Gout and Osteoporosis

As a gout patient, managing your gout symptoms can often feel like a full-time job. As frequent readers of my blog, you know that living with gout is easier than people make it out to be. But it does require taking some meaningful steps to keep your symptoms in check.

Of course, we still have a lot to learn about this condition. But based on what we do know so far, living with gout is definitely manageable!

But what happens when we add another potentially life-changing condition to the mix, such as osteoporosis? Many of you may find that strange at first. However, studies are indicating that there may be a link between gout and osteoporosis.

For instance, Taiwanese researchers discovered that individuals with gout have a 20% higher risk than those without gout of developing osteoporosis.

In another study, featured in the National Library of Medicine, patients with hyperuricemia or gout arthritis, are at higher risk of bone fractures. Researchers found that inflammatory cytokines and oxidative stress may both promote bone resorption and inhibit bone formation.

We’ll dive into the specifics of these studies in a little bit. But first, the good news: osteoporosis may be treated with bone-building drugs. That’s a double dose of good news for patients suffering from both gout and osteoporosis.

That means that you don’t have to live in fear of suffering from these life-changing conditions. Your doctor’s recommended treatment plan, along with some of the tried-and-true advice we’ll share below, will help you feel more confident in tackling your symptoms.

As we always say you should always check with your doctor first before trying any new treatments. Continue reading, and we’re confident you’ll find a wealth of useful information on the most recent gout and osteoporosis research. This will allow you to have more meaningful conversations with your doctor.

What Is Osteoporosis?

Osteoporosis is a disease that weakens bones, making them more fragile and prone to breaking. It gradually worsens over time, and frequently isn’t discovered until a bone is broken in a fall or other sudden impact. Its name is derived from the Latin phrase “porous bones.”

Bone is a living tissue that undergoes continuous deterioration and replacement. Osteoporosis develops when the production of new bone is insufficient to counteract the loss of existing bone.

Men and women of all races may develop osteoporosis. White and Asian women, particularly older women who have reached menopause, are particularly vulnerable. Medications, a healthy diet, and weight-bearing exercise may help prevent bone loss or strengthen bones that are already weak.

Common Injuries From Osteoporosis

The following are the most common injuries in people with osteoporosis:

wrist fractures
hip fracture (hip fracture)
spinal fractures (vertebrae)

However, other bones, like those in the arm or pelvis, can also break. Simple respiratory movements like coughing or sneezing may potentially break ribs in some patients. In more extreme circumstances, it may even result in a bone in the spine partially collapsing.

Similar to a honeycomb, the inside of a healthy bone is full of tiny spaces. However, once osteoporosis sets in, it can cause the bone to lose strength and density. This can cause the little “honeycomb” spaces to widen. To make matters worse, the bone’s exterior begins to thin and weaken over time.

Most of the time, osteoporosis is not painful until the bone fractures. On the other hand, broken bones in the spine frequently result in chronic pain.

Often, the first indication that someone has osteoporosis is a broken bone. The characteristic stooped (bent forward) posture of older people, on the other hand, is often distinguishable.

Usually, this indicates that the spine’s bones have broken in some places. As a result, it makes it significantly challenging to support the body’s weight.

Osteoporosis-Related Bone Loss (Osteopenia)

Osteopenia is the condition that comes before osteoporosis. This occurs when a bone density scan reveals that you have less bone density than the average person your age. It is, however, not low enough to be classified as osteoporosis.

That fact that you may have developed osteopenia does not always mean you will develop osteoporosis. There are many factors at play that can ultimately affect the outcome. Even if you have osteopenia, you can take steps to keep your bones healthy and lower your risk of developing osteoporosis.

Your doctor may also recommend one of the bone-strengthening treatments used to treat osteoporosis. That being said, it will depend on how weak your bones are and your risk of breaking a bone.

How Is Osteoporosis Managed?

Medication to support bone mass development is part of the treatment for osteoporosis. These drugs frequently have hormonal effects that stimulate or mimic the effects of estrogen in the body to promote bone growth.

The following are some examples of drugs used to treat osteoporosis:

bisphosphonates
parathyroid hormone (PTH), such as teriparatide
parathyroid hormone-related protein, such as abaloparatide
raloxifene (Evista)
calcitonin
estrogen

What Causes Osteoporosis?

Losing bone is a natural part of the aging process, but some people lose bone much faster than others. This may result in osteoporosis and an increased risk of fractures.

Women, too, lose bone quickly in the first few years after menopause. Women are more likely than men to develop osteoporosis, particularly if menopause occurs prematurely (before the age of 45) or if their ovaries have been removed.

Osteoporosis can, however, also affect men, younger women, and kids. Numerous additional elements, such as the following, may also raise the risk of developing osteoporosis:

a history of osteoporosis in the family, particularly a parent’s hip fracture.
use of certain medications over an extended period of time that may have an impact on bone
taking steroid tablets at a high dosage for longer than three months.
other medical conditions, such as hormonal imbalances, inflammatory conditions, or issues with absorption.
having a low body mass index (BMI).
not working out on a regular basis.
smoking and binge drinking.
density or hormone levels, such as the anti-oestrogen pills that many women take after breast cancer.
possessing or having had an eating disorder like bulimia or anorexia.

