Like a character in a mystery movie, this disease goes by a couple of aliases. Gout, Gouty Arthritis or if you’re in ancient Rome, The rich man’s disease or King’s disease. The Romans and indeed the rest of ancient medicine, named it so because the foods that were associated with Gout, Red Meat and Wines were mainly accessible to Rich people or Royalty. But what causes Gout? Let’s get a better understanding.
What Causes Gout?
Gout is caused when Uric Acid concentration in the blood is too high, which causes it to crystalize and form around bone joints. This high concentration of Uric Acid is known as Hyperuricemia.
The causes of Hyperuricemia.
When components found in our cells and everyday food and drink are known as Purines are broken down, they form Uric Acid, which is filtered out through the kidneys and excreted in Urine. But the damage to the Kidneys reduces efficient filtration, leading to Hyperuricemia. When cells in the Kidney responsible for transporting Uric Acid like Uric Acid Transporter 1 or URAT 1 mutate, they can reabsorb Uric Acid back into the bloodstream. The Uric Acid then crystalizes around bone joints. But the formation of sharp crystals isn’t the source of the pain generally associated with patients of Gout. Get Additional info Here
Trauma or continued consumption of foods rich in Purines caused theses crystals to dislodge from their formations. When they dislodge, they come into contact with immune cells known as Macrophages. The Macrophages swallow the dislodged crystals and identify them as a threat, sending distress signals to other immune cells. This is a natural response by the body as Uric Acid is released from dying or dead cells and presence of the crystals are indicative of an infection that is killing body cells and will result in inflammation to fight the infection. Even though there isn’t any infection in Gout, the swelling will occur none the less.
This inflammation is the cause of severe pain or a Gout attack, which usually happens at night when temperatures are low leading to more crystallization of Uric Acid. This tends to occur in the feet as they have lower temperatures than other parts of the body and also because our feet are most likely to experience trauma such as stubbing a toe, making the crystals to dislodge. If the Hyperuricemia is not treated, it leads to more massive crystal formation and more severe Gout attacks. When the crystal formations are more significant, they form what is known as Tophi, which disfigure joints and damage bones. These are what cause toe or finger joints to have a mangled appearance.
Now, you may or may not know someone suffering from Gout to see the severity of this disease, but it is a very painful ailment. People in danger of suffering from Gout include:
- People taking Diuretics that cause more water to be excreted by the body, leading to higher levels of Uric Acid in the blood.
- Gout is also a hereditary disease where a person can inherit mutations in the Uric Acid Transporters in the Kidney.
- Men, are three times more likely to suffer from Gout than Women. This is because women produce Oestrogen, which causes Uric Acid to be flushed out of their system.
- Gout is more prevalent in post-menopausal women because it is at that time when their bodies produce less Oestrogen.
- People with impaired Kidney functions such as those of old age, sufferers of High Blood Pressure and Diabetes.