Some people are bothered by gout but do not know much about it. They may have heard it’s due to high uric acid levels in their blood or because they ate too many purine-rich foods. However, this is just part of the story. We are going to help debunk myths on how to deal with gout in today’s post.
What is gout?
Gout is a chronic disease characterized by recurrent episodes of severe pain and swelling of joints. It is caused by uric acid that forms monosodium urate crystals in joints, which creates pain. Uric acid is a chemical that is produced when the body breaks down certain foods, usually purine-containing foods.
Our body constantly processes purines by breaking it down, recycling it, and removing its by-products. When the kidneys cannot effectively excrete uric acid, it will cause the level of uric acid to build up in the body, and over time, the uric acid may become crystalized and precipitate in the body tissue.
Gout tends to occur in the joints of the lower extremities. About half of gout attacks happens on the big toe, but it can happen in other places too, such as the ankles, heels, knees, fingers, etc. The formation of uric acid crystals can lead to joint deformation and severe disability. The pain usually begins at night and is severe enough to wake a person from sleep.
Usually, the progression of the disease happens in four stages: asymptomatic, gout flare, intercritical gout, and tophaceous gout.
Prevalence of gout
It is estimated that gout prevalence ranges from 0.1% to about 10% globally. 
Men are almost three times more likely to be affected by gout than women
The first onset of gout for men, often happens between the ages of 40 and 60.
The first onset of gout for women, often happens between age of 50 and 70. The disease rarely occurs in premenopausal women (possibly associated with protective effect of estrogen)
Risk factors of gout
Most flare ups occur without obvious causes. Factors that increase the risk of gout include:
Obesity (however, rapid weight loss / hunger (e.g. fasting)/ dehydration also increases the risk of gout)
Excessive alcohol use (not only increases the production of uric acid, but also reduces the excretion of uric acid)
Consuming large amounts of meat or seafood
Certain medications: low-dose aspirin as well as several types of antihypertensive drugs are associated with drugs including diuretics, beta-receptor blockers and most renin-angiotensin system drugs
Family history of gout
Decreased kidney function
How does uric acid get crystalized?
Some people have high uric acid but never develop gout, while some people get frequent gout attacks with only a slightly elevated uric acid level. In fact, less than 20% of people with hyperuricemia will develop gout. Uric acid needs to form crystals in order to create a problem.
Temperature (the lower the temperature, the easier to form crystals)
Blood pH level (too high or too low pH level increase crystallization)
Other factors (such as mechanical stress, cartilage components, and other synovial and serum factors)
Besides the uric acid level and dietary components, one should also pay attention to keeping warm, avoid excessive exercise (exercise increases lactic acid to reduce blood pH), keep hydrated, etc. to help reduce risk of gout flare up.