Common Symptoms of Osteoporosis

Learning about symptoms and risk factors may help you keep your bones healthy for the rest of your life. Treating osteoporosis in its early stages, like gout, is the best way to avoid some of the more serious consequences. These frequently include bone fractures or pain in the bones.

So, what kinds of symptoms should you look out for, and when do they appear? Let’s take a closer look at what we know about osteoporosis symptoms in the early and late stages.

Early-Stage Osteoporosis

One of the most critical challenges with osteoporosis is that bone loss rarely manifests itself early. Most people are unaware that they have weak bones until they break their hip, wrist, or another bone.

Some signs and symptoms, however, may indicate potential bone loss, such as:

Grip strength is reduced: In a study of postmenopausal women and overall bone mineral density, researchers discovered a link between low handgrip strength and low bone mineral density. Furthermore, a loss of grip strength may increase your chances of falling.
Gums that are receding: If your jaw is losing bone, your gums may recede. Request that your dentist check your jaw for bone loss.
Fingernails that are weak and brittle: Nail strength may indicate bone health. However, you should also consider other factors that may have an impact on your nails. Exposure to extremely hot or cold temperatures, regular use of nail polish remover or acrylic nails, or prolonged immersion in water.

Osteoporosis typically has few initial symptoms aside from changes in bone density. Talking with your doctor or other healthcare provider is your best bet for catching it in its early stages, especially if you have a family history of osteoporosis.

Later-Stage Osteoporosis

Once your bone mass has further decreased, you might start to notice symptoms that are more overt, like:

Back or neck ache: Compression fractures of the spine may result from osteoporosis. Because the collapsed vertebrae may pinch nerves radiating from the spinal cord, these fractures can be excruciatingly painful. Pain symptoms may range from minor tenderness to severe pain.
Height decrease: Spinal compression fractures may cause you to grow shorter. This is one of the most obvious signs of osteoporosis.
A hunched posture or a fracture: Vertebral compression may also cause a slight curving of the upper back. Kyphosis is a stooped back that may cause back and neck pain. It may even impair breathing due to increased airway pressure and limited lung expansion.
A fracture caused by a fall: One of the most common signs of fragile bones is a fracture. Fractures may occur because of a fall or minor movement, such as stepping off a curb. A strong sneeze or cough may even cause osteoporosis.

Risk Factors for Osteoporosis

Both men and women can develop osteoporosis, but it is more common in women because of hormonal changes that occur with aging. The following are some of the most common risk factors for osteoporosis:

older years
menopause occurring before the age of 45.
ovaries being removed prior to the age of 45.
low testosterone levels in males
low levels of estrogen in females
not engaging in enough regular exercise, especially weight-bearing activities like walking.
having osteoporosis in one’s family.
frequent alcohol consumption.
taking specific drugs that lower hormone levels.
using tobacco products.

As a gout patient, you may have noticed that gout and osteoporosis patients share very similar risk factors. Therefore, let’s now turn our focus on gout and how it may potentially lead to the development of osteoporosis.

What is Gout?

Gout is a relatively common type of arthritis that develops when the body produces too much uric acid, and it crystallizes inside the joints.

A “gout attack,” which may cause pain that lasts longer than a week, follows an increase in blood uric levels, which is how gout typically manifests. Attacks may be very frequent in people with chronic gout, and permanent joint damage may also occur.

Gout Risk Factors and Causes

High uric levels in the body have a wide range of potential causes, which may result in gout. These might include underlying medical conditions or way of life choices.

For instance, illnesses, chemotherapy, and prior joint injuries, as well as excessive alcohol use and dehydration, may increase a person’s risk for developing gout.

You may also be more likely to develop gout if you have close relatives who have already done so. Diabetes, heart disease, and high blood pressure are additional gout risk factors.

Does Gout Really Increase the Risk of a Fracture?

There is still debate over whether high uric acid protects against osteoporotic fracture or bone resorption caused by gout inflammation. In one study, researchers investigated whether gout has a protective effect on bone health.

They conducted a population-based retrospective cohort study across the country to assess the relationship between gout history and fracture risk factors. Gout, even in the absence of osteoporosis, increased the risk of fractures in the lower limbs and spine, according to the findings.

Bone and Joint Disease

Bone and joint disorders may range from a traumatic leg fracture to the gradual onset of arthritis in the hands. Without proper treatment, bone and joint conditions may cause chronic pain and disability.

When your joints, such as your wrists, shoulders, knees, ankles, and finger joints, are healthy, moving around is much simpler. Additionally, bones like the femur and humerus permit movement.

The secondary function of a bone is equally significant to its primary function. They safeguard your internal organs, including the skull, which guards the brain.

Bone marrow is where blood is made. In addition to minerals, calcium and a hormone that controls blood sugar are stored in bones. Due to the numerous ways that bones support physical health, bone diseases may seriously harm your entire body.

