What Are the Triggers for Gout Pain?

Gout is a common form of arthritis that can affect any joint but usually affects the big toe. Gout usually has times when there are no symptoms and times when there are symptoms. When symptoms show up, it’s called a flare or an attack. Gout flares can make the joint hurt, swell, turn red, and make it hard to move. They usually last one to two weeks. A gout flare-up can be caused by a lot of different things, like food, medicine, or even being too thirsty. 1

Causes of Gout Flares that Happen Often

High amounts of uric acid in the body cause gout. When the body breaks down purines, which are chemicals found in the body and in some foods, uric acid is made. Most of the time, the body breaks down uric acid and gets rid of it through urine. When the body doesn’t get rid of too much uric acid properly, it builds up in the joints as needle-shaped crystals that cause gout flares. 1

There are some well-known things that can make gout flare up. And because most of the triggers can be avoided, it’s important to know what they are if you want to avoid or deal with gout pain. 2

Not all purine-rich foods seem to raise your risk of gout or uric acid levels, though. Peas, beans, lentils, asparagus, spinach, and mushrooms are all high in purines, but eating them in small amounts doesn’t seem to increase the risk of getting gout. 5

Some types of meat and fish

Many foods that are high in purines can raise the amount of uric acid in the body, which makes it more likely that a gout attack will happen. There are more purines in foods like:34

• Beef, lamb, and pork are all examples of red meat.
• The liver and kidney are examples of organ meat.
• Some fish and shellfish
• Anchovies
• Sardines
• Mussels
• Scallops
• Trout
• Tuna

Alcohol
It is known that drinking beer, wine, or liquor raises the amount of uric acid in the blood. The chance of getting gout is higher the more alcohol you drink.

But one study found that even small amounts of alcohol may make men more likely to get gout. In fact, men who had up to two drinks in a 24-hour period were 36% more likely to have a gout flare-up than men who didn’t drink at all in the same time frame. On the other hand, having one drink in 24 hours did not raise the risk by much. 6

Flares might be less likely to happen if people drink less alcohol.

High-fructose drinks and foods
The only type of sugar that makes the body make more uric acid is fructose. Fruit juices and soft drinks with added sugar have a lot of fructose, which has been shown to raise the amount of uric acid in the blood. 5

Cookies and candy, which are high in fructose, have also been linked to an increased risk of gout flares. If you have gout, you might want to avoid or eat less of these high-sugar drinks and foods. 4

Body Mass Index (BMI)
The first time someone gets gout, they are more likely to be overweight or obese. Higher levels of uric acid are linked to a higher body mass index (BMI). 5 Even if you already have gout, the link between the two can still be important.

If your BMI puts you in the “overweight” or “obese” category, you may be able to lower your uric acid levels and stop future flares by eating less and exercising more.

Unexpected Things That Cause Gout
Some foods, drinks, and ways of living are known to cause gout attacks, but there are other things that should also be thought about.

Stress
The exact link hasn’t been figured out yet, but research shows that stress can raise the amount of uric acid in the blood. Researchers say that people with gout should try to avoid stress or take steps to reduce stress if they want to avoid flares. 5

Aspirin
Low-dose aspirin can raise the amount of uric acid in the blood and sometimes almost double the chance of a gout attack. One study found that taking low-dose aspirin for two days increases the chance of having a gout attack. The association is stronger the less the dose is. 8

But low doses of aspirin are often used to protect against heart disease. So, even though it might make your gout flare up, you shouldn’t stop taking your low-dose aspirin or change how you use it if you’re taking it to prevent a heart attack or stroke. Instead, you can deal with other things in your life that might cause gout, such as how much alcohol and red meat you eat. 9

Dehydration
Due to less urination, which gets rid of uric acid, uric acid levels can rise when you’re dehydrated.

People with gout should drink a lot of water every day to lessen the chance of an attack. It’s important to drink more water when you work out or spend time in places that are hotter, like a sauna. 5

Changes in temperature
Gout can be changed by the weather. Both high temperatures and low humidity make it more likely that you will have an attack of gout. When it’s hot and dry, it can make gout flare up more than usual. Extremely high humidity can also make flare-ups of gout more likely, but not as much. 6

No one knows for sure why the two things are linked, but one theory is that being dehydrated plays a role. People with gout should drink plenty of water to try to keep their symptoms from getting worse when the weather is hot or dry. 10

Summary: Red meat, alcohol, and high-sugar drinks are common things that can cause a gout flare. Limiting or avoiding these things can help lower the risk of a gout flare. Other things that can cause gout flares, like aspirin, stress, or the weather, should also be taken into account when figuring out how to stop them and deal with them when they happen.