Gout is an inflammatory joint disease where disease where meat is broken down into purines and uric acid, which is deposited as crystal deposits in and around joints. When meat and alcohol are consumed together, it makes gout worse. In the middle ages gout was a disease of the affluent and royalty was afflicted by gout.
Gout is actually only one of the manifestations of a faulty uric acid metabolism. Kidney stones are another manifestation. Apart from uric acid crystal disease there are other crystal-induced diseases such as pseudogout, which is produced by precipitation of another crystalized salt, calcium pyrophosphate dihydrate (CPPD). The other name for pseudogout therefore is CPPD crystal deposit disease. These crystal deposits cause an inflammatory arthritis that leads to scarring and a lack of range of motion, if it is not detected early and treated.
Not everybody can handle uric acid in their system as well as the person next door. Uric acid is one of the breakdown products of meat. We are all born with slightly different enzyme patterns. However, the person that cannot break down purines as well will end up with too much uric acid in the system until it reaches a critical point of solubility where it precipitates as uric acid crystals.
When uric acid levels exceed 7.0 mg/dL (or 0.41 mmol/L) in plasma, a critical point is reached where monosodium urate crystals, which under the microscope look like micro-needles, will be spontaneously deposited in tissue with a lack of blood supply such as tendons, joints, ligaments or cooler tissues such as ear lobes. This point can also be reached in patients who have leukemia, lymphomas, hemolytic anemias or other cancers where purines are overproduced because of rapid cell division. Some children are born with an enzyme defect, which leads to uric acid kidney stones, severe gout and kidney damage at a young age. Most cases of gout though are in adults and are often associated with an overindulgence of meals containing large helpings of meat in combination with consumption of alcohol. This might be part of the explanation why males are much more commonly affected by gout then females (ratio of 20:1).
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