Causes of gout

So now that we have covered the symptoms of gout, its time to answer the question "What is the cause of gout?"

That answer is simple. The buildup of uric acid which crystallizes in a joint. These crystals are pointy and sharp which is the cause of the pain. Thats the short and simple answer. Now to expand upon the underlying causes behind that buildup of uric acid.



There are numerous things that can cause a buildup of uric acid in the body but can largely be broken down to two items.  Either the kidneys do not secrete enough uric acid, or too much uric acid is being created or a combination of the two. Now, it is possible that there are problems with the kidneys so that they do not process uric acid normally. This can be due to a mutation of the uromodulin (or UMOD) gene, which may also be referred to as  uromodulin-associated kidney disease. I will discuss this further in another post as this is a less likely root cause.

The bigger part of the equation is the buildup of excess uric acid. No doubt you have read of purines over and over again, but what you may not know is why purines are the bogeyman. Purines are necessary to life. As Wikipedia puts it: Aside from the crucial role of purines (adenine and guanine) in DNA and RNA, purines are also significant components in a number of other important biomolecules, such as ATP, GTP, cyclic AMP, NADH, and coenzyme A.

Most animals, in fact all mammals with the exception of humans produce an enzyme called uricase that breaks down purines so that they can be removed from the body. But as we don't, the purines get processed in the liver where they become uric acid. This then goes through the bloodstream until it is processed out by the kidneys. If the production of uric acid exceeds the rate of removal for a long enough period of time, the body will enter a state of hyperuricemia, which simply means elevated uric acid. Once in this state, the risk of gout increases greatly. The body starts to form the needle like monosodium urate (MSU) crystals which are what cause gout to be so painful.

Next up: Purines, where are they found