Why Does Gout Attacks Almost Always Happen In The Big Toe?
Gout attacks can happen in any joint in your body, but some are more susceptible than others. The most common body parts for flareups seems to be those where there are most small bones, joints, and ligaments. That means your hands and feet.
Big toes are susceptible for three reasons, as far as I can find. They have a fairly high amount of blood vessels and nerves, so when the blood vessels expand during the inflammation, they put pressure on the nerves. That is the immediate cause of the pain.
The inflammation comes because the big toe is the part of your body that is farthest from your heart, so the blood is a little colder and the blood flow is not as strong, which means the uric acid in the blood can start to crystallize there.
And the third reason is that they have lots of connective tissue, which seems to be where uric acid crystals like to form.
Gout attacks happen only where there is uric acid crystals, but arthritis (which is like gout without uric acid) can happen in any joint.
The inflammation comes because the big toe is the part of your body that is farthest from your heart, so the blood is a little colder and the blood flow is not as strong, which means the uric acid in the blood can start to crystallize there.
And the third reason is that they have lots of connective tissue, which seems to be where uric acid crystals like to form.
Gout attacks happen only where there is uric acid crystals, but arthritis (which is like gout without uric acid) can happen in any joint.
URIC ACID KEEPS STORING UP
Your body produces the pain promoters in gout. But uric acid creation does not stop because you stop eating meat. Since your body produces its own uric acid by using purines from recycled cells, you could have a gout attack even if you ate nothing and did not drink enough water, so the concentration of uric acid in your blood went up. You are not out of the risk zone until you have lowered the level of uric acid in your blood and kept it low for a few weeks, or even months.
One lowers it by flushing it out, the other lowers production.
If you just lower production you will still have uric acid in your body which only gets flushed gradually; if you flush it out without lowering production your body will just create more when you flush it out.
One lowers it by flushing it out, the other lowers production.
If you just lower production you will still have uric acid in your body which only gets flushed gradually; if you flush it out without lowering production your body will just create more when you flush it out.
UA STORAGE IN THE FEET
Here is another reason the big toe is ausceptible to gout attacks. When your body has had a concentration of uric acid which is over the crystallization threshhold for some time, the uric acid crystals get stored in the connective tissue, mostly in the feet. It seems uric acid crystals have an affinity for connective tissue or ligaments, although nobody has really figured out why. But once the UA level has been high enough for a sufficiently long time, the gout attack will start and those crystals will contribute to the gout attack, making it last longer.
WHAT TRIGGERS THE GOUT ATTACK
There is no one trigger for gout, unfortunately. Gout attacks can be triggered by dehydration, trauma to the foot (usually), weight loss, sugar intake, high- purine foods (may even be several days ago), I could go on.
What happens is that if you have more than 6.8 mg/dL of uric acid in your blood for an extensive time, and this gets stored in the connective tissue as uric acid crystals (actually monosodium urate). When there is an event that releases crystals into the joint, or which promotes more crystal formation than the connective tissue can store (like dehydration), then the crystals collect in the connective tissue and you have a gout attack when your immune system tries to chase them down and get rid of them.
What happens is that if you have more than 6.8 mg/dL of uric acid in your blood for an extensive time, and this gets stored in the connective tissue as uric acid crystals (actually monosodium urate). When there is an event that releases crystals into the joint, or which promotes more crystal formation than the connective tissue can store (like dehydration), then the crystals collect in the connective tissue and you have a gout attack when your immune system tries to chase them down and get rid of them.
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