Gout is a type of arthritis that can affect any joint, but it most commonly affects the big toe. Gout typically manifests as periods of no symptoms followed by periods of symptoms. When symptoms appear, this is referred to as a flare or attack. Gout flares typically last one to two weeks and are characterised by pain, swelling, redness, and difficulty moving the joint. A gout flare can be triggered by a variety of factors, including food, medications, and dehydration.
Common Gout Flare Triggers
Gout is caused by high uric acid levels in the body. Uric acid is produced by the body when purines, which are chemicals found naturally in the body and in some foods, are broken down. Uric acid is normally broken down and excreted in the urine. Excess uric acid, if not properly eliminated, forms needle-shaped crystals in the joints, causing gout flares.
Certain things are well-known triggers of gout flare-ups. And, because the triggers can be avoided in most cases, knowing what they are is essential when attempting to prevent or manage gout pain.
Specific Meats and Seafood
Many purine-rich foods can raise uric acid levels in the body, increasing the risk of a gout attack. Foods with higher purine levels include:
- Beef, lamb, and pork are examples of red meat.
- Organ meats like liver and kidney
- Various types of seafood
However, not all purine-rich foods appear to increase uric acid levels or the risk of gout. Vegetables high in purine, such as peas, beans, lentils, asparagus, spinach, and mushrooms, do not appear to increase the risk of gout when consumed in moderation.
It is well known that drinking beer, wine, and liquor raises uric acid levels in the blood. The more alcohol you consume, the more likely you are to have a gout attack.
However, according to one study, even moderate alcohol consumption may increase the risk of gout attack in men. In fact, male participants who consumed up to two drinks in a 24-hour period were 36% more likely to experience a gout flare than those who did not consume any alcohol during the same time period. One drink in a 24-hour period, on the other hand, did not significantly increase the risk. Limiting alcohol consumption may help prevent flare-ups.
Fructose-rich beverages and foods
The only sugar that raises uric acid levels in the body is fructose, a type of sugar. Drinks high in fructose, such as fruit juices and sweetened soft drinks, have been shown to raise uric acid levels in the blood.
Fructose-rich foods, such as cookies and candy, have also been linked to an increased risk of gout flares. Avoiding or limiting high-sugar drinks and foods may help lower the risk of a gout attack.
Obesity or being overweight is linked to the early development of gout. A higher body mass index (BMI) is associated with higher uric acid levels. 5 Even if you’ve already developed gout, the connection can still play a role.
If you have an overweight or obese BMI, losing weight through diet and exercise may help lower uric acid levels and prevent future flares.
The precise relationship is unknown, but research suggests that stress can cause an increase in uric acid levels in the blood. Researchers recommend that people with gout avoid or reduce stress in order to avoid gout flares.
Low-dose aspirin can raise uric acid levels in the blood, nearly doubling the risk of a gout flare. According to one study, taking low-dose aspirin for two days increases the risk of a gout attack. The stronger the association, the lower the dose.
However, low-dose aspirin is frequently used to prevent cardiovascular disease. Even though it may cause gout flares, it is not recommended that you discontinue or change your low-dose aspirin if you are taking it to prevent a heart attack or stroke. Instead, you can address other gout triggers in your life, such as alcohol and red meat consumption.
Dehydration can raise uric acid levels because it reduces urination and thus uric acid elimination. People with gout should drink plenty of water on a daily basis to reduce their risk of a gout attack. When exercising or spending time in hotter environments, such as a sauna, it is critical to drink plenty of water.
Gout can be influenced by the weather. Both high temperatures and low humidity increase the likelihood of a gout attack. A gout flare can be exacerbated by a combination of hot and dry weather. Extremely high humidity can also increase the risk of gout flares, albeit to a lesser extent.
The exact reasoning behind the associations is unknown, but one theory is that dehydration plays a role. When in hot or dry weather, people with gout should stay hydrated to avoid weather-related gout flares.
To help reduce the risk of a gout flare, common triggers such as red meat, alcohol, and high-sugar drinks should be limited or avoided. Other gout triggers, such as aspirin, stress, or the weather, should be considered when determining how to prevent and manage flares.
Every trigger will not affect everyone with gout. Take note of what you consumed or what activities you participated in before the gout flared up to determine which factors trigger a gout attack for you. You might be able to identify a pattern in your gout flares if you keep a journal of these factors. A healthcare provider can also assist you in identifying triggers and preventing future flares. If you are experiencing a flare, consult with your doctor about treatment options.