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Your Gout Triggers

By Mary Jo DiLonardo
WebMD Feature

Reviewed by David Zelman, MD

When you have gout, you have higher than normal levels of uric acid in your body. When too much uric acid builds up around a joint, uric crystal forms, causing a painful gout flare.

All sorts of things -- from certain foods and drinks to stress and medicines -- can cause your uric acid levels to go up. Knowing what can trigger the uric acid to build up in your body may help you avoid future gout attacks.

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Common Gout Triggers

There are some things that are likely to trigger flares in most people with gout, also known as gouty arthritis. If you know you have gout, you should try to stay away from these gout triggers.

Foods -- Foods that are high in a substance called purines can raise the uric acid level in your blood. This includes organ meats like liver; seafood like sardines, anchovies, mussels, and salmon; and even some vegetables such as spinach. Eating just one of these foods or several of them together, can cause a gout flare. Purines are found in all foods that have protein.
Alcohol -- Beer and liquor can raise the uric acid level in the blood and many bring on a gout flare. They can be extra bad for you because they also can make you dehydrated -- another common gout trigger. Wine is not linked to gout attacks and can be enjoyed in moderation.
Medication -- Some drugs that people take for other medical conditions -- such as high blood pressure or heart failure -- may also bring on a gout flare. Some possible flare-triggering drugs include diuretics, beta-blockers, and cyclosporine. Even low-dose aspirin can cause an attack. If your doctor is going to start you on a new medicine, be sure to tell her that you have gout.
Dehydration -- When your body is dehydrated, the amount of uric acid in your body rises, and your kidneys' ability to get rid of extra uric acid decreases. So when your body doesn't have enough water, you can be more likely to get a gout attack.
Fructose beverages -- Don't drink lots of sugary drinks containing fructose. Fructose-sweetened beverages can bring on gout flare-ups.
Medical stress -- Hospital visits, surgery, pneumonia, and other medical conditions and procedures can cause your uric acid levels to go up and your gout to flare. If you're going into the hospital or if you become sick, be sure to tell your doctor that you have gout.