The Dangerous Complications of Gout

So, you’ve got gout! You’ve been dealing with it for a few years now, with the occasional gout attack or flare-up. Are you aware of the complications associated with gout years down the road and into the future?

These are risks that can have a significant impact on your quality of life if the disease is not properly treated.

A More In-Depth Look at Gout

Gout is caused by an accumulation of uric acid in the blood, a natural waste product produced by your body. Gout is a painful and sudden onset of arthritis. When your blood uric acid levels are high, it can build up in your joints and trigger an inflammatory process that causes excruciating pain and swelling.

Gout frequently affects only one joint at a time (the big toe is a common place for gout to start). However, if not properly treated, it can affect many joints as well as other parts of the body over time.

Gout causes swelling, redness, warmth, and tenderness to the touch in the joints. When gout flares up, you might not even be able to tolerate having your bedclothes touch the injured joint.

Gout Treatment Medications

There are two different types of gout medications that each target a different issue. The first kind aids in reducing the pain and swelling brought on by gout attacks. The second type reduces the level of uric acid in your blood to prevent gout complications.

The type of medication that is best for you is determined by the frequency and severity of your symptoms. You must also consider any other health issues you may have. As we always say, speaking with your doctor before trying anything new is the best way to treat your gout symptoms.

Despite this, there are numerous instances where patients naively think they can go to their primary care doctor and receive treatment for a gout flare. Sadly, they frequently aren’t informed that gout is a chronic illness like diabetes, high cholesterol, or hypertension.

This is critical because chronic conditions require a long-term treatment strategy. Otherwise, most patients will simply take an over-the-counter ibuprofen pill and go about their business. While this may provide some temporary relief, the condition will persist and worsen over time.

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Is Gout Fatal if Not Treated?

Gout flare-ups can be excruciatingly painful as if the world were about to end, but they do not directly cause death. However, if not treated properly, it can lead to life-threatening complications.

Gout may raise your risk of cardiovascular issues like heart failure, heart attacks, and stroke, according to the Arthritis Foundation. A buildup of uric acid crystals may harm blood vessels, even though numerous factors may be to blame.

Gout also raises the risk of type 2 diabetes, with a 71% increase in risk for women and a 22% increase in risk for men. This could be caused by significant inflammation. Additionally, gout sufferers may be more likely to be overweight, have high blood pressure, or have high cholesterol.

Gout has also been linked to a 78% increase in the risk of moderate kidney disease. Kidney disease can progress to kidney failure if not treated. Gout may also increase the risk of sleep apnea, a condition that affects breathing while sleeping.

We’ll take a closer look at these complications below.

Giving Your Gout Symptoms the Proper Treatment Is Critical

It’s important to treat gout properly. Medication-assisted lowering of uric acid levels can prevent gout flare-ups and the long-term complications they bring, in addition to treating an acute gout attack.

Treatment of gout with medication and lifestyle changes can help prevent a variety of gout-related complications, also known as comorbidities. It is critical to be aware of all potential gout comorbidities and complications.

After reviewing this list of gout complications, speak with your doctor about any questions or concerns you may have. You may need to form a healthcare team of different specialists, such as seeing a rheumatologist and a nephrologist or facilitate better communication between them to ensure you’re getting the best care for your gout and its comorbidities.

Common Gout Complications

Gout is responsible for more than just pain. If left untreated, gout, particularly chronic gout, can lead to serious health problems over time.

Here are some of the most common ones:

  • Deformity and Joint Damage: When you have chronic gout, your joints swell on a regular basis. Tophi and chronic inflammation can cause permanent joint damage, deformity, and stiffness. In severe cases of chronic gout, surgery to repair or replace joints may be required.
  • Tophi: Tophi are urate crystal clumps that harden under your skin. They can develop on nearly any joint or cartilage, including your fingers, hands, feet, and/or ankles. Tophi can also form on the ears. Tophi may not cause pain, but it can cause joint, bone, and cartilage damage if left untreated.
  • Kidney Stones: Gout sufferers may be at a higher risk of developing uric acid kidney stones. This is due to the higher level of uric acid excreted by the kidneys. They also have more acidic urine, which increases the likelihood of uric acid crystallization.
  • Kidney Failure and Kidney Disease: Kidney stones made of urate crystals can form and cause damage and scarring in your kidneys. This kidney damage caused by urate crystals is thought to progress to kidney disease over time, particularly if gout is not treated.
  • Heart Disease: People who have gout have a higher risk of heart disease, but understanding this link is the first step toward lowering it. If you have an inflammatory rheumatic disease, your chances of having a heart attack, stroke, or other serious cardiovascular problem are much higher than the average.
  • Emotional and Psychological Issues: Gout is a painful condition that can last for years. Gout can impair your ability to walk, work, and perform everyday tasks. Living with pain can be emotionally draining. Talk to your doctor about how gout affects your emotional health and ask for suggestions on how to cope.

Deformity and Joint Damage

First and foremost, if gout is not treated and you continue to have frequent gout attacks, you may suffer irreversible and permanent joint damage over time. Your joints may become deformed, rendering you disabled.

