The Truth About Gout
“Nothing exceeds like excess, Stoute got gout from having the best of the best,” raps Jay-Z on Justin Timberlake’s single Suit & Tie. It is just the latest repetition of an age-old myth about gout, “the disease of kings,” which has long been associated with the type of overindulgence in rich foods and wine that only the very wealthy could afford.
In reality, if Jay-Z’s pal Steve Stoute, a 42-year-old music-industry insider and advertising executive, actually has gout, it is likely due to his gender, genetics and age as much as his alleged affluent lifestyle.
- Gout is a form of arthritis that can develop when uric acid, a waste product normally excreted in urine, builds up in the blood. After many years of high uric acid levels in the blood, needle-like urate crystals may form in joints causing severe inflammation and pain.
- Men under 65 are four times more likely than women under 65 to develop gout, and it affects black men at almost twice the rate of white men, according to the U.S. Centers for Disease Control and Prevention. In men, the disease typically first shows up after age 40. Women rarely get it before menopause.
- Alcoholic drinks and foods high in sugar or purines (found in red meat and shellfish) can raise uric acid levels. However, diet is not the exclusive cause of gout, and lifestyle changes alone cannot treat or prevent it.
The myth that gout is largely self-inflicted may discourage some people from seeking the treatment they need, says Spencer Lowe, M.D., a Mills-Peninsula rheumatologist. But left untreated or poorly managed, gout will keep coming back in longer and more frequent attacks that cause severe joint damage and permanent disability. Treatment for gout usually involves medication.
Drugs used to treat gout include:
- Colchicine – a medication used both to control pain and prevent the acute phase of gout
- Allopurinol (Lopurin, Zyloprim) – medications that stop the body from producing uric acid
- Febuxostat (Uloric) – a newer medicine that reduces uric acid production
When uric acid levels drop below 5 or 6 milligrams per deciliter (mg/dL), the uric crystals that cause the inflammation dissolve. Pain resolves or becomes manageable.
“For the vast majority of patients, we can successfully treat their gout,” says Dr. Lowe.
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