4 Stages of Gout: Which Stage Are You In?

Medical professionals have broken down the development of gout in four stages, how the disease can evolve over time. First stage is what they call Asymptomatic Gout the stage where somebody develops hyperuricemia which is higher uric acid levels in the blood, the body becomes increasingly acidic but no symptoms are present.

At this stage, uric acid crystallizes and silently accumulates in the joint. Treatment is not required at this stage and no medication is required but if you do find out by taking a blood test, that you do suffer from hyperuricemia, a change in your diet should take place immediately.

Second stage is the very first gout attack. What they call Acute Gout or Acute Gouty Arthritis. Yes your first time comes as a shock and is excruciatingly painful causing severe inflammation and severe pain in the joint. Before that night, where you got your gout attack, you may have consumed something like seafood, organ meat, had too many Cokes or had a night of drinking that raised your uric acid levels which triggered your gout attack.

Even stress or the presence of another illness can cause it too! The pain will escalate over the next 8 to 12 hours making walking very difficult. Generally, this gout attack will be in the big toe area and will feel like a broken foot. The inflamed area will be reddish and you can experience a slight fever or even chills.

You should find some relief after three days but symptoms can hang around up to 10 days and sometimes even longer. These attacks can then become more severe and prolonged if nothing is done about them. The next acute attack can take months or more than a year to reoccur. Over time, however, attacks can last longer and occur more frequently.

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Disease progression of gout

Next up is the third stage, what they call Intercritical Gout or Interval Gout which is the period of time in between gout attacks where you feel no symptoms and your joints function properly. Life is great and you feel great but everything is just an illusion! For most gout sufferers, uric acid in the blood remains high and the crystals remain in the joint.

The truth is gout hasn’t gone away and the low levels of inflammation between attacks may be causing you joint damage even if you do not feel any symptoms or pain. In addition, a low level of inflammation could be associated with the risk of developing heart disease or even a stroke! These delayed attacks can be far more threatening than the initial attack and will move to different joint areas such as the Achilles area. It is essential to seek proper medical treatment for the disease and change your lifestyle through proper diet and exercise to avoid and/or prevent any future gout attacks.

Finally, we end it with the final and fourth stage, what they call Chronic Gout or Chronic Tophaceous Gout which is the stage you definitely want to avoid at all costs. At this stage gout becomes disabling and occurs after many years of suffering that can be associated with irreversible damage to the affected joints, damage to your kidneys and even death!

Over time gout attacks become longer and more frequent. This is the worst and most destructive stage due to the fact that you can develop tophi causing the destruction of the affected bone and cartilage to occur. This stage usually occurs after 10 years if the disease hasn’t been treated properly and no lifestyle changes were implemented. With proper treatment most gout sufferers do not progress to this stage and thank goodness for that! It is critical that you treat gout in the earlier stages.

Posted by Spiro Koulouris

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    7 replies to "Stages of Gout"

    • Daniel

      Hi Spiro,

      I’m on my second, I’d say, flare up. I’ve had a few small ones that would last a day or two that I really should have paid attention to but just thought I was lucky and moved on with my day. Well here I am hating life wanting to rip my toe off. I have done some research and read a lot of your articles but I still cannot get past this pain.

      It’s been about 8 days now but starting the 2nd or 3rd day I began doing most of the recommended things to reduce my uric acid levels. About 3 cups or black or tart cherry juice a day, 1000mg celery seed extract 2x a day, 400mg magnesium a day, nettle and my prescription of 100mg alpurinol a day. All of this and it only seems the sweeling and pain is getting worse.

      I am at a loss, I don’t know what to do. I work on my feet and can’t afford to take time off but I can barely walk. What else can I do? I don’t see my doc for another 12 days and had to plead just to be put back on my meds because I hadn’t filled the prescription in so long. Any further advice would be appreciated.

      Thank you

      • Spiro Koulouris

        Hi Daniel!

        When suffering from a gout attack, natural remedies don’t work as fast, they take longer to help compared to medication. You can try our inflammation cream that we sell on the store and is very popular, you apply it up to 4 times a day to help remove some swelling and make walking bearable. Try soaking your feet in warm water twice a day with Epsom salt to relax the muscles. Drink at least 12 cups of water daily to flush out excess uric acid. You can also take some ibuprofen, takes some pain away, again making walking more bearable. As gout sufferers we’ve all been there.

        Good luck!

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    • Bev

      Hi Spiro

      I m 67, female and got blindsided by gout last summer. I m vegetarian and was working on reducing my weight ( got from 220ish to 180ish), drank a couple of Molsons 67 ( 3%) a day when one day last summer I thought I broke my toe, just as you describe. Went into full panic and research mode, like you and found such conflicting information I was hysterical for a while, especially about purines in veggies. I had a severe fever and was extremely emotional which seems shocking now. My doctor means well but isnt much help. I dont want another of those attacks ever!

      Back then I ate the odd lobster or tuna but now stick to veggies. And a bit of butter and cheese though if I have another attack they ll go too. Still trying to lose weight but avoiding extremes; make lots of salads with home made ginger dressings, drink apple cider vinegar water several times a day and cherry juice, indulged a bit in sweets over the holidays but havent had a coke in decades; no glucose/fructose. Am frightened by the aging issues and inflammation which I had no idea about before this. Do have high blood pressure thankfully treated and am trying to avoid cholesterol meds.

      The experts apparently don t know much about this ancient condition and the blogs are few and far between. Your blog is consistently the best and I want to say a heartfelt thank you. Also great that you re Canadian too! However you are also a young man and I d be interested in learning how other older women manage as there seem to be few of us and there may well be gender differences. I cant read comments on your entries; do I need to do something more than subscribe which I do?

      Again thank you for sharing this precious resource you ve created! I m so happy every time your newsletter appears! Keep it up and I ll nominate you for a national award. Cant believe there s so little research on this destructive disease!

      • Spiro Koulouris

        Thank you for the kind words and feedback!! Yes alcohol is a common villain in triggering gout attacks, so stay off it. Avoid lobster completely, that’s what I do, I don’t eat any shellfish anymore and if you do, eat it at your own risk. As for more information concerning women and gout, please read my post on that topic–> https://goutandyou.com/gout-and-women/ . Do note that women represent a much smaller segment of gout sufferers since the vast majority are men so there is less information on women and gout compared to men.

    • […] The 4 stages of gout […]

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