Article by Dr. Misako Mcleod, DPM 

Gout is a very common problem – and a very painful one! Many people experience gout attacks which commonly affects the big toe joint, but can affect other joints and tissues as well. Usually, the big toe joint will be the first to be affected and will suddenly become red, hot, swollen, and very painful. It usually occurs at night or the early morning.

Gout can affect other areas of the body long term and should not be disregarded as just a “one-time” problem. Gout can affect the kidneys, joints, and tissues, so it needs to be managed long-term by either an internal medicine doctor or rheumatologist. Gout is usually controlled by dietary changes and medications.

What happens with Gout?  

First, gout is caused by deposits of crystallized uric acid in the joints and tissues. Uric acid is normally present in the blood from the break down of purines which are found in foods such as meat products, shellfish, wine, and other foods. The uric acid crystals tend to precipitate out in the big toe.


High purine level foods should be avoided such as:



Other risks factor for developing gout include: high blood pressure, diuretics, obesity, surgery, chemotherapy, stress, certain vitamins and medications. Gout tends to occur in men 40-60, but can occur in post-menopausal women as well.

When being evaluated for gout, Dr. McLeod will usually perform the following:

Gout usually resolves in 3-10 days with treatment. However, if there are repeat attacks, long term medication may be considered. It is important to manage gout to prevent kidney damage and joint damage long-term and referral to a rheumatologist may be warranted. Rememeber gout is not something that should be ignored and a through evaluation is necessary.


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