Have you ever woken up in the middle of the night because of an intense burning sensation in your big toe?  If so, you might be experiencing gout.  

Gout attacks are most likely to strike at night.  They start out moderately, but gradually get worse.  Most attacks cease after a week, but it is common to have a second attack within 6 months to 2 years later.  Mild attacks are often misdiagnosed as tendinitis or a sprain.  With the progression of the disease, attacks will increase in intensity and persistence.  Severe attacks can cause harm to the cartilage and can have lingering soreness that lasts up to a month.  

There are three stages of Gout.

 The first stage is interesting because symptoms are not visible and many people do not even know that they are in the first stage.  Stage One occurs when the Uric Acid levels increase and start accumulating in the body.  Many times, people become aware of Stage One Gout because they develop kidney stones, which is a result of too much uric acid buildup in the kidneys.  

During the second stage, Gout sufferers begin to experience attacks, generally in their big toe.  In this stage, the attacks do not last long and the time between attacks can be spaced out.  As this disease progresses, attacks evolve in strength, duration, and can even begin to occur in multiple joints.

The third stage is the worst.  Symptoms may be continuous in multiple joints.  Gout sufferers can have tophus, a deposit of urate crystals (Latin meaning: "stone"), that develops on the joints, bones, cartilage, and other places on the body.  Sometimes tophi appears on the outside of the skin as yellowish, white nodules.  This occurrence can limit the function of the joints and cause bone and cartilage destruction.  It could potentially be crippling!  Thankfully, with today's medical advances, few people reach this debilitating stage because they can be diagnosed and treated before the disease progresses this far.

Doctors can test for gout by checking the blood for levels of uric acid.  Another test a doctor can perform is a joint fluid test.  For this test, a doctor draws fluid from the painful joint in order to see if uric acid hard crystals are present.  

You are more at risk for developing Gout if you:   

• Are a man over 30
• Are Overweight
• Have a family member who has been diagnosed with Gout
• Drink too much alcohol
• Eat too many foods with high concentrations of purines.  Examples of high levels include:  anchovies, sardines, liver, beef kidneys, brains, herring, scallops, mackerel, game meats, and beer (due to the yeast).  Moderate examples are: beef, pork, poultry, other fish and seafood, asparagus, cauliflower, spinach, mushrooms, green peas, lentils, dried peas, beans, oatmeal, wheat bran, and wheat germ.
• Have an enzyme defect that makes it hard for the body to break down purines
• Are exposed to lead in the environment
• Have had an organ transplant
• Use some medicines such as diuretics, aspirin, cyclosporine, or levodopa
• Take the vitamin niacin.