beer
Foods to emphasize:
- Low-fat dairy products (calcium and proteins lower uric acid)
- Plant-based proteins (lower purine than meat)
- Cherries (may lower uric acid)
- Vitamin C sources (help excrete uric acid)
Weight Management
Obesity increases gout risk. Gradual weight loss through diet and exercise reduces uric acid levels and gout frequency.
Hydration
Adequate water intake improves kidney function and uric acid excretion. Most people benefit from 2-3 liters daily, more if exercising or in hot weather.
Alcohol Moderation
All alcohol increases gout risk, but beer particularly—it contains purines and interferes with uric acid excretion. Moderation or elimination significantly reduces attacks.
Acute Attack Management
NSAIDs, colchicine, or corticosteroids reduce pain and inflammation during attacks. Long-term management with xanthine oxidase inhibitors or uricosuric agents normalizes uric acid levels and prevents future attacks.
Prevent attacks through lifestyle modification and medication adherence if prescribed.