On many levels, gout causes are simple. It is simply excess uric acid that causes gout.

I’ve recently started reorganizing my gout causes pages, and I want to make sure I have not missed any. Also, there has not been much discussion of gout causes recently, so this is the place to discuss any aspects of the causes of gout.

Please note that I am not particularly interested here in what causes a single gout flare. I am interested in the underlying causes of gout. My list so far is:

  • Kidney disease
  • Surgery
  • Leukemia, lymphoma, or hemoglobin disorders
  • Medical conditions that cause rapid weight change (increase or decrease)
  • Medications for other health conditions
  • Exposure to lead and other metal salts

Can you think of others?

What are your feelings on obesity? I believe that diet can play a part, and I would add that starvation, dehydration, and malnutrition can also affect gout. I am certainly not interested in specific foods, but have you ever cured gout by completely stopping a bad aspect of diet? To qualify for that, you need to demonstrate uric acid over 6.5 being reduced to 5 or below. This is important, because stopping the pain is not enough – uric acid crystals continue to grow slowly, and they will destroy your joints, kidneys, and other organs, which is definitely not a gout cure.

Please see my article, Gout Causes: Why Does It Matter?, and the What Causes Gout guidelines, for more details of exactly what I mean.

Leave What are your Gout Causes? to browse the What Causes Gout guidelines


  • Toby

    I have been a follower of GoutPal for several years now and learned a lot. Much more than what my doctor ever told me. I do not comment much (technically challenged I guess). I did send in a comment once that got zero feedback and I will continue to share it now and again. Your question here was about underlying causes of gout. I believe that Keith and others have often stated that certain things can “trigger” gout or a gout attack. I am pretty certain I know what it was for me – eating too many BLUEBERRIES. I had been eating blueberries daily to help with other issues. After my first major gout attack and getting on allopurinol, I kept having minor pain in my big toe. Once I read that Fructose can cause gout I decided to stop the blueberries and within a week or so, no more pain. Six months later, I tried blueberries again for a week (couple tablespoons on my morning cereal) and the toe pain came back. Stopped the blueberries and pain went away. I tried this experiment once again with same results. I can turn it on and off again which proves to me I have found the root cause.

    • Hi Toby, If you check out the forum (search for Toby) you’ll see that you have posted twice. Your post about Uloric and allopurinol got good responses. If they did not help you, you should have asked follow-up questions. If they did help you, a “thank you” with an explanation of how the answers helped you is a good forum habit.

      Your second post was basically what you have written here. It did get one response, but this type of thing tends to get ignored. I will try to explain why.

      If you reread my article that this debate is about (Gout Causes: Why Does It Matter?), you should note that I am specifically talking about things that affect uric acid. I make the point that, when we ask What causes gout?, only uric acid causes gout. After the first gout attack, subsequent attacks can happen when new crystals form, or when old crystals start to dissolve. Without uric acid test results, any judgment is pointless. You simply do not know if blueberries are triggering an attack by causing an increase in uric acid, or if they are triggering an attack because they lowered uric acid causing old crystals to start dissolving. This is the same thing that occurs for many gout patients during the first few months of allopurinol or Uloric.

      Whilst it would be really good to see some data showing the link between blueberries and uric acid (if there is a link), your statements do not help much, and don’t really inspire people to respond. The significant things missing are:
      1. Uric acid levels.
      2. Quantity of blueberries consumed
      3. Total daily fructose intake

      It would also be useful to do comparisons with other fructose sources.

      Finally, be careful what you read about fructose. Excess fructose consumption is not healthy. Unfortunately, there is a lot of pseudoscience, and some poor quality published investigations on the Internet. If you see something that appears to a be from a legitimate source, please share it in a new topic on the gout forum. If it is not a legitimate scientific sources, you should ignore it.

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