Verifying the Link between Gout and Osteoporosis

Uric acid functions as an antioxidant as well as a pre-oxidant that causes oxidative stress, playing a paradoxical role in inflammation. However, the impact of gout, a symptom of hyperuricemia, on osteoporosis is unknown.

As a result, one study sought to investigate the link between gout and osteoporosis. The Korean National Health Insurance Service Database was used in this retrospective cohort study.

In total, 628,565 people with gout who had been taking gout medications for at least 90 days were chosen. The patients in the control group had never had gout. The Cox proportional hazards model and age and gender 1:1 propensity score matching was used to investigate osteoporosis risk factors. In total, 305,810 gout patients met the inclusion criteria.

Both men and women with gout had an increased incidence rate ratio of osteoporosis when compared to the control group. Patients with gout had an increased incidence rate ratio for osteoporosis in all age groups, except those over 80 years old, in the stratified analysis by age.

This study’s findings revealed that the incidence of osteoporosis increased up to fourfold in male patients in their twenties with gout compared to those without gout.

Even If You Are Not in Pain, Gout May Cause Bone Damage

If you have gout, you understand how painful an attack can be. What you may not realize is that underlying damage may occur even when you are not in pain. According to a new study, bone erosions affect up to 44% of gout patients.

The Shanghai-based researchers performed ultrasounds on 980 gout patients. Participants in the study were more likely to have evidence of bone damage if they were older (on average, age 55 versus 47), had lived with the disease for a longer period (nine years versus five), and had more frequent attacks (nine versus four in a year).

High blood pressure, high blood sugar, and kidney disease were also linked to an increased risk of bone erosion in gout patients. People with visible evidence of tophi — a deposit of uric acid crystals around a joint — were much more likely to have bone deterioration.

According to the authors, this is the first large-scale study of its kind to assess the prevalence of bone erosions in gout patients. We know the pain from a gout attack usually subsides within a few days.

However, these findings suggest that more people may require long-term medication (such as allopurinol) to lower uric acid levels in order to reduce the number of future attacks and avoid or limit bone damage.

The authors concluded that early detection of gout, control of [uric acid] levels, and reduction of local urate crystal deposition may be the most effective way to prevent bone erosion in gout patients.

How Gout Affects Your Body

Gout doesn’t just affect your joints; it may affect virtually every joint in your body. Gout attacks may also occur in your kidneys, bursae, and tendon sheaths in addition to your joints (thin sacs that act as cushions between bones and soft tissues).

Gout sufferers are more likely to experience other health issues like kidney stones, high blood pressure, kidney and heart disease, among others. All ages and lifestyles are susceptible to this crippling illness.

Men and post-menopausal women are more likely to have it diagnosed, particularly if they have other risk factors like diabetes, a high red meat intake, alcoholism, kidney or heart disease, or obesity.

Your body’s joints are impacted by gout, which typically begins at the base of your big toe and progresses to other joints over time.

Gout attacks occur in two stages:

Stage #1: The initial swelling and pain, which may last anywhere from a few hours to several days. This pain is usually excruciating.
Stage #2: The lingering discomfort, which may last up to ten days and causes a restricted range of motion.

Even though the length and severity of each attack may vary, they all eventually get better on their own.

Reducing the Impact of Gout Attacks

Gout can’t really be cured, but there are ways to reduce the frequency, severity, and duration of gout attacks. You’ll need to adjust your lifestyle and take the appropriate medications for this.

Recognizing your individual triggers is the first step because every patient has unique underlying causes for their gout.

Recognize and avoid your triggers. Gout attacks may be triggered and worsened by a variety of foods, including red meat, seafood, fatty foods, alcohol, and sugar.

Keep a healthy weight and exercise routine. When you are overweight or obese, your body produces more uric acid. Maintaining a healthy weight may aid in weight loss.
Keep hydrated. Drinking at least eight glasses of water per day is good health advice in general, but it may also help reduce your risk of gout flare-ups.

Address any underlying health concerns. Gout has been linked to several other health problems, including high blood pressure, diabetes, heart disease, and kidney disease.
Check that you’re taking the correct medications. In addition to starting you on new gout medications, we’ll review any current medications you’re taking. Gout flare-ups may be exacerbated by aspirin and diuretics used to treat high blood pressure.

Procrastination Is Not a Strategy to Help Fight Gout

The longer you wait to treat your gout, the more severe and frequent your attacks will be. Your first flare-up should be a wake-up call to start living a healthier lifestyle. If you don’t deal with it now, dealing with it later when the attacks have worsened will be more difficult.

Getting your gout under control will not be accomplished overnight. We will do our best to get you back to living your best life by working closely with you to identify your individual triggers and providing the right medication for you.

Although you must learn to live with gout, you do not have to live with all its consequences all of the time. You may reduce the severity of your gout attacks and live a more normal, pain-free life. However, it will entail a few changes in your lifestyle and habits.

Get in touch with your doctor today if you need help getting your gout and/or osteoporosis symptoms under control.