What Is The Mystery Of The Gout: “Black Box Theory”?


As time goes by, despite the great advancements in the medical field, it is said that gout is still an obscure medical condition. As a matter of fact, the site where gout can possibly occur is usually unknown or unpredictable. Moreover, even the complications of this illness are not yet fully understood.

On the other hand, since gout is said to be filled with mystery, did you know that you can suffer from gout even if you have a normal uric acid? Yes, you read it right. As a matter of fact, in this article, you will learn more about gout and the possible reasons for having gout despite the fact that you have a normal level of uric acid.

What is Uric Acid Level?

Uric acid is said to be the leading factor that affects the occurrence of gout. As a matter of fact, it is the end product of the purine metabolism which is found throughout the body. Purine is said to be one of the building blocks of our DNA and it can be obtained from the foods that we eat because they contain purine. On the other hand, purine cannot be excreted on our body unless broken down into uric acid. Thus, normal level of uric acid in our body is very important as it acts as an indicator whether you are healthy or not.

If you want to know the levels of uric acid within your body, there are two ways to do it. The first one is through the uric acid urine test which can be done by collecting urine within the entire 24 hour period. Hence, it is expected that there will be 250 to 750 mg of the uric acid level per day to indicate that you have a normal uric acid level. On the other hand, the second method is through the uric acid blood test. In the uric acid blood test, the indication of a normal uric acid level varies from the person’s sexual orientation. So if you are a female, your normal uric acid level is ranging from 2.5 to 7.5 mg/dL and if you are a male your normal uric acid level will range from 4.0 to 8.5 mg/dL.

However, as what said earlier, people having normal levels of uric acid are still prone to the occurrence of gout. As a matter of fact, the occurrence of gout is ambiguous as it does not occur in others that far exceeds the normal levels of uric acid. Hence, the “gout block box theory” takes place.

The Gout Black Box Theory

A gout attack is surely an unpredictable attack, hence it is often characterized as a mysterious black box used in magic shows. People will never know the things happening inside the box and surely they will never predict the things that will appear from it. Same goes for the uric acid levels in our body. We’ll never know when it is really normal and when it is really not. Sometimes, your supposedly normal uric acid level can depart from the recommended levels that are needed by your body.

Hence, there are two main reasons that can trigger gout even with normal uric acid level:

  • Your Uric Acid is hidden – the levels of uric acid within our body are very essential. As a matter of fact, if both serum and the uric acid level are below average and you have gout, your uric acid is possibly hidden. This is possibly due to the formation of tophaceous deposit some time ago, thus placing the uric acid in the joints.
  • Your normal uric acid level is different from the average range – every people have a different body composition wherein the solubility of uric acid may vary from individual to individual due to the existence of different solutes in the blood. For instance, a person known to have a high sodium diet has a lower supersaturation point for uric acid crystals resulting in gout. Moreover, people with low kidney filtering capacity can reduce uric acid excretion rate. In addition, the uric acid output rate can possibly be reduced if your body is too acidic. Thus, these reasons can trigger not just gout but any other diseases related to the uric acid levels in the body.


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