Henry VIII

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The other day a friend asked me about gout. Someone she knew was recently diagnosed and she was curious about what caused it. “Isn’t that a disease of kings?” she asked me. Well, gout did plague at least one famous king — Henry VIII.

What is gout?

Gout is a form of arthritis that was recognized long before King Henry’s reign. The 2006 article A concise history of gout and hyperuricemia and their treatment says it was first identified by the Egyptians in 2640 BC. They called it podagra then instead of gout. Hippocrates also recognized it in the fifth century BC, referring to it as the “unwalkable disease” because it caused so much pain.

The authors wrote that “Throughout history gout has been associated with rich foods and excessive alcohol consumption. Because it is clearly associated with a lifestyle that, at least in the past, could only be afforded by the affluent, gout has been referred to as the ‘disease of kings’. In some eras gout was perceived as socially desirable because of its prevalence among the politically and socially powerful.”

What really causes gout?

Gout develops when uric acid crystals form in and around a joint, most commonly the big toe. The crystals form when there’s too much uric acid in the blood. That can happen if you eat a diet rich in foods that contain purines. They’re chemical compounds that the body converts to uric acid. Normally, we get rid of uric acid when we urinate. But if it builds up, that’s when trouble can start.

So yes, Hippocrates was right about the connection between gout and certain foods. More precisely, it’s purines you need to watch out for.

High purine foods

  • Organ meats — liver, kidneys, sweetbreads, brains, heart
  • Game meats — venison, rabbit, squirrel, pheasant, duck, goose
  • Other meats in large quantities
  • Fatty fish and seafood — anchovies, sardines, herring, mackerel, scallops, shrimp, trout, tuna, mussels, caviar, lobster, haddock
  • Beer

A high purine diet doesn’t mean it’s inevitable you will develop gout, but it may increase your risk. And dairy products may lower your risk.

Gout symptoms

Gout symptoms usually come on suddenly, often in the middle of the night. Whether you are a king or a commoner, gout is painful.

The Mayo Clinic lists these symptoms:

  • Intense joint pain. Gout usually affects the large joint of your big toe, but it can occur in your feet, ankles, knees, hands and wrists. The pain is likely to be most severe within the first four to 12 hours after it begins.
  • Lingering discomfort. After the most severe pain subsides, some joint discomfort may last from a few days to a few weeks. Later attacks are likely to last longer and affect more joints.
  • Inflammation and redness. The affected joint or joints become swollen, tender, warm and red.
  • Limited range of motion. Decreased joint mobility may occur as gout progresses.

Risk factors

About 4 percent of the adult population in the United States suffer from gout — mostly men. Risk factors, along with what you eat, include:

  • Family history —It can run in families.
  • Gender/age — Men are at generally at higher risk, but a woman’s risk increases after menopause and loss of estrogen.
  • Medications — So-called fluid pills and immunosuppressive drugs can increase uric acid levels in the blood.
  • Weight — Obese people are at a higher risk.
  • Chronic health issues — High blood pressure, heart disease, kidney disease and diabetes may increase risk.
  • Diet — Purine-rich foods (including beer) may increase risk.

More famous people who suffered from gout

Here’s another bit of interesting information from the gout article I mentioned earlier in this post:

“Franklin, Jefferson, and the Comte de Vergennes: pivotal figures during the American Revolution whose relationships were crystallized by their gout affliction

Gout played a role in the outcome, as well as the origins, of the American Revolution, the signing of the Declaration of Independence, and the ratification of the Constitution. Benjamin Franklin – the only person to have signed all three founding documents of the USA – suffered from severe gout, as did Thomas Jefferson and the Comte de Vergennes, a French nobleman who was instrumental in obtaining the money to finance the Revolution. Reportedly, Franklin was so severely afflicted by gout that he was carried by convicts in a sedan chair to the Constitutional Convention. Some have speculated that these pivotal figures in American history had such strong connections because they were all sufferers of gout.”

Treating gout

Some people get one gout attack and never suffer again. Others have chronic gout — intense pain over and over again. Anti-inflammatory medications may help, but the best treatment is often prevention.

Understanding what is at the core of the problem and making some lifestyle changes — losing weight, eating a healthier diet, cutting back on alcohol, especially beer, could make a huge difference. No more gout attacks and you’ll probably feel much better in general. Instead of sitting with your sore foot propped up on a pillow, you could go out dancing or play a round of golf or … whatever you like!