Gout in the Family

Bottom Line Publications—February 9, 2012   

Dr. Theodore R. Fields, attending physcian and director of the Rheumatology Faculty Practice Plan at Hospital for Special Surgery, offers advice on gout prevention. Dr. Fields specializes in the treatment of gout, rheumatoid arthritis, and osteoarthritis.

Q: Both of my parents suffered terribly from gout. How can I avoid getting it?

A: You are right to be concerned. While anyone can get gout—a painful type of arthritis that typically affects the big toe, mid-foot, ankle and/or knee joints—this condition does tend to run in families.

A key to gout is uric acid, which is produced from the natural breakdown of foods. Elevated blood levels of uric acid can lead to the formation of crystals in the joints and surrounding tissues, triggering inflammation and excruciating pain. Though men are at higher risk for gout, women develop this potentially disabling condition, too, especially after menopause.

What to do: Have your doctor test your blood level of uric acid. If it is over 6 mg/dL, you are at increased risk of developing gout, especially given your family history. In that case, you would be wise to take preventive action…

• Ask your doctor whether any medication you are currently taking might be raising your uric acid level. For example, the diuretic (“water pill”) hydrochlorothiazide, often taken to control blood pressure, can increase uric acid. Do not simply stop taking a diuretic on your own.
• Reduce your consumption of red meat, shellfish and sugar-sweetened sodas. All of these foods can increase uric acid levels.
• Cut down on alcohol. In a recent study, consumption of more than about five drinks per week tripled women’s risk for gout. Avoid beer entirely, as it is particularly likely to be problematic.
• Increase your intake of skim milk. Recent research suggests that nonfat dairy may protect against gout onset.
• If you are overweight, make a point of taking off those excess pounds—achieving the proper weight generally lowers uric acid levels.
• Ask your doctor about supplementing with vitamin C, which some research suggests may help protect against gout.

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