Eventually, the affected joints can come out of alignment and be rendered completely immobile. It’s also very possible that you might need surgery done on your joints to screw back the bones together due to bone erosion over the years.

If the underlying cause of gout is not addressed, acute attacks become more common. Inflammation caused by these attacks, as well as tophi growth, causes joint tissue damage.

Gout-related arthritis can cause bone erosion and cartilage loss, resulting in joint destruction. Yes, the thought is frightening, which is why it is critical to discipline yourself if you have this disease to avoid worsening it.


Another complication of gout after many years is the development of tophi. Uric acid deposits in the soft tissues, especially around the joints. These may cause nodules known as tophi which are small white or yellowish lumps that build up under the skin.

Despite their ugly appearance, tophi are usually painless. However, they can form in awkward places like around your toes or ends of your fingers even on heels, knees, and elbows.

They can appear anywhere in the body even on your spine and vocal cords! If there are tophi below your skin, there is even more within the cartilage and bone of your joints!

Tophi are most found in the following areas of the body:

  • hands
  • feet
  • ankles
  • ears
  • Wrists

The following tissue types are those where uric acid most frequently accumulates to form tophi:

  • tendons that link muscles and joints
  • around your joints, and cartilage
  • cartilage in your joints is lined with synovial membranes
  • any fat or ligaments that may be soft tissue in your joints
  • Bursae, tiny sacs, act as a sort of cushion between the soft tissues and the bones

Additionally, connective tissue outside of a joint can develop tophi. A few of these places are:

  • Sclerae, also known as “whites,” of the eyes.
  • Aorta and other heart valves (very rarely).
  • The kidneys’ triangular-shaped renal pyramids, which are composed of nephrons and ducts, aid in absorbing nutrients before excreting waste as urine.

Tophi is obviously a sign that you have severe gout and must treat it with allopurinol or another uric acid-lowering therapy to dissolve the crystals. Tophi may also be surgically removed.

When and Why Do Tophi Appear?

Tophi may not appear right away in people suffering from gout. Gout is divided into four stages:

  1. Asymptomatic hyperuricemia: You have an excess of uric acid in your blood (hyperuricemia), but no visible symptoms.
  2. Acute gout: Uric acid buildup (or crystals) begin to form in a joint, causing severe inflammation and pain. This can cause your joint to feel warm to the touch (a gout attack).
  3. Interval gout (intercritical): between gout attacks is the period of no symptoms. This stage may last a few days, a few months, or even years.
  4. Chronic tophaceous gout: Tophi start to form in your joints and the tissues around them at this stage. They typically occur when gout is not treated for an extended period of time (about 10 years or more). Your ears may also develop tophi.

Symptoms of Tophus

Common gout symptoms that could be present along with tophi include:

  • Warmth, tenderness, and swelling where the tophus is
  • days after the attack has subsided, the affected joint may be difficult to use or cause discomfort
  • severe pain, especially in the first few hours of the attack, in the affected joint
  • losing mobility in the affected joint, which may become more obvious if gout is left untreated

Kidney Stones

Kidney stones are another complication you want to keep off the radar and occur in 10% to 40% of gout patients. But since we suffer from gout, our chances double that some of us may end up with kidney stones.

A history of gout does not increase the chances of developing kidney stones though. Uric acid can deposit in the kidneys and cause kidney stones as well as decreased kidney function.

What happens is uric acid crystallizes in the urinary system forming stones and the urine becomes too concentrated. Symptoms will occur once the stones begin to move down the ureter causing intense pain when passing urine.

What Causes Kidney Stones?

Urine normally removes waste from your body, including small crystals such as calcium, uric acid, and oxalate, which are easily diluted and passed through your urinary system.

When you produce more of these minerals than your urine can handle, the minerals can stick together in larger groups and form kidney stones. This causes one of four types of stones: calcium, struvite, uric acid, or cystine.

Signs That You May Have Kidney Stones

Kidney stones are mineral deposits that form inside your kidneys. Obviously, if you have any, you will immediately recognize that something is wrong. They are extremely painful and debilitating, and many people mistake them for back pain or other similar conditions.

While these stones are painful, if treated promptly, they do not cause permanent damage. To determine if you have kidney stones, you must first understand the symptoms. Let’s take a look at how these stones form, what causes them, and what symptoms to look for.

Common signs you may be suffering from kidney stones include:

  1. Pain: Renal colic is the medical term for pain caused by kidney stones in the abdomen, back, or sides. This type of pain is a common reason for emergency room visits.
  2. The urgency of urination: A strong desire to urinate may indicate that the stone has moved to the lower area of your urinary tract. This can also be misdiagnosed as a UTI.
  3. A burning sensation while urinating: When a stone reaches the area between your ureter and bladder, urinating may cause a painful or burning sensation. This is often confused with a urinary tract infection (UTI), but you can have both an infection and a kidney stone.
  4. Unusual color or odor: Healthy urine is usually clear and has a mild odor, but if you have cloudy or smelly urine, you may have kidney stones.
  5. Urine in trace amounts: If you have a large stone, it can cause a blockage that makes urine difficult to pass, causing the flow of urine to slow or stop completely. If your urine stops flowing, you should seek medical attention right away.
  6. Hematuria: Blood in your urine is a medical term that can cause your urine to turn pink, red, or brown. Although the blood may be too small to see, your urine can be tested.

