Gout and Stress is my review of a study of stress-induced gout. So you can learn to stop emotional stress making gout worse.
Gout and Stress Audience
I wrote Gout and Stress mainly for Secondary Gout Sufferers. That is gout sufferers who suspect their gout is caused by another health problem. In this case, I explain emotional issues that may cause gout attacks. Then, if you control stress, you might stop gout.
However, the information is also useful to other types of gout sufferer who might consider stress-reduction. If you are new to GoutPal, you should read Questions for Gout Sufferers first.
Gout and Stress
In Gout and Stress, I give my layman’s view of Katz and Weiner’s 1972 critical review. It investigates stress, linked with gout and excess uric acid[*]. Until recently, Katz and Weiner’s investigations of gout and stress have been the only significant source of relevant information. However, in my second article in this series, I will introduce current gout and stress research.
Gout and Stress Report
Firstly, the report introduces psychological aspects of several diseases. Then it focuses on gout. Secondly, their section, ‘A Brief History of Ideas About Gout’, gives a quick historical perspective. Before summarizing Genetic Aspects of Gout, including high uric acid. Because the authors need to set the stage for their investigation with:
allows the investigator to select for study a population at risk and to further ponder what the anatomic, physiologic, humoral, environmental and behavioral (social, experiential, dietary) factors are which [lead to clinical gout]
Is Gout Stress-Related?
The report continues with a long section (Pathophysiology and Pathology). Which describes the processes and nature of gout. This is useful to establish the facts of many different causes of gout. Hence high uric acid is caused by:
various metabolic and physiologic defects. These defects, in turn, presumably reflect a variety of genetic factors and can further be influenced by certain hormonal, physical, and dietary variables.
Therefore, the authors reframe their quest for:
- A) Are there psychological and social factors that affect high uric acid?
- B) Do psychological and social factors trigger gout attacks? And if so, how?
Uric Acid and Emotions
Before reviewing stress, the authors summarize the wider aspect of emotions related to uric acid. So, they review 13 studies of links between uric acid and emotions[44-56]. From which they conclude:
Thus, most, although not all, of the work reviewed here appears to show a positive relationship between intelligence, drive, achievement, etc and serum uric acid level.
With the result that, we have an apparent emotional link with uric acid. Although, this is a much wider psychological link than stress alone.
Uric Acid and Stress
The authors note there is a lack of psychiatric investigation into gout. One study suggests that emotional states might trigger gout attacks. Then, the authors look at uric acid levels related to stress.
In short, they review 10 reports about changes in uric acid levels in response to stressful situations[65-74]. So, there appear to be links between gout attacks and stress. But, as noted earlier, there are many different stress-related factors. Also, there are many different types of gout sufferer. Therefore, the authors only offer some potential reasons for how uric acid and stress might be linked. Then they emphasize that more investigation is needed.
Gout and Stress Conclusion
To conclude, the authors look at the wider nature of gout. From which they suggest several potential reasons why apparent links between gout and stress might be coincidences. In particular, they note that stress often affects eating habits. Therefore there is insufficient evidence to confidently claim that stress can cause gout. But, the authors hope that further investigations will allow them to “shed more light” on the issue of gout and stress. So, I will review their progress in my next stress and gout review.
Gout and Your Stress
Now, despite the length of Katz and Weiner’s review, we cannot be certain that your stress is causing your gout. But, we have clear pointers to what you should do.
Firstly, if you suffer from stress, you need to get a clear medical diagnosis. Because there are different types of emotional disorders. So, you really need to look at specific types of stress and anxiety to get value from the research. This type of psychological investigation is beyond the scope of GoutPal. However, feel free to discuss your concerns in the gout forum. Because you might get help from gout sufferers who have experienced the same issues as you.
Secondly, it might help you to keep a daily diary of gout symptoms and stress symptoms. Then, you might see a link between the two that you could act on. Obviously, you can do this privately at home. But, if you want to monitor your symptoms so you can discuss them with others, ask for your personal gout diary.
Finally, you can read my second review at Stress and Gout: Secondary Gout from stress or behavior?
Leave Gout and Stress to browse more Secondary Gout Plan Step 5 Resources.
Gout and Stress References
* This is a review of:
- Katz JL, and Weiner H.
- Psychosomatic Considerations in Hyperuricemia and Gout.
