Gout Images Media

Overview of high uric acid leading to urate crystal deposits. Many factors can enhance or inhibit the formation of crystals, which is why high uric acid may not manifest itself as gout immediately.

Leave this page to browse the uric acid crystals in the Understanding Uric Acid Section

This chart emphasizes how the risk of gout rises with higher uric acid levels. The data comes from “Asymptomatic hyperuricemia. Risks and consequences in the Normative Aging Study.” report, from which, the abstract states:

To quantify the consequences of asymptomatic hyperuricemia, this study examined rates for a first episode of gouty arthritis based on 30,147 human-years of prospective observation. A cohort of 2,046 initially healthy men in the Normative Aging Study was followed for 14.9 years with serial examinations and measurement of urate levels. With prior serum urate levels of 9 mg/dl or more, the annual incidence rate of gouty arthritis was 4.9 percent, compared with 0.5 percent for urate levels of 7.0 to 8.9 mg/dl and 0.1 percent for urate levels below 7.0 mg/dl. With urate levels of 9 mg/dl or higher, cumulative incidence of gouty arthritis reached 22 percent after five years. Incidence rates were three times higher for hypertensive patients than for normotensive patients (p less than 0.01). The strongest predictors of gout in a proportional hazards model were age, body mass index, hypertension, and cholesterol level, and alcohol intake. When the serum urate level became a factor in the model, none of these variables retained independent predictive power. At the final examination, only 0.7 percent of participants had a serum creatinine level of 2.0 mg/dl or more, with no evidence of renal deterioration attributable to hyperuricemia. These data support conservative management of asymptomatic hyperuricemia.

Diagram showing that, if excretion of gout through kidneys and the gut is less than food intake and natural metabolism, then uric acid becomes too concentrated, and crystallization may lead to gout

Gout diet is crucial, but only as part of a gout management plan. This image illustrates clearly how top rheumatologists see that diet is important, but only in the context of a proper diagnosis followed by a proper treatment plan. The full chart, in Gout: Diagnosis and Management of Gouty Arthritis and Hyperuricemia, is clearly aimed at doctors, but you must also see gout diet as part of a gout treatment plan that monitors and manages your uric acid levels and all other aspects of gout.

Table of dietary recommendations for gout management. Taken from Gout: Diagnosis and Management of Gouty Arthritis and Hyperuricemia, this diet and gout list shows how overall gout diet is much more important than individual food items.

I have included other principles in my Gout Diet Section, as their are other important food factors. Also, beverages, exercise, and other lifestyle issues must be considered. The best approach is to assess your current diet, then slowly adjust that diet, decreasing bad influences, and increasing good ones. That way, you are more likely to stick to gout diet improvements.

A chart comparing the 10% increase in uric acid after drinking soy milk, with the 10% decrease after drinking skim milk.

Please remember that no single individual food is important. You (or your nutritionist) should check the Gout Diet Section to fully understand the part that food and drink play in the treatment of gout)

All these delicious high protein foods are often banned for gouties. But who is doing the banning? And do they know what they are talking about?

I’ve used this image in a number of gout diet articles where I’ve discussed the relationship of protein to gout.

Have a browse, and you’ll see that the low protein brigade are rarely right.