Skip to main content


All information on gout

At a glance

The term gout (also uricopathy or arthritis Urica) stands for a metabolic disease, the cause of which is an increased serum uric acid level(hyperuricemia). Gout is therefore a result of too much uric acid in the blood, which is deposited in crystal form in the joint skin. Women and men are affected about equally often, but women often only develop gout after menopause , as estrogens act as a protective factor until then.

Further information

If the uric acid concentration in the blood rises permanently above a value of 6.4 mg/dl or if the body temperature and/or pH value drop, then uric acid crystals in the form of sodium urate can precipitate. The uric acid salt triggers a series of inflammatory processes. The immune system reacts to the crystal deposits as it does to invading foreign bodies. The big toe is particularly frequently affected by gout. This is due to the fact that the big toe base joint is the coldest part of the body. The temperature there can vary by up to 10 degrees Celsius.

A distinction is made between primary and secondary hyperuricemia.

The primary form can be attributed to a genetic disorder in most patients (99%). Only in 1% an increased endogenous uric acid formation is the cause.

Secondary hyperuricemia develops as a result of a disease in which the renal excretion of uric acid is impeded. These include, for example, renal insufficiency and diabetes.

Typical symptoms are aching, sometimes also swollen, reddened joints. The pain is not triggered by the uric acid crystals directly, but by the inflammatory reaction caused. The inflammation also leads to a pH lowering in the tissue, which in turn ensures that even more uric acid is precipitated.

Through a consistent change in diet and the optimization of other lifestyle factors, the uric acid level in the blood can usually be well controlled. It is primarily necessary to normalize body weight, to limit purine intake with food, to refrain from alcohol consumption and fructose-rich drinks as far as possible, and to ensure a sufficient supply of fluids.

From the point of view of urine diagnostics, monitoring the pH value in the urine is very useful for high-risk patients . Permanent acidification of the body (latent acidosis) increases the risk of gout crystals failing and causing an attack of gout. A regulation of the pH value via a change in diet and, if necessary, medical help is an important measure in this case.

In addition to the risk of gout, increased blood and urine uric acid levels also increase the risk of forming urine stones containing uric acid.


  • Schroeder, U. et al. (02/2017):Übersäuerung – basische Ernährung– Entschlackung, Tritime Magazine
  • Neogi T et al. (2015): Gout Classification Criteria. An American College of Rheumatology/European League Against Rheumatism Collaborative Initiative. Arthritis Rheumatol, 2557-2568
  • Roche Diagnostics Deutschland GmbH (2009): Nierendiagnostik Grundlagen der Labormedizin, 1-60
  • Stetka, B. (2016): Nutrition in gout: “A lack of understanding and a lot of misinformation”, URL:
  • Mutschler, E. et al. (2013): Arzneimittelwirkungen. Lehrbuch der Pharmakologie und Toxikologie. 10. Aufl., Wissenschaftliche Verlagsgesellschaft, Stuttgart
  • Herdegen, T. (2014): Kurzlehrbuch Pharmakologie und Toxikologie. 3. Aufl., Georg Thieme Verlag, Stuttgart
  • Bruhn, C.: Preventing gout attacks, URL:
  • Goraya, N., Wesson, D. E. (2012): Acid-base status and progression of chronic kidney disease, Curr Opin Nephrol Hypertens, 21(5):552-6
  • Akute Gicht in der hausärztlichen Versorgung. S1-Leitlinie der Deutschen Gesellschaft für Allgemeinmedizin und Familienmedizin (DEGAM), AWMF-Registernr. Phone 053/032B
  • Matzik, S. & Fux, C. (2018): Gout, URL:
  • Acid-Base Guide: Gout Patients, URL:
  • Flückiger, A, Brühlmann, P. (2009): Die Therapie der Gicht, Rheuma 44
Status of information: 2022