The Gout You Don't Want

Throbbing, crushing, excruciating pain …

Typically associated with lifestyle excesses, usually food and drink, there are other contributing factors: genetic disposition, metabolism and, even race.

Gout is an “attack” disease, a form of inflammatory arthritis characterised by recurrent assaults of a red, tender, hot, and swollen joint. 

Pain typically comes on rapidly in less than twelve hours.

The joint at the base of the big toe is affected in about half of the cases. Feet, ankles, wrists, knees and elbows can also be affected.

Gout has been known since antiquity, first documented in Egypt in 2,600 BC in a description of arthritis of the big toe. 

 In 1683, Thomas Sydenham, an English physician, described its occurrence in the early hours of the morning and its predilection for older males:

The victim goes to bed and sleeps in good health. About two o'clock in the morning he is awakened by a severe pain in the great toe. 

The pain is like that of a dislocation and yet parts feel as if cold water were poured over them. Then follows chills and shivers and a little fever. 

The night is passed in torture, sleeplessness, turning the part affected and perpetual change of posture; the tossing about of body being as incessant as the pain of the tortured joint, and being worse, as the fit comes on.

… and ain’t that the truth!

In 1848, English physician Alfred Baring Garrod identified excess uric acid in the blood as the cause of gout. 

The attack starts when uric acid accumulates, forming urate crystals, which are sharp and penetrate and irritate the joints. 

White blood cells attack the crystals, the crystals “pop” the cells. The cells release proteins, which call in more white blood cells and cause inflammation and pain. 

The proteins lower pH making it possible for more crystals to form … and it spirals, downwards, ever downwards!!!