Join Our Thyroid Awareness Campaign this January!

January is Thyroid Awareness Month

Join us this January to spotlight thyroid health. Participate, share, and spread awareness for a chance to win exciting prizes!

Gout and Hypothyroidism

A look at the connection between the painful joint condition known as gout and hypothyroidism.
Gout and Hypothyroidism
Last updated:
9/18/2023
Written by:
Medically Reviewed by:

In this article

Gout and hypothyroidism may seem like unrelated health conditions, but they actually have a close relationship. Gout is a form of arthritis caused by the buildup of uric acid crystals in the joints.

On the other hand, hypothyroidism is a condition characterized by an underactive thyroid gland. The thyroid gland does not produce enough thyroid hormones. The thyroid hormones are crucial in regulating various bodily functions, including metabolism. When levels of these hormones are low, it can slow down the body’s processes, leading to fatigue, weight gain, and muscle and joint pain, including gout.

Understanding the connection between these two conditions can lead to better management and treatment options for individuals experiencing symptoms related to both.  Ahead, a look at gout and the link to an underactive thyroid.

What is gout?

Gout is a form of inflammatory arthritis typically caused by the overproduction or underexcretion of uric acid in the body, a condition known as hyperuricemia. Uric acid is a waste product produced when the body breaks down purines found in the body and the foods we eat. Uric acid is usually filtered out by the kidneys and excreted by the kidneys in urine. However, in individuals with gout, the body produces too much uric acid, has impaired renal function, or has difficulty eliminating uric acid. Excess uric acid leads to a buildup of uric acid crystals in the joints. Gout most commonly affects the joints in the big toe but can also occur in other joints, such as the ankles, knees, elbows, wrists, and fingers.

The intense pain, swelling, and inflammation associated with gout can be debilitating and last several days or weeks. Dietary and lifestyle factors, as well as certain medical conditions, can contribute to the development of gout. Treatment typically involves medications to manage pain and inflammation and lifestyle modifications to reduce uric acid levels in the body.

What are the symptoms of gout?

Gout symptoms typically include sudden and severe pain, swelling, redness, and tenderness in the joints, most commonly in the big toe. The affected joint may also feel warm to the touch and become stiff. Gout attacks usually occur suddenly, often at night, and can last a few days or several weeks. Some individuals may experience recurring gout attacks, while others may have periods of remission with no symptoms.

What are the long-term complications of gout?

The long-term complications of gout can be significant and may impact multiple aspects of a person’s health. One of the main complications is the development of joint damage and deformities, which can lead to chronic pain, stiffness, and limited mobility. In some cases, gout can affect a person’s ability to walk, work, and perform everyday tasks. Gout can also contribute to the development of kidney stones and, in some cases, chronic kidney disease.

Additionally, gout increases the risk of developing other health conditions such as hypertension, heart disease, and diabetes. These complications can profoundly impact the overall quality of life and require ongoing management and treatment to prevent further damage and reduce the risk of future gout attacks.

How is gout diagnosed?

Gout is typically diagnosed using a combination of medical history, physical examination, and laboratory tests. The doctor will ask about the symptoms experienced by the patient, such as sudden and intense joint pain, swelling, and redness. They will also inquire about any risk factors or medical conditions that may increase the likelihood of developing gout.

During a physical examination, the doctor should assess the affected joint for tenderness, inflammation, and tophi (deposits of uric acid crystals).

To confirm the diagnosis and rule out other possible causes of joint pain, laboratory tests such as blood tests to measure serum uric acid levels, joint fluid analysis to check for uric acid crystals or imaging tests like X-rays or ultrasound may be conducted. Combining these approaches helps diagnose gout accurately and determine the most appropriate treatment plan.

What is the relationship between gout and hypothyroidism?

So, how are gout and hypothyroidism related? Research suggests that patients with hypothyroidism have an increased risk of developing gout. One study examined the relationship between gout and hypothyroidism and found that the prevalence of hypothyroidism was significantly higher in patients with gouty arthritis compared to the control group of euthyroid subjects (patients with normal thyroid function). In general, 15% of the patients with gouty arthritis had hypothyroidism, with higher rates in women than men. The mean TSH of the gouty patients was also significantly greater (TSH of around 5.2) compared to the control patients (TSH of about 1.8). The study also suggested that screening for hypothyroidism should be considered in all patients presenting with gout or a history of recurrent gouty flares.

This link connection may be due to the influence of thyroid hormones on uric acid metabolism. Thyroid hormones play a role in regulating enzymes involved in the breakdown and elimination of uric acid. A deficiency of these hormones in individuals with hypothyroidism can lead to reduced enzyme activity, impairing uric acid clearance. As a result, uric acid levels in the blood increase, increasing the risk of gout development.

How is gout treated?

Managing gout in hypothyroid patients requires a comprehensive approach that addresses both conditions simultaneously. In the case of hypothyroidism, hormone replacement therapy is the primary treatment. This treatment restores thyroid hormone levels to normal in the body. Regularly monitoring thyroid hormone levels and adjusting medication dosage are essential to manage hypothyroidism effectively. While treating hypothyroidism does not directly resolve gout, optimal thyroid treatment may help improve the response to gout treatment.

Gout is typically treated through a combination of medication and lifestyle changes. The primary goal of treatment is to manage the pain and inflammation associated with gout attacks, as well as to prevent future attacks and reduce the risk of complications.

