Health Conditions

What causes it?

There are two types of gout, primary and secondary, depending on the cause of high uric acid in the blood.

Primary Gout: Primary gout is the most common. In primary gout the cause of excess uric acid is usually not known. Most scientists believe that primary gout is caused by genetics, which means that patients probably inherited this condition from someone in their family. The basic defect is either an impaired clearance of uric acid by the kidneys (also termed "underexcreter"), an increase in production of uric acid (termed "overproducer"), or a combination of both defects.

Secondary Gout: In secondary gout, the cause of excess uric acid is usually known. Most commonly, secondary gout is caused by certain medications, foods high in purine, or health conditions.

Medications that may cause secondary gout include:

• Diuretics ("water pills"), such as chlorothiazide (Diuril), chlorthalidone (Hygroton), hydrochlorothiazide (Esidrix, HCTZ, HydroDIURIL, Oretic), metolazone (Mykrox, Zaroxolyn), bumetanide (Bumex, Edecrin), ethacrynic acid, furosemide (Lasix), torsemide (Demadex)
• Pyrazinamide (PZA)
• Cyclosporine (Sandimmune, Neoral)
• Aspirin
• Nicotinic acid (Niacin)
• Levodopa

Foods that contain Purine:

• High levels: Liver, kidney, anchovies, sardines, herring, mussels, bacon, codfish, scallops, trout, haddock, veal, venison, turkey, alcoholic beverages
• Moderate levels: Asparagus, beef, bouillon, chicken, crab, duck, ham, kidney beans, lentils, lima beans, mushrooms, lobster, oysters, pork, shrimp, spinach

Health conditions that may cause secondary gout include:

• Alcoholism
• Leukemia
• Lymphoma
• Lung cancer
• Smoking
• Psoriasis
• Obesity
• Kidney dysfunction
• Congestive heart failure
• Starvation
• Anemia
• Untreated high blood pressure
• Diabetes
• Severe illness or injury
• Immobility due to bed rest
• Down syndrome
• Thyroid disorders