Gout is triggered by low lead

Jacob Schor ND

August 21, 2012


Summary: Lead in the body, even in small amounts, may trigger gout attacks.



Treating patients with gout is usually straightforward. Tell them to avoid foods high in purines and start them on a few supplements that block uric acid formation and your job is done.  But sometimes this doesn’t work. A new study from Stanford University provides a possible explanation why.


Gout is an excruciatingly painful form of arthritis caused by the buildup of uric acid crystals in the joints.  Purines found in foods are converted to uric acid by the enzyme xanthine oxidase.  Typically we tell the patient to cut down on meat, seafood, and alcohol, particularly beer, as they all contain significant amounts of purine.  More recently, fructose found in fruits, juices and in high fructose corn and agave syrups has also been linked to gout episodes, so patients are also told to avoid these foods.


Patients following this diet usually have fewer and milder attacks, but if this doesn’t work we are going to start testing for lead in their blood. According to a study published August 21, 2012 in the Annals of Internal Medicine, even tiny amounts of lead increase risk of gout attacks. 


Lead poisoning blocks the excretion of uric acid from the body and increases gout risk. High lead levels, above 80 micrograms per deciliter (mcg/dL), increase gout risk by a factor of 8. The new study, conducted at Stanford University, reveals that even low lead levels, as low as 1.2 mcg/dL, still increase risk.  The researchers analyzed data from 6,153 people comparing their blood lead levels with whether or not they had either symptoms of gout or blood markers associated with gout.


The study participants were divided into 4 groups according to the amount of lead in their blood. The group with the lowest lead had a mean level of only 0.89 mcg/dL.  The group with the highest mean level had 3.95 mcg/dL. While this was about four and a half times as much lead as the low lead group, it is still well with in what the EPA considers acceptable.  For each doubling of lead quantity, the risk of gout increased by 74%.  Overall, the risk in the high lead group was 3.6 times as high as for the low lead group. 


According to the Stanford researchers, “… there is no such thing as a safe lead level.” Any detectable lead is too much.  Yet current national government standard says levels below 10 mcg/dL are acceptable.


This study changes our protocol for treating gout.  We need to put the same effort into lowering blood lead levels as we have devoted to lowering purine.




In unrelated study Harvard researchers reported earlier this year that lead levels as low as 2 mcg/dL lower IQ in children. http://www.wellnesstimes.com/articles/get-lead-out


 Reference: http://annals.org/data/Journals/AIM/24774/0000605-201208210-00001.pdf