'disease of kings' or 'rich man's disease'


Uric Acid Levels and Gout

So, what causes gout? Deposition of uric acid crystals in tissues around the joints leads to recurrent attacks of severe debilitating pain and joint inflammation. Accumulation of excess uric acid (high uric acid levels) in the body results in formation of crystals of this acid. This condition is known as 'gout'.

Causes and Symptoms of Gout

Uric acid in the body is generated during the metabolism of purine that is obtained from the food. It is flushed out of the body regularly through urine. This means, dysfunction of kidneys (body unable to get rid of uric acid), impaired metabolic functions (unable to process purine) and high purine intake can result in high uric acid levels. Mushrooms, wheat bran, meat products, fish, legumes like black-eyed peas, white beans, split peas, lentils, red beans, garbanzo beans, vegetables like spinach, cauliflower, asparagus, are some examples of purine rich foods. Those who are diagnosed with gout should avoid foods that cause gout. Excessive consumption of alcohol and caffeine can raise uric acid levels. So, alcoholic or caffeine rich beverages should be avoided by gout sufferers.

Gout mainly affects legs or feet. It generally affects a single joint at a time. Sudden occurrence of pain and swelling in joints at the ankles, knees, wrists, fingers and elbows is the main symptom of gout. Reddened skin at the affected joint, warmth, increased tenderness, restricted movement of the joint and severe pain is experienced during the attack. The person experiences pain for several hours or days. Now, let us take a look at what medication causes gout.

Medication that Contribute to Gout

  • Diuretics that are prescribed for conditions like hypertension and heart disease contain hydrochlorothiazide, furosemide and metolazone which can trigger gout attacks.
  • The immunosuppressive drugs (used to treat autoimmune diseases, or to avoid the rejection of transplanted organs and tissues) like ciclosporin and tacrolimus can cause gout.
  • Cyclosporine when used with hydrochlorothiazide can lead to gout pain. This drug suppresses body's immune system.
  • Levodopa or Laradopa, the drug used to treat Parkinson's disease and some other degenerative diseases can result in gout attack.
  • Antiuricosurics, like ethambutol or pyrazinamide, which are used to treat tuberculosis, can affect the process of removal of uric acid from blood by the kidneys.
  • Excessive intake of over-the-counter medicines like niacin (B vitamin) or ascorbic acid (vitamin C) is one of the main causes of gout attacks.
  • Prescription medication like theophylline (for asthma), methyldopa (to lower blood pressure) and cisplatin (used in cancer treatment) are also considered as instigators of gout.
  • Experts believe that excessive consumption of certain drugs like Pyrazinamide, Lotrel, Maxzide, Nadide, Ethacrynic Acid, Dyazide, etc. can result in gout attacks but more research is needed to confirm this belief.
  • Aspirin (acetylsalicylic acid) and other analgesics contain salicylate which can affect the function of the kidneys and thus can prevent elimination of uric acid from body. Therefore, excessive consumption of these medicines is said to be harmful for health, especially for gout sufferers.
  • Antibiotics destroy friendly bacteria (probiotics) in the intestines while destroying the pathogenic bacteria. Along with the kidneys, the bowels also play an important role in elimination of uric acid. But destruction of probiotics affects this process significantly. This can lead to elevated uric acid levels in blood. So, antibiotics that cause gout should be consumed only when essential.
You should always consult your physician and discuss the side effects of medication. It is essential to follow the instructions of the physician religiously. This helps avoid serious health complications.

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