Gout in Young People: Why It's Not Only a Disease of the Elderly

Gout is an inflammatory arthritis in which uric acid crystals are deposited in a joint. It is usually thought of as a disease of older men, but attacks also occur in teenagers and young adults. Let's look at why this happens and what to pay attention to.

Can gout occur at a young age

Yes, although rarely. An acute gout attack in teenagers and young adults is uncommon and is usually associated with a primary or secondary defect in uric acid synthesis. The peak incidence in men is at 40–50 years, in women at 60 years and older. At the same time, the frequency of gout cases has increased in recent years.

Why gout appears in young people

The disease is based on an elevated level of uric acid in the blood (hyperuricemia): the body produces too much of it or the kidneys excrete too little. Urate crystals form around the joints and cause pain. Risk factors include excess weight, alcohol (especially beer), drinks and foods with fructose, red meat and organ meats, and certain seafood. Medications can also play a role: diuretics, low-dose aspirin, and drugs that weaken the immune system. There is also a hereditary predisposition, as well as rare genetic conditions with elevated uric acid levels.

Gout in young men

Men develop gout significantly more often than women; the ratio in various data ranges from 7:1 to 19:1. An attack often begins at night with sudden intense pain, swelling, redness, and heat in one joint — often in the big toe, but also in other toes, the ankle, or the knee. The pain can be so severe that it wakes the person.

Gout in young women

Before menopause, women rarely develop the disease — probably due to the effect of estrogens on uric acid excretion. After menopause, the risk increases. Recurrent joint pain attacks require medical evaluation.

Gout in athletes

Intense physical exertion can be accompanied by an increase in blood uric acid levels. Dehydration and joint injury can also trigger an attack. This does not mean that sports are harmful; the point is that an attack in an active young person cannot automatically be explained by a sprain.

How the diagnosis is confirmed and when to see a doctor

The doctor asks about symptoms, diet, and alcohol, examines the joint, and may order a blood test for uric acid. If the picture is unclear, the patient is referred to a rheumatologist: a sample of fluid is taken from the joint and examined under a microscope for urate crystals, and an ultrasound or a special CT scan is also performed. An untreated attack usually lasts 1–2 weeks, and recurrent attacks may become longer and damage the joints. Without treatment, dense nodules under the skin — tophi — may eventually appear, and attacks may become more frequent.

You should see a doctor if:

• there is sudden severe joint pain, swelling, and redness of the skin over it;
• signs of gout have appeared for the first time;
• the usual treatment does not help.

Gout itself is not a reason to call an ambulance. Call 103 or 112 if sudden joint pain and swelling are accompanied by a very high fever, chills, nausea, or inability to eat — this may be an infection inside the joint.

This material is for reference: it helps prepare questions for a doctor but does not replace a consultation and examination by a specialist.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer