Gout is an inflammatory arthritis caused by hyperuricemia-high levels of uric acid in the blood. Uric acid is a waste product created when the body breaks down purines, which are chemical compounds found in certain foods and also produced naturally by human cells. When uric acid levels get too high, the chemical crystallises in the joints, most famously the big toe, causing severe pain and swelling.
The widespread misconception is that people with gout simply produce too much uric acid because of their diet. In reality, about 90% of gout sufferers have a different problem: their kidneys don’t pump out enough uric acid. If someone inherits high-performing pumps, their kidneys can easily handle heavy purine loads from red meat, shellfish, and alcohol without letting uric acid build up. If someone inherits sluggish pumps, their kidneys struggle to clear even the baseline amount of uric acid their own body produces naturally. Dietary choices only account for about 1% to 2% of the variation in a person’s serum uric acid levels. Genetics, by contrast, account for nearly a quarter of the variation.
This means someone with poor renal transport genes is fighting a losing battle if they try to manage the condition through diet alone. The main treatment for gout is the use of painkillers as prescribed by a doctor. If your pain isn’t too bad, try cold packs or compresses on your affected joint to lower inflammation and soothe the ache. Wrap ice in a thin towel and apply it to the joint for up to 20 minutes, several times a day. Don’t ice your hands or feet if you have nerve problems from diabetes or other causes.
It’s a good idea to rest it until the pain eases up. You probably don’t want to move it much anyway. If you can, raise the joint on a pillow or other soft object. When your body doesn’t have enough water, your uric acid levels rise even higher. Stay hydrated to help keep those levels down. It is also important to watch what you eat and drink. Foods high in substances called purines, such as some seafood, organ meats such as liver, and fatty foods, can raise the uric acid in your blood and trigger a flare. So can fructose-sweetened drinks and alcohol, especially beer.