Gout is a painful inflammatory condition. Symptoms of gout are similar to those of autoimmune diseases such as rheumatoid arthritis (RA). When symptoms appear, you may wonder what’s causing them and whether you have an autoimmune disease.

This article explains the causes of gout, its relationship to autoimmune diseases, and how to deal with it.

Is gout an autoimmune disease?

Gout is caused by excess uric acid in the body. Uric acid crystals form in joints and tissues, and the body reacts to them with inflammation. Gout is an autoinflammatory disease, but it is not an autoimmune disease.

Like many autoimmune diseases, gout tends to have periods of active inflammation followed by periods of remission. However, in autoimmune diseases, the immune system mistakenly attacks healthy tissue.

Understanding gout

Gout is the most common type of inflammatory arthritis. Approximately 9.2 million people in the United States are affected.

Gout causes acute inflammation in one or more joints, known as a gout flare. It is often accompanied by sudden, severe pain and swelling. These attacks occur when crystallized uric acid builds up in the joints.

Gout tends to occur on the big toe. This is because uric acid is sensitive to temperature, and the toes, which are far from the heart, are cooler than the rest of the body. However, it can occur in any joint, including the wrists and ankles.

Untreated gout can cause permanent joint damage known as chronic gouty arthritis. Additionally, uric acid crystals can leave hard lumps called toffee on the skin.

What causes gout?

Gout is caused by hyperuricemia (excess uric acid in the blood) and the deposition of uric acid crystals, causing acute inflammation in one or more joints.

Your body produces uric acid when it breaks down chemicals called purines. Gout can develop when the kidneys cannot properly remove uric acid or when the body produces too much uric acid.

Hyperuricemia can also occur when people consume large amounts of foods high in purines, such as meat, certain types of seafood, and alcohol. Other factors that can lead to increased uric acid levels include:

However, elevated uric acid levels are not always the only cause of gout.

In one study, only 9% of people with hyperuricemia between 7.0 and 8.9 milligrams per deciliter (mg/dL) had a gout flare-up over a 15-year period. Also, at levels above 10 mg/dL, only half of people developed gout over a 15-year period. Researchers have identified at least 13 inflammatory pathway genes that may be involved in the development of gout.

gout symptoms

Symptoms of gout include:

• Severe pain in the affected joint, usually the big toe
• The pain starts suddenly at night and wakes me up from sleep.
• Joints appear swollen, red, and warm

Gout can also affect:

• bursa, a cushioned sac between bones and other soft tissues
• tendon sheath, membrane surrounding the tendon
• Kidneys that can develop stones due to high levels of uric acid

Things that can cause a flare-up include:

• Excessive intake of foods high in purines
• alcohol
• very cold or very warm weather
• dehydration
• joint damage
• excessive physical activity
• certain drugs or illnesses

Flares last 1 to 2 weeks, followed by periods of remission. Some people experience frequent flare-ups, while others may take years to develop symptoms. Without treatment, flare-ups can get worse over time, occur more frequently, last longer, and involve more joints.

Risk factors for gout

Gout affects approximately 1% to 4% of the general population. Factors that can increase your risk of developing gout include:

• Family history of gout
• being a man
• Menopause (period in which menstruation stops for 12 consecutive months)
• increase in age
• drink alcohol
• Unhealthy diet and foods high in purines
• overweight or obese
• Metabolic syndrome (a combination of conditions that increases the risk of heart disease, type 2 diabetes, and stroke)
• chronic kidney disease
• high blood pressure
• psoriasis
• some types of cancer
• Rare genetic diseases such as Kelly-Seegmiller syndrome and Lesch-Nyhan syndrome
• Medications such as diuretics (which remove excess water from the body), low-dose aspirin, niacin, and cyclosporine

What is an autoimmune disease?

The immune system attacks foreign microorganisms and substances to prevent disease and infection. When you have an autoimmune disease, your immune system mistakenly attacks healthy cells. There are more than 80 types of autoimmune diseases, including type 1 diabetes and rheumatoid arthritis. Having one increases your risk of developing another.