- Psychosom Med. 1972 Mar-Apr;34(2):165-82.
The following list of references are from the original report. However, I have omitted references that I have not referred to in my review, above. For the full report, you can search the Internet for the report title. Or, GoutPal Members can download a PDF copy of the report for personal private use.
- 44. Stetten DcW, Hearon JZ: Intellectual level measured by army classification battery and serum uric acid concentration. Science 129:1737, 1959.
- 45. Dunn JP, Brooks GW, Mausner J, et al: Social class gradient of serum uric acid levels in males. JAMA 185:431-436, 1963.
- 46. Zachau-Christiansen B: The variations in serum uric acid during 24 hours and from day to day. Scand J Clin Lab Invest 9:244-248, 1957.
- 47. Rubin RT, Plag JA, Arthur RJ, et al: Serum uric acid levels: Diurnal and hebdomadal variability in normoactive subjects. JAMA 208:1184-1186, 1969.
- 48. Brooks GW, Mueller E: Serum urate concentrations among university professors: Relation to drive, achievement and leadership. JAMA 195:415-418, 1966.
- 49. Grayzel Al, Liddle L, Seegmiller JF: Diagnostic significance of hyperuricemia in arthritis. NEJM 265:763-768, 1961.
- 50. Anumonye A, Dobson JW, Oppenheim S, Sutherland JS: Plasma uric acid concentrations among Edinburgh business executives. JAMA 208:1141-1144, 1969.
- 51. Montoye HJ, Faulkner JA, Dodge HJ, et al: Serum uric acid concentration among business executives. Ann Intern Med 66:838-850, 1967.
- 52. Achcson RM: Social class gradients and serum uric acid in males and females. Brit Med J 4:65-67, 1969.
- 53. Lanese RR, Gresham GE, Keller MD: Behavioral and physiological characteristics in hyperuricemia. JAMA 207:1878-1882, 1969.
- 54. Kasl SV, Brooks GW, Cobb S: Serum urate concentrations in male high school students. JAMA 198:713-716, 1966.
- 55. Kasl SV, Brooks GW, Rodgers WL: Serum uric acid and cholesterol in achievement behavior and motivation: I The relationship to ability, grades, lest performance, and motivation. JAMA 213:1158-1164, 1970.
- 56. Kasl SV, Brooks GW, Rodgers WL: Serum uric acid and cholesterol in achievement behavior and motivation: II. The relationship to college attendance, extracurricular and social activities, and vocational aspirations. JAMA 213:1291-1299, 1970.
- 64. Castelnuovo-Tedesco P: Psychiatric observations on attacks of gout in a patient with ulcerative colitis. Psychosom Med 28:781-788, 1966.
- 65. Dreyfuss F, Czaczkes JW: Blood cholesterol and uric acid of healthy medical students under stress of examination. Arch Int Med 103:708-711, 1959.
- 66. Pfeiffer CC, lliev V, Nichols RE, Sugarman AA: The serum urate level reflects degree of stress. J Clin Pharm 9:384-392, 1969.
- 67. Kasl SV, Cobb S, Brooks GW: Changes in serum uric acid and cholesterol levels in men undergoing job loss. JAMA 206:1500-1507, 1968.
- 68. Rahe RH, Arthur RJ: Stressful underwater demolition training: Serum urate and cholesterol variability. JAMA 202:1052-1054, 1967.
- 69. Rahe RH, Rubin RT, Arthur RJ, Clark BR: Serum uric acid and cholesterol variability: A comprehensive view of underwater demolition team training. JAMA 206:2875-2880, 1968.
- 70. Hamburg DA, Adams JE: A perspective oncoping behavior. Arch Gen Psychiat 17:277-284, 1967.
- 71. Katz JL, Weiner H, Gallagher TF, Hellman L: Stress, distress and ego defenses. Arch Gen Psychiat 23:131-142, 1970.
- 72. Rubin RT, Rahe RH, Arthur RJ, Clark BR: Adrenal cortical activity changes during underwater demolition team training. Psychosom Med 31:553-563, 1969.
- 73. Rubin RT, Rahe RH, Clark BR, Arthur RJ: Serum uric acid, cholesterol and cortisol levels: Interrelationships in normal men under stress. Arch Intern Med 125:815-819, 1970.
- 74. Hellman L: Production of acute gouty arthritis by adrenocorticotropin. Science 109:280-281, 1949.