Why is gout on the rise (even in the health conscious)?

One thing I always look for in my clinic is themes. When I see patterns in my clients' results or symptoms, my first question is how are these linked, and then, what could be the root cause?


Recently, I have seen raised uric acid in a number of my clients' results and, unlike the kings of the past, my clients are not indulging in red med, alcohol and other indulgences, so what could be driving this new trend?

In this article, I'll explain the symptoms of gout, how you can test for it, examine the reasons behind its potential resurgence, and explore the relationship between high-purine foods, inflammation, autoimmune diseases, and gout.

What is gout?

Gout is a painful and debilitating form of arthritis that has plagued humanity for centuries. While it may not be as prevalent as other chronic diseases, it remains a significant health concern, and recent trends suggest that gout might be on the rise once again.

To understand the current rise of gout, it is crucial to look back at its historical roots. Gout has been well-documented throughout history, with one of the most famous historical figures suffering from it being King Henry VIII of England. Gout was often referred to as the 'disease of kings' due to its association with a diet rich in red meat, alcohol, and other indulgences. 

While modern society no longer indulges in the same royal feasts, certain dietary habits and lifestyle factors have contributed to the reemergence of gout as a concern.

The risk of high-purine foods

Gout is primarily caused by the accumulation of uric acid crystals in the joints, leading to inflammation and intense pain. Uric acid is a natural byproduct of the breakdown of purines, compounds found in various foods.

High-purine foods, such as red meat, organ meats, shellfish, and alcohol, can raise uric acid levels in the body, increasing the risk of gout attacks.

The modern diet, characterised by high consumption of processed and fast foods, along with excessive intake of sugary beverages, has led to rising obesity rates and an increased prevalence of metabolic syndrome.

Obesity and metabolic syndrome are known risk factors for gout, as they contribute to insulin resistance and elevated uric acid levels. Additionally, excessive alcohol consumption, particularly beer and spirits, remains a well-known gout trigger.

However, even when you are more health conscious, especially when you have an autoimmune disease and, through popular media, are encouraged to follow a more paleo-based diet, purine levels can rise, leading to gout.

Gout diet: Good alternative foods

To manage gout and reduce the risk of flare-ups, it is essential to make dietary changes. Opting for foods lower in purines, such as fruits, vegetables, whole grains, and lean proteins like poultry and tofu, can help. Staying well-hydrated by drinking plenty of water is also crucial in flushing out excess uric acid. 

Low-fat dairy products like milk and yoghurt have been associated with a reduced risk of gout and may be beneficial. However, if you have a sensitivity to dairy, be cautious. 

When it comes to animal products, opt for organic, grass-fed dairy. If you have an issue breaking down lactose, the large carbohydrate molecule in sugar, there are now digestive enzymes available to help break this down. 

Other causes of gout

Besides high-purine foods, several other factors can contribute to the development of gout, such as:

  • genetics
  • obesity
  • dehydration
  • certain medications

In addition, chronic kidney disease is also linked to elevated uric acid, as impaired kidney function can hinder the body's ability to eliminate uric acid, leading to its accumulation and gout.

Autoimmune kidney diseases, such as lupus nephritis caused by systemic lupus erythematosus, may also present with high uric acid for the same reason. 

Even certain medical procedures or injuries can lead to temporary spikes in uric acid levels, triggering a gout attack, as well as rapid weight loss, often associated with crash diets or fasting, which can increase uric acid production and lead to gout attacks.

What's the link between gout and autoimmune disease?

Gout is more than just a painful arthritis condition, it is intricately linked to inflammation and, to some extent, autoimmune diseases. The presence of uric acid crystals in the joints triggers an immune response, leading to inflammation. 

Chronic inflammation can increase the risk of autoimmune diseases, as the body's immune system may become dysregulated. In some cases, gout can coexist with autoimmune conditions like rheumatoid arthritis.

Gout's historical prominence as the 'disease of kings' has given way to a modern resurgence driven by poor dietary choices and sedentary lifestyles, and in addition to this, the focus on more extreme health regimes that focus on eating high-purine foods. High-purine foods and excess uric acid in the body remain the primary culprits behind gout attacks. 

While gout itself is not classified as an autoimmune disease, it is closely tied to inflammation, which can increase the risk of autoimmune conditions. Eating a varied, nutrient-dense diet with a mix of plant-based foods, healthy fats and lean proteins and maintaining an active lifestyle are vital steps in preventing and managing this painful condition.

In The Autoimmunity Nutritionist clinic, we offer functional testing to not only determine your uric acid levels but also to provide insights into the underlying cause. If you would like to find out more about my services and how I can help, please book a free initial consultation with me.

The views expressed in this article are those of the author. All articles published on Nutritionist Resource are reviewed by our editorial team.

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London W1G & Harrogate HG1
Written by V. J. Hamilton, Autoimmune Disease Expert | BSc (Immunology), DipION, mBANT
London W1G & Harrogate HG1

VJ Hamilton is a qualified Nutritional Therapist and member of BANT, focusing on autoimmunity including inflammatory skin disorders, fatigue and neurological issues as well as gut health.

VJ has a BSc in Biochemistry and Immunology which she uses in her practice, using only evidence-based nutritional therapies to support chronic conditions.

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