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By CT Foot Care Podiatrists
April 10, 2013
Category: Gout

A study published last September by The American Journal of Medicine says that gaining too much weight in early and mid-life can drastically increase your chances of getting gout.

Janet W. Maynard, MD, MHS at Johns Hopkins University School of Medicine in Baltimore, MD and colleagues found cumulative incidence of gout by age 70 years for women at 3.6 percent among those who were overweight at the baseline and 7.9 percent among those with obesity at the baseline. Women who have a healthy weight at baseline had a gout incidence of 1.9 percent, and those who were considered morbidly obese had an incidence of 11.8 percent.

The study included 6263 women aged 45 to 65 years and without a history of gout, accepted between 1987 and 1989 in the Atherosclerosis Risk in Communities Study. During the nine year study, 106 women developed gout. Those considered obese were twice as likely to get gout than those considered non-obese.

Early adult obesity, before 25 years of age, among women correlated to a 2.8 times increased risk of gout, compared to those who were not obese at 25.

The researchers concluded that, "In a large cohort of black and white women, obesity in early- and mid-adulthood, and weight gain during this interval, were each independent risk factors for incident gout in women."

A different study, led Ronenn Roubenoff, MD, MHS and colleagues, was published in The Journal of American Medical Association and used men as subjects. Their study associated obesity, excessive weight gain in young adulthood, and hypertension with increased risk of gout.

In their report, the researchers state, "prevention of obesity and hypertension may decrease the incidence and morbidity from gout; studies of weight reduction in the primary and secondary prevention of gout are indicated."

A possible reason for the increase in gout is the consumption of sugar-sweetened soft drinks, which have already been associated with the obesity epidemic in the United States. Soft drinks often contain fructose, which leads to the formation of gout-promoting uric acid.

If you believe have a foot problem and do not currently see a podiatrist, call one of our six locations to make an appointment.

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By CT Foot Care Podiatrists
November 26, 2012
Category: Gout

Got lead in your house? Here's another reason to remove lead from your home: adults with "safe" blood levels of lead have an increased incidence of gout and hyperuricema than adults with low blood levels of lead.

The new population study, after adjustments for population characteristics, people with the highest blood levels of lead had a threefold risk of gout compared to those with the lowest levels. "This study documents that low-level exposure to lead... as it occurs in the general population is associated with a significantly elevated presence of gout. These data suggest that there is no such thing as a 'safe' level of exposure to lead. Further refinement in national goals for prevention, detection, and removal of lead from the environment should be pursued," wrote study authors.

However, current standards for acceptable lead exposure do not reflect the actual threshold for harm. Authors cited recent studies showing the blood lead levels under a certain amount are associated with progression of chronic kidney disease and with cardiovascular mortality. The association between lead and gout and hyperuricema is a controversial issue for lower levels of lead exposure. Population based studies have had conflicting results.

Co-author Eswar Krishnan, MD, of Stanford University, and colleagues studied whether current accepted standards for lead exposure have an association with gout. Mercury and cadmium were also included in the study. Data for the study was taken from the 2005 to 2006 and the 2007 to 2008 National Health and Nutrition Examination Survey. Researchers limited the study to adults 40 to 85 with information on serum creatinine, blood levels of heavy metals, and serum urate concentrations. Participants who had a history of renal problems or dialysis were excluded. The final number of participants was 6,153 with an even distribution between men and women.

Of the 6,153 participants, 290 had gout, 229 of the cases were men. The subgroup with gout was older and had kidney ailments.

Author of an accompanying editorial, Ashwini R. Seghal, MD, of Case Western Reserve University in Cleveland said, "Lower thresholds for toxic lead levels are desirable and feasible. Lead and its myriad uses will remain an integral part of our external environment. However, both children and adults deserve an internal environment that is as unleaded as was our evolutionary past."

If you suspect you have gout, call one of our six locations to make an appointment.

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Gout is a disorder that results from the build-up of uric acid in the tissue or a joint. It most often affects the joint of the big toe.

goutGout attacks are caused by deposits of crystallized uric acid in the joint. Uric acid is present in the blood and eliminated in the urine, but in people who have gout, uric acid accumulates and crystallizes in the joints. Uric acid is the result of the breakdown of purines, chemicals that are found naturally in our bodies and in food. Some people develop gout because their kidneys have difficulty eliminating normal amounts of uric acid, while others produce too much uric acid.

Gout occurs most commonly in the big toe because uric acid is sensitive to temperature changes. At cooler temperatures, uric acid turns into crystals. Since the toe is part of the body that is farthest from the heart, it's also the coolest part of the body- and, thus, the most likely target of gout. However, gout can affect any joint in the body.

The tendency to accumulate uric acid is often inherited. Other factors that put a person at risk for developing gout include: high blood pressure, diabetes, obesity, surgery, chemotherapy, stress, and certain medications and vitamins. For example, the body's ability to remove uric acid can be negatively affected by taking aspirin, some diuretic medication (water pills), and the vitamin niacin (also called nicotinic acid). While gout is more common in men aged 40 to 60 years, it can occur in younger men as well as women.

Consuming foods and beverages that contain high levels of purines can trigger an attack of gout. Some foods contain more purines than other and have been associated with an increase of uric acid, which leads to gout. You may be able to reduce your chance of getting a gout attack by limiting or avoiding shellfish, organ meat (kidney, liver, etc), red wine, beer, and red meat.

An attack of gout can be miserable, marked by the following symptoms:

  • Intense pain that comes on suddenly- often in the middle of the night or upon arising.
  • Signs of inflammation such as redness, swelling, and warmth over the joint.

To diagnose gout, the podiatrist will ask questions about your personal and family medical history, followed by an examination of the affected joint. Laboratory tests and x-rays are sometimes ordered to determine if the inflammation is caused by something other than gout.

Initial treatment of a gout attack typically includes the following:

  • Medications. Prescription medications or injections are used to treat the pain, swelling, and inflammation.
  • Dietary restrictions. Foods and beverages that are high in purines should be avoided, since purines are converted in the body to uric acid.
  • Fluids. Drink plenty of water and other fluids each day, while also avoiding alcoholic beverages, which cause dehydration.
  • Immobilize and elevate the foot. Avoid standing and walking to give your foot a rest. Also, elevate your foot (level with or slightly above the heart) to help reduce swelling.

The symptoms of gout and the inflammatory process usually resolve in three to ten days with treatment. If gout symptoms continue despite the initial treatment, or if repeated attacks occur, see your primary care physician for maintenance treatment that may involve daily medication. In cases of repeated episodes, the underlying problem must be addressed, as the build-up of uric acid over time can cause arthritic damage to the joint.

If you have gout, call one of our six locations to make an appointment. 

Connecticut Foot Care Centers

Podiatrists in CT

Visit our website, friend and like our page on Facebook, and follow our tweets on Twitter.