Uric acid crystals drive gout pain
Physicians explain why the condition is linked to metabolic health and why men are affected more than women before menopause.
By Bianca Shevchenko ·
Dr. Rhea Rogers, a board-certified physician, explains that gout results from uric acid accumulating in the blood and forming crystals in joints and tissues.
The condition triggers a strong inflammatory response that causes intense pain, according to Rogers. The Centers for Disease Control and Prevention classifies gout as a painful form of arthritis that typically affects one joint at a time.
While many people associate the disease with a red, throbbing big toe, a condition known as podagra, the pain mechanism is complex. Gerontologist Sam Cradduck notes that her daughter, who has experienced gout twice, describes the sensation as feeling like a shard of glass.
Cradduck explains that the pain is not caused by the crystal itself, but by the immune system attacking it. Rogers agrees, stating that the body treats the crystal as a foreign object.
Rogers warns that uric acid buildup can signal underlying metabolic disease. Many patients with gout also suffer from insulin resistance, diabetes, or cardiovascular issues.
High uric acid levels reduce nitric oxide, a compound that helps arteries relax. Rogers notes that this is the same mechanism involved in atherosclerosis, or hardening of the arteries.
Men are more prone to gout than women due to hormonal differences. Rogers explains that estradiol is protective and is present in higher levels in premenopausal women. Men have lower levels of estradiol, which they produce by converting testosterone.
As men age, testosterone levels drop and visceral fat increases, raising the risk. For women, the risk changes after menopause when estradiol levels decline, narrowing the gap between the sexes.
Katherine Ambrose, an aging well coach, notes that gout has historically been called the disease of kings due to links with rich foods and alcohol. Amy O’Rourke, an aging expert, advises patients to monitor what they consume to maintain overall health.
O’Rourke observes that men often delay seeking treatment compared to women. Rogers mentions that doctors may prescribe allopurinol to lower uric acid. She also notes that supplements containing vitamin C, quercetin, and luteolin can naturally lower uric acid levels.
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