Rhea Rogers says gout pain stems from immune response to uric acid crystals

Dr. Rhea Rogers, a board-certified physician, detailed the mechanical process behind gout on the program Aging Untold. She stated that uric acid accumulates in the blood, leading to crystal formation in joints and tissues. This buildup triggers an inflammatory and painful response, according to Rogers.

Gerontologist Sam Cradduck described the physical sensation based on her experience with her youngest daughter, who has suffered from the condition twice. Cradduck said her daughter describes the pain as feeling like a shard of glass. The discomfort is so intense that even walking near the affected foot causes pain, Cradduck noted. She clarified that the crystal itself is not the source of the suffering.

“It’s not actually the crystal. It’s the immune system that’s coming after to attack that,” Cradduck said. Rogers agreed with this assessment, explaining that the immune system identifies the crystal as a foreign object and launches an attack. This biological reaction is what generates the severe pain associated with the condition.

Rogers indicated that elevated uric acid levels often signal underlying metabolic issues. She described the condition as a marker for other health problems. Many patients with gout also present with insulin resistance, diabetes, or cardiovascular issues, Rogers said. Uric acid reduces nitric oxide, a substance that helps arteries relax. This mechanism is similar to the process involved in atherosclerosis, or the hardening of the arteries, according to Rogers.

“It’s the same mechanism that’s involved with atherosclerosis, or hardening of the arteries,” Rogers said. “That’s why it’s so significant to recognize.” She explained that men typically develop gout more frequently than women due to differences in estradiol levels. Estradiol offers protection against the condition. Premenopausal women have higher levels of this hormone, while men produce it through the conversion of testosterone.

As men age, testosterone levels decrease and visceral fat often increases, according to Rogers. For women, the risk profile changes after menopause. “After menopause, when the estradiol drops, then that gap closes,” Rogers said. Aging well coach Katherine Ambrose noted that gout has historically been called “the disease of kings” due to its association with rich foods and alcohol. However, Rogers emphasized that sugary foods and drinks rapidly raise fructose levels, which pushes insulin high and helps the body retain uric acid.

Treatment options include the medication allopurinol, which lowers uric acid. Rogers also mentioned that vitamin C, quercetin, and lutein can naturally lower uric acid levels. Some products combine these three ingredients for that purpose. Aging expert Amy O’Rourke advised that men often delay seeking treatment compared to women. She suggested that family members encourage male relatives to see a doctor if symptoms appear. The program noted that the information is for educational purposes and does not replace professional medical advice.