Urinary System Infection

Kidney stones may also cause an infection in the urinary system. You may be prescribed medication to help make your urine less acidic helping dissolve any kidney stones that may have formed.

Want to avoid kidney stones? Watch your diet like a hawk and change your lifestyle ASAP!!! Don’t forget to drink plenty of water on a daily basis.

​​Uric acid stones, which account for 10 to 15% of all cases of stone disease, can be dissolved by alkalinizing the urine with medication. Other stones must be removed, which can be accomplished using one of the following methods:

  • Using sound waves to break up the stone will make it easier for the user to pass during urination.
  • Surgical removal of the stone

To help the tube pass, doctors can prescribe pain relievers and medication that promotes dilation in the tube.

You can learn more in my book “Gout and You: The Ultimate Gout Diet & Cookbook”. You may also suffer one day from kidney disease and renal failure if you don’t manage your uric acid levels properly. 25% of gout patients will eventually suffer from this.

Heart Disease

Heart disease is next on the list that can come about from your gout since gout is associated with unhealthy cholesterol and lipid levels. Gout increases the risk of you developing a heart attack.

One of the most common misconceptions about gout is that it only causes joint pain. Although your joints may feel the most pain, gout is an inflammatory disease that is linked to a number of health issues throughout your body, including your heart and blood vessels.

Since we suffer from gout, we also suffer from hyperuricemia which has also been associated with a higher risk of death from heart conditions including high blood pressure and coronary artery disease.

According to a recent study, more than half of gout patients are at “very high risk” for heart disease. This is due to a variety of factors, including the accumulation of fatty plaque in their carotid arteries (major vessels that provide blood flow to the brain). A stroke could occur if your carotid arteries become clogged with plaque.

Reasons Gout Could Damage Your Heart

Although the exact mechanism linking cardiovascular disease and gout is still being worked out, researchers are aware of several factors that contribute to the diseases’ frequent overlap.

  1. Inflammation: High levels of urate (uric acid) accumulate in the bloodstream in gout patients, crystallize, and then deposit in one or more joints. That causes an inflammatory reaction that manifests as redness, swelling, and excruciating pain. However, it is a sign of generalized body inflammation, which puts you at risk for blood clots, stroke, heart attacks, and other cardiovascular issues.
  2. High blood pressure: Although the connection between gout and high blood pressure is complex, it is undeniable that they are connected. Hypertension (chronic high blood pressure), which increases the risk of heart attack and stroke, affects more than 70% of people with gout.While it’s true that some of these people had high blood pressure before getting gout, there is evidence that people with pre-hypertension (borderline high blood pressure) are more likely to develop the full-blown condition in the future due to the high uric acid levels associated with gout.
  3. Obesity and diabetes: Anyone can develop gout, but those with a high body mass index (BMI) are at a higher risk because obesity tends to raise blood uric acid levels. Heart disease and obesity are strongly correlated. Excessive levels of fat frequently increase triglycerides and LDL (“bad”) cholesterol while lowering HDL (“good”) cholesterol. Additionally, type 2 diabetes and higher blood pressure are risks that are increased by obesity.A significant risk factor for heart disease is diabetes. Cardiovascular disease is two to four times more likely to develop if you have diabetes. Even borderline pre-diabetes, which is frequently characterized by insulin resistance, can cause problems.Your blood sugar levels stay too high when you don’t produce enough or use insulin as effectively as you should. Your blood vessels may be harmed and inflamed as a result, increasing your risk of cardiovascular disease.

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The Psychological Toll of Living With Gout Symptoms

Let’s not forget the psychological effects that the disease can cause the gout patient in the long-term affecting your mood causing either depression or anxiety.

Stress, anxiety, and depression can result from the persistent pain brought on by recurrent gout attacks. Intense pain brought on by gout can make it difficult for you to move around, go to work, and carry out daily tasks. The effect on daily life can influence a patient’s mental, social, and physical health.

Finally, other complications that can occur in gout patients are the development of cataracts or dry eye syndrome and in rarer cases, you could have uric acid crystals deposited in the lungs.

The Bottom Line

If gout flares up, people should see a doctor to discuss the best treatment options. Treatments that reduce inflammation work best within 24 hours of a gout flare-up.

If a person notices any signs of gout complications, they should seek medical attention. They will also require immediate medical attention if they exhibit any symptoms of a cardiac event, such as a stroke or heart attack.

I hope this post makes you think long and hard about the importance of disciplining yourself when it comes to your diet and lifestyle as well as taking your doctor’s advice on prescription drugs to avoid the nasty complications of gout.

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