Obese people are 4 times more likely to develop gout than those of normal weight.


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Gout Symptoms and Stages of Severity

Gout can occasionally be difficult to diagnose because the symptoms of gout mimic several other conditions. To confirm a diagnosis of gout, a medical professional will take a sample of fluid from the inflamed joint and will view it under a microscope. If a patient has gout, urate crystals will be evident. The absence of crystals, however, does not completely rule out a diagnosis of gout.

Gout Symptoms

Gout symptoms are most often felt in the large joint of the big toe, but can affect other joints such as:

  • Instep
  • Ankle
  • Heel
  • Knee
  • Achilles tendon
  • Wrist
  • Finger
  • Elbow

Stages of Gout

There are four stages medical professionals use to classify the severity of gout in a patient. With proper management of lifestyle and medication, it’s possible to avoid the latter stages and the health consequences that go along with them.


Stage 1 – Asymptomatic Hyperuricemia


  • Elevated levels of uric acid
  • No symptoms of gout
  • Treatment usually not necessary.

Most people will have elevated levels of uric acid for many years before their first attack. Many people with elevated uric acid will never have an attack. The risk of an attack increases as the uric acid level increases.

Stage 2 – Acute Gout Attack


  • A gout attack awakens someone at night by intense pain and swelling in the joint
  • Pain goes away (even without treatment) after three to 10 days
  • This is the time to see a physician to obtain appropriate therapy and to rule out another form of arthritis as the cause of the painful joint.

Another gout attack may not occur for months or years.

Stage 3 – Intercritical Gout


  • Symptom-free period between attacks
  • Joints functioning normally
  • Consult your physician to:
    • Determine if any medications you are taking may aggravate the condition
    • Review dietary guidelines for gout
    • Assess alcohol intake and if there is need to cut back
    • Assess BMI and if there is a need to lose weight
    • Discuss therapeutic options to prevent or treat future attacks.

Unfortunately, if ignored, this phase is frequently followed by continued attacks of gout. Despite a lack of symptoms, there is ongoing inflammation. A low level of inflammation may be associated with risks for heart disease and stroke.

Stage 4 – Chronic Tophaceous Gout


  • This is the stage of chronic arthritis
  • Deformity and destruction to affected bone and cartilage occur
  • Kidney damage is possible
  • An ongoing destructive inflammatory process is active.

With proper medical attention and treatment, most gout patients will not progress to this advanced, disabling stage.