Nonsteroidal anti-inflammatory drugs (NSAIDs) are often prescribed to alleviate pain and reduce inflammation during an acute gout attack. Colchicine is another medication that can relieve pain and inflammation associated with gout. Corticosteroids can help decrease inflammation, relieve gout pain, and may help slow damage to the joints.

Additionally, medications such as febuxostat (Uloric) and allopurinol (Zyloprim) may be prescribed to lower uric acid levels in the body and prevent the formation of urate crystals that cause gout.

An important note about allopurinol (Zyloprim)

Hypothyroidism patients and their practitioners need to be aware that long-term use of allopurinol, a common medication used to treat gout, is associated with increasing thyroid stimulating hormone (TSH) levels. Researchers have concluded that the use of allopurinol may induce mild or subclinical forms of hypothyroidism. It’s also possible that in a patient with hypothyroidism, long-term treatment with allopurinol may require adjustments of thyroid hormone dosage to maintain optimal thyroid treatment.





What dietary changes are recommended for gout?

Patients with gout should also make the following dietary changes to manage their condition effectively:

1. First, it is important to reduce the intake of purine-rich foods, as purines can raise uric acid levels in the body, leading to gout flare-ups. Purine-rich foods to avoid or limit include:

  • Organ meats, such as liver, kidneys, and sweetbreads
  • Seafood, including anchovies, sardines, mackerel, and herring
  • Game meats, like venison, rabbit, and pheasant
  • Beer
  • Yeast extracts, such as Marmite and Vegemite
  • Specific vegetables that have moderate levels of purine, including asparagus, cauliflower, spinach, and mushrooms
  • Sugary drinks, particularly those containing high-fructose corn syrup

2. Second, increasing the consumption of low-fat dairy products such as milk, yogurt, and cheese can help lower the risk of gout attacks. These products contain compounds that are believed to reduce uric acid levels.

3. Third, opt for a diet rich in fruits, vegetables, whole grains, and nuts, as these foods are associated with a lower risk of gout.

4. Finally, it’s important to stay well-hydrated by drinking adequate water each day to help flush out uric acid from the body.

A note from Paloma

Patients with gout should get regular thyroid screening to monitor any changes in thyroid function. The Paloma Home Thyroid Test kit can make it easy and affordable to get a complete thyroid panel from the comfort of your home.

If you have both hypothyroidism and gout, working closely with a healthcare professional to develop an individualized treatment plan that addresses both conditions is crucial. By effectively managing both gout and hypothyroidism, you can enjoy improved quality of life and reduce the risk of complications associated with these conditions.

For diagnosis, management, and optimized treatment of their hypothyroidism, more thyroid patients are choosing to work with Paloma’s top thyroid doctors. Paloma’s thyroid-savvy team of practitioners work with you to develop an effective treatment plan, including thyroid medications and lifestyle changes that can safely normalize your thyroid function for optimal health.

Because nutritional changes are also a key component of treatment for gout, you may want to schedule a consult with one of Paloma’s registered nutritionists. As experts in healthy eating, our experienced nutritionists can help you make nutritional choices to support your overall health.

References:

See, C., Kuo, F., Yu, H., Luo, F., Chou, J., Ko, S., Chiou, J., & Liu, R. (2014). Hyperthyroid and Hypothyroid Status Was Strongly Associated with Gout and Weakly Associated with Hyperuricaemia. PLOS ONE, 9(12), e114579. https://doi.org/10.1371/journal.pone.0114579 https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0114579

Choi W, Yang YS, Chang DJ, et al. Association between the use of allopurinol and risk of increased thyroid-stimulating hormone level. Scientific Reports. 2021;11(1):20305. doi:https://doi.org/10.1038/s41598-021-98954-1 https://www.nature.com/articles/s41598-021-98954-1

Erickson, Alan et al. The prevalence of hypothyroidism in gout. American Journal of Medicine. Volume 97, Issue 3, September 1994. DOI:https://doi.org/10.1016/0002-9343(94)90005-1. https://www.amjmed.com/article/0002-9343(94)90005-1/abstract

Gout | CDC. www.cdc.gov. Published August 16, 2021. https://www.cdc.gov/arthritis/types/gout.html

Complications of Gout – American Kidney Fund. www.kidneyfund.org. Published November 5, 2021. https://www.kidneyfund.org/living-kidney-disease/health-problems-caused-kidney-disease/gout/complications-gout

Hainer BL, Matheson E, Wilkes RT. Diagnosis, treatment, and prevention of gout. Am Fam Physician. 2014 Dec 15;90(12):831-6. PMID: 25591183. https://pubmed.ncbi.nlm.nih.gov/25591183/

Nancy Garrick DD. Gout. National Institute of Arthritis and Musculoskeletal and Skin Diseases. Published April 12, 2017. https://www.niams.nih.gov/health-topics/gout/diagnosis-treatment-and-steps-to-take

Share article:

Mary Shomon

Patient Advocate

Mary Shomon is an internationally-recognized writer, award-winning patient advocate, health coach, and activist, and the New York Times bestselling author of 15 books on health and wellness, including the Thyroid Diet Revolution and Living Well With Hypothyroidism. On social media, Mary empowers and informs a community of more than a quarter million patients who have thyroid and hormonal health challenges.

Read more

Is Paloma Right For Me?

Hypothyroidism is a long-term commitment and we’re committed to you. Schedule a free, no-obligation phone consultation with one of our intake specialists to find out more.

Schedule a call
thyroid hormone for hypothyroidism

Find out if Paloma is right for you. Schedule a free call with one of our health care advisors.

Schedule a Call