As with gout, people with autoimmune diseases may experience flare-ups of disease activity. The exact reason why people develop autoimmune diseases is not clear. Treatment may include anti-inflammatory and/or immunosuppressive drugs.

Rheumatoid arthritis (RA)

Rheumatoid arthritis is a progressive autoimmune disease characterized by inflammation of the joints. It usually attacks many joints at the same time, commonly affecting the hands, wrists, and knees.

This is a classically symmetrical disease, affecting the same joints on both sides of the body. Without treatment, rheumatoid arthritis can cause permanent joint damage. It can also affect the lungs, eyes, and skin.

Rheumatoid arthritis and gout have similar symptoms, and both can occur together. In a study of nearly 2,000 people with RA, 17% had high uric acid levels and 6.1% also had gout.

lupus

Systemic lupus erythematosus is a chronic autoimmune disease that can affect many parts of the body and cause arthritis-like symptoms. In addition to the joints, lupus can also affect the skin, heart, lungs, kidneys, brain, and blood vessels.

celiac disease

When people with celiac disease eat gluten, it triggers an inflammatory response that damages the lining of the intestines. Gluten is a protein found in the grains of wheat, barley, and rye. Researchers believe it may be caused by a combination of many different genetic and non-genetic factors.

Some people with celiac disease develop symptoms of joint pain.

crohn’s disease

Crohn’s disease is an inflammatory bowel disease that primarily affects the digestive system. It is thought to be immune-mediated. Some people develop joint problems associated with Crohn’s disease, such as joint pain and swelling in the back, hands, feet, arms, and legs.

Addison’s disease

Addison’s disease is a rare disease that occurs when the immune system attacks the adrenal glands and prevents them from producing important hormones. Common symptoms include fatigue, skin discoloration, gastrointestinal problems, and muscle and joint pain. Addison’s disease can lead to adrenal insufficiency, a life-threatening condition.

Graves’ disease

Graves’ disease occurs when the immune system attacks the thyroid gland, causing it to produce more hormones than necessary. If Graves’ disease is not treated, it can lead to serious problems such as osteoporosis, heart failure, and stroke.

You may be at higher risk of developing Graves’ disease if you have vitiligo (a condition that causes loss of pigment in patches of skin), type 1 diabetes, RA, or autoimmune gastritis.

How can I deal with gout?

If you have hyperuricemia but no gout symptoms, no treatment is necessary. Gout is a very treatable disease. With treatment and lifestyle changes, many people can avoid recurrence and reduce symptoms. Some people’s gout goes away. Without treatment, more frequent and severe recurrences may occur.

Gout symptoms usually resolve within 3 to 10 days with treatment. When gout flares up, resting your feet can be helpful. Try not to walk or stand too much, and keep your posture as high as possible. You can also apply ice or cold compresses to relieve pain.

Treatment for gout flares may include anti-inflammatory drugs such as Colcrys (colchicine), nonsteroidal anti-inflammatory drugs (NSAIDs), or oral steroids.

Long-term medications such as Zyloprim (allopurinol), Uloric (febuxostat), and Probalan (probenecid) may help lower uric acid levels and reduce the risk of future flare-ups.

Changing your diet can also help reduce future attacks. These include:

Other ways to prevent future gout flare-ups include:

• Make sure to stay hydrated.
• Do regular exercise.
• If you have excess weight or obesity, try to lose weight.
• Talk to your health care provider about avoiding medications associated with gout, such as diuretics.
• Maintain medical appointments and manage comorbidities.

summary

Gout is a type of painful arthritis. Usually he relapses in one joint at a time, usually the big toe. Gout has much in common with certain autoimmune diseases. However, autoimmune diseases are caused by a defective immune system response. Gout is caused by too much uric acid in the body.

Fortunately, gout is manageable in most cases. With treatment, typical flare-ups clear up in 3 to 10 days. Also, making some lifestyle changes, especially avoiding certain foods, can help prevent future attacks.