#811 Worst time to check gout with a blood test (when you have pain) - DOC

#811 Worst time to check gout with a blood test (when you have pain)

When is the worst time to check for gout with a blood test? Well, that’s what we’re talking about today on the Doc On The Run Podcast.



If you get gout, it’s going to be painful and what gout is in short, is that you get so much uric acid built up in your bloodstream that it starts to crystallize, and it actually forms little bitty needle shaped crystals in the joint.

They’re pointed, they’re sharp, they are needle shaped and they’re poking the tissue on the inside of the joint, the synovial tissue and it hurts. So, if you get an attack of gout, when you have pain, that is actually the worst time to check for gout.

Why? Let me explain, it’s really simple. When you get gout what’s happening is that uric acid is building up over time in your bloodstream. The level that we check with a blood test is getting higher and higher and higher, until you have an attack of gout because the crystals are not in your joint when they’re in your bloodstream.

They’re in your bloodstream and they’re dissolved. They’re not actually crystallized. You just have molecules floating around, they’re getting to a higher concentration, and then when the concentration in your blood is high enough, it crystallizes, usually in a joint, like the big toe joint, it becomes red. It’s hot. It’s painful, it’s swollen.

But at that point, those molecules of uric acid that were flooding around your bloodstream are now in the joint sitting there in the form of crystals. They’re not in the blood anymore. So, if you have pain and you go see your doctor, and they say, “Oh, maybe you have gout, we’re going to check for it. We’re going to draw some blood and we’ll see we’ll call you back later.”

Well, they take the blood out of your arm, and then it looks like your level is maybe normal, or maybe a little bit high, but not really, really high. So the doctor says, “Well, you know, the it’s not that high. So, we don’t think you have gout.” But the way to check better is to actually take some fluid out of the joint and look at it, but that’s not what most primary care physicians do in most emergency room physicians, they just draw some blood and look for a high level of uric acid and check it.

So, if you suspect that you might have been missed in terms of having gout, what you’re going to want to do is try to get your doctor to check it several times. And so, if your pain goes away over time, like maybe periodically you check and those levels are going up and up and up, then you might actually be really high risk for getting attack of gout. And obviously, if you have gout, you can’t even sleep with the bed sheets on it. You’re not going to be going for a run.

But hopefully this helps you understand a little bit about why it’s important that you think about the timing of a test for gout if you really suspect that that might be causing the pain in your foot.

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