A growing cohort of people in their 20s and 30s are now afflicted by gout, finds Luke Mintz. In a generation that’s shunning everything from meat to cigarettes, is genetics or lifestyle to blame?
It’s the disease that’s no longer confined to gluttonous medieval kings – gout is now afflicting health-conscious millennials.
Harry Tyndall assumed he’d fractured a bone when he stepped out of bed one morning and wasn’t able to walk on his right foot. Hobbling along to a physiotherapy clinic near his home, the otherwise healthy 28-year-old turned out to be wrong; after one look at his foot, the clinician told him he was suffering from gout – a severe form of inflammatory arthritis, which causes limbs to swell up in size. Harry, who was working as head of sales for a courier firm at the time, was a keen fan of football and travelling, trying to visit a new country each year. The prospect of a disease that would scupper his ability to walk long distances seemed terrifying.
‘I honestly thought I’d been shot back into the Tudor era,’ he said. ‘Not for one second did I ever think I had gout, because I knew it was for people double my age.’
Harry is not alone. Mention gout to most people, and their minds will jump to a few well-worn stereotypes: gluttonous medieval kings who have indulged in too much alcohol, or florid golf club managers with a weakness for rare steaks.
Rarely do we imagine health-conscious millennials who are, as we are frequently reminded, abstaining from meat and alcohol at higher rates than any generation before them. But gout may well be on the rise among this very group, as a growing consumption of sugar and fatty foods leaves them vulnerable to the condition, which can cause immensely painful attacks of arthritis.
A UK study examining 15 years of patient data found that gout diagnoses rose by 64 per cent between 1997 and 2012, with one in 40 people now suffering from the condition. Although most patients are still aged over 60, hospital appointments for those in their 20s and 30s complaining of gout symptoms have increased by 30 per cent since 2012, says the report.
Millennials are the most abstemious generation alive, recent figures suggest, with those born between 1980 and 2000 shunning everything from meat to cigarettes to alcohol.
Meanwhile, the raucous pre-wedding celebrations for so long favoured by brides-to-be are out, now deemed deeply ‘uncool’, as ‘healthy hen parties’ soar in popularity. Yet gout appears to be proliferating. Triggered by a build-up of uric acid in the blood, which goes on to crystallise in bone joints, it usually affects the joint at the bottom of the big toe, leading to the enormous swelling that plagues many sufferers.
The worsening obesity epidemic is believed to be at the heart of the issue, according to Prof Alan Silman, the medical director of Arthritis Research UK. Prof Silman points particular blame at fizzy drinks, and there is almost certainly a genetic factor as well, with around one in 10 patients inheriting the condition from their parents, according to the UK Gout Society.
However, experts do not yet agree on how much of the condition is down to genetics and how much to lifestyle.
An attack of gout, Prof Silman says, is ‘probably the most painful form of severe arthritis there is’. Many of his patients say their besieged joint becomes so tender they can’t even sleep under a bedsheet.
Indeed, it was the pain that Harry remembers most vividly. The big toes in both of his feet swelled up enormously, which made walking something of a ‘major hobbling process’. He remembers being ‘on his hands and knees’ in agony. But what Harry has found even more difficult than the pain is the total change in diet he’s been forced to undertake. ‘This year in particular has been quite frustrating,’ he says. ‘I’ve had gout come up three or four times, and I don’t really know what from. So for the last four or five weeks I’ve actually cut out most dairy [including] ice cream, yogurt, milk, chocolate and cheese.’
He says he hasn’t touched red meat or red wine for twoand-a-half years – though he concedes that a particularly potent sweet tooth used to see him drink whole tubs of ice cream after melting them in the microwave. Needless to say, then, these changes have presented their share of challenges.
Harry’s diet transformation did give him one added benefit, though – an idea for his next business venture. Unable to have any of his beloved dairy or chocolate, he found himself buying pot after pot of hummus.
He has also had to sustain a fair amount of (mostly) wellintentioned banter from friends and family for being struck down by an illness many thought was consigned to centuries past. His work colleagues began to call him Henry VIII when they found out about his gout diagnosis, a nickname shared by his girlfriend’s family, who warned her not to ‘lose her head over him’.
Though he is sanguine about their barbs – ‘you’ve got to learn to laugh about it’, Harry says with a chuckle – it is this embarrassment that can be difficult to overcome for many sufferers, according to Lynsey Conway, of the UK Gout Society.
Harry has also had to sustain a fair amount of (mostly) wellintentioned banter from friends and family for being struck down by an illness many thought was consigned to centuries past
‘People laugh because they think it’s funny, but it’s actually excruciatingly painful,’ she says.
She thinks much greater public understanding is needed, calling for a national awareness campaign to teach people that gout is ‘linked to serious health conditions’ and is ‘not just a lifestyle disease’. Harry is now being treated, and his condition is improving. He takes allopurinol pills each day, which reduces the levels of uric acid in his blood. His acid levels have already dropped from 5.4 to 4.4 mg/dL, and his doctor hopes eventually to get them below 3.5.
Harry will be crossing his fingers as he awaits the results of his latest blood test, but he hasn’t let his potentially inhibiting condition hold him back. He was able to walk up the aisle at his wedding last year, and his wife, Samantha, a radiologist, supports his effort to fend off gout by adopting his diet restrictions whenever they eat together in restaurants – no to steak, yes to vegan pasta.
Harry now wants to warn more people – particularly those of his own age – about the dangers of gout, which he is frustrated remain poorly understood. ‘I think young people just don’t really understand or appreciate what we’re putting into our bodies,’ he says, adding that he hopes his cautionary tale may go some way to changing things.