Newsweek magazine revealed that the so-called disease of kings – gout – is on the rise in the United States, as experts urge people to take steps to reduce it, by making sure to drink water, exercise and eat healthy food.
The magazine said that gout is a type of arthritis that causes severe and often sudden pain in and around the big toe, and is caused by the accumulation of uric acid, a natural byproduct formed when the body breaks down purines.
She explained that purines are colorless crystalline compounds found in red meat, internal organ meat, sugary foods, seafood, sugary sweets, and alcoholic drinks. Some vegetables, such as spinach and asparagus, also contain purines.
“Gout is unique because it is an immune response to uric acid and the sharp uric acid crystals that accumulate in and around the joints,” added Malinda Whitlow, an internal medicine specialist from the University of Virginia.
Historically, gout was seen as a disease that mainly affected the wealthy classes; in the past, members of the poorer classes had very limited access to the types of luxuries needed to cause the disease.
English King Henry VIII was perhaps the most famous sufferer of the condition, while legend has it that Benjamin Franklin treated a bout of the condition by “bathing with warm water, and applying poultices of mustard.”
Gout is known today as a more complex metabolic condition caused by a variety of factors, and a research study published in 2019 mentioned some risk factors for developing gout, such as obesity, insulin resistance, metabolic syndrome, high blood pressure, and chronic kidney disease.
Gout is a disease that is on the rise in America. In 2018, a study published in the journal JAMA Network Open estimated that the total number of Americans with gout was about 12.1 million people, and the results of the Global Burden of Diseases, Injuries and Risk Factors 2024 (GBD) study revealed that the prevalence of gout has increased by 20% in the United States since 1990.
Although general health and diet are key factors, it is not necessary to follow a rich diet or drink excessive alcohol to develop gout. Dr. Whitlow has encountered patients whose uric acid levels were within the normal range, but who complained of sudden pain in the big toe without any history of injury or trauma to that area. In these cases, gout is suspected.
“You also start to see more cases of gout with age, in people over 60 and in people with certain metabolic conditions, such as high blood pressure, obesity, diabetes, and chronic kidney disease,” Whitlow said.
Men are more susceptible to gout than women, and some studies have indicated that the hormone estrogen helps protect women from this disease, which may explain why women are more likely to develop gout after menopause.
Whitlow expects the number of gout cases to continue to rise as Americans age and the average lifespan of those with chronic diseases increases, and notes that there are steps that can be taken to reduce the risk of developing gout or worsening of its symptoms.
Gout treatment
Although medications are available, the easiest and best way to avoid gout is to eat a healthy diet, exercise regularly, and drink adequate amounts of water. Drinking adequate amounts of water is crucial to helping the kidneys get rid of excess uric acid.
“As temperatures rise, when we start to complete a patient’s medical history, we look at how much water they’re drinking, especially if they have a chronic condition that puts them at risk,” Whitlow said. Talking with the doctor about the impact of any other medications the patient is taking is also extremely important.
She pointed out that there are conditions that increase the risk of gout, such as diabetes, high blood pressure, obesity, chronic kidney disease, and other metabolic diseases.
Gout can damage and erode the joints, resulting in permanent deformity and decreased mobility due to urate crystal deposits that may form in the joints and soft tissues. Therefore, regular check-ups with a doctor are necessary.
“The most important thing is to make sure people have regular checkups with their health care provider, to make sure they’re managing chronic conditions to prevent gout,” Whitlow said.
