Although experts do not fully understand why some people get gout and others do not, many causes and risk factors of gout are well established.
Diet. The risk of gout is increased by the frequent consumption of foods high in purines, including meats, seafood, certain vegetables and beans, and foods containing fructose.
Alcohol use. Drinking alcohol decreases the body's ability to flush out uric acid. Additionally, beer is made with brewer's yeast, which is high in purines.
Gender. Men are more likely to have gout. Women are less likely to get gout, however, their risk of developing gout increases after menopause.
Age. Many people have their first episode of gout between the ages of 30 and 50, and the risk of gout continues to increase with age. It is estimated that nearly 12% of men aged 70 to 79 have had gout while less than 3% of men under the age of 50 have had it.10,11
Excess weight. People who are overweight have a greater risk of developing gout.
Race. African American men are nearly twice as likely to report having had gout as Caucasian men, according to a study cited by the Centers for Disease Control and Prevention.12
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Family history. Genetics plays a role, making some people’s bodies more prone to accumulating uric acid and developing the uric acid crystals that lead to gout. More research needs to be done to understand why some people have several risk factors and never get gout while other people have few or no risk factors and do get gout.
Certain medications. Taking certain medications can increase the risk of gout. Some of these medications include:
- Diuretics, sometimes called "water pills"
- Cyclosporine, an immunosuppressant sometimes prescribed to people who have rheumatoid arthritis or psoriasis, or who have had an organ transplant
- Levodopa, often used to treat Parkinson's disease
Chronic renal failure. A person who has chronic renal failure no longer has fully functioning kidneys. When the kidneys’ ability to flush out uric acid is compromised, gout may develop.
Lead exposure. People who are exposed to lead in the environment have a higher incidence of gout. Though much less common today, gout caused by lead exposure was common years ago when people unwittingly drank from leaded crystal glassware.
A trigger event, such as injury, surgery, or medical therapy. Specific events can trigger a change in body chemistry and bring on a gout flare up. Such events include, but are not limited to, infection, trauma, surgery, psoriasis, and the initiation of chemotherapy. Stopping or starting allopurinol, which is used to treat gout, can also bring on gout symptoms.
Interestingly, many people who experience an episode of gout may not ever have symptoms again, or at least not for several years. People who do experience gout symptoms repeatedly may notice that episodes get longer and more severe. Gout and its precursor, hyperuricemia, should be addressed to prevent joint damage in the long term.
- Kramer & Curhan. The association between gout and nephrolithiasis…. Am J Kidney Dis. 2002;40(1):37–42. doi: 10.1053/ajkd.2002.33911.
- Lawrence et al. Estimates of the prevalence of arthritis…. Arthritis Rheum. 2008;58(1):26–35. doi: 10.1002/art.23176.
- Hochberg MC, Thomas J, Thomas DJ, Mead L, Levine DM, Klag MJ. Racial difference in the incidence of gout. The role of hypertension. Arthritis Rheum 1995;38(5): 628–632.