Gout and Venous Thromboembolism: Are They Related?

Gout and venous thromboembolism (VTE) are two different medical conditions with distinct symptoms, causes, and treatment approaches. However, recent research suggests a potential link between the two. While gout is a type of inflammatory arthritis characterized by sudden, severe attacks of pain and redness, often occurring at night in the big toe, VTE is a term for blood clots that form in veins, typically in the legs, called deep vein thrombosis (DVT). A DVT blood clot can break loose and travel to the lungs, causing a potentially fatal condition called pulmonary embolism (PE). While serious, VTE is often preventable and treatable.

In this blog, we'll delve into the relationship between gout and VTE, including the role of vein disease. Understanding the link between these conditions, their symptoms, risk factors, and treatment options is not just important; it's crucial. This knowledge empowers you to take control of your leg health and prevent serious complications.

Remember, early detection and treatment of VTE can significantly improve outcomes, so it's always better to err on the side of caution and seek medical evaluation if you're concerned. Call CVR’s DVT hotline at 877-SCAN-DVT (877-722-6388) to access their same-day DVT rule-out service.

Understanding Gout

According to the Arthritis Foundation, gout is primarily caused by excess uric acid in the body. This buildup can occur due to several factors, including the body's overproduction of uric acid, the kidneys' inability to excrete it efficiently, or a diet high in purines. Purines are natural compounds found in various foods, particularly red meat, organ meats, certain types of seafood, sugary beverages, and beer.

When uric acid levels become too high, it can crystallize and accumulate in joints, triggering intense pain and inflammation. These gout attacks typically peak within 12 to 24 hours and may subside on their own, but if left untreated, they can become more frequent and severe and involve multiple joints over time. While some individuals may experience only occasional gout attacks, others may suffer from recurrent episodes, highlighting the importance of proper management and treatment to prevent complications and improve quality of life.

Symptoms of Gout

• Sudden, Severe Pain: Gout often affects the big toe but can also impact other joints, such as the ankles, knees, elbows, wrists, and fingers.
• Redness and Swelling: The affected joint may become red, swollen, and warm to the touch.
• Limited Range of Motion: As the gout attack progresses, you might find it difficult to move the affected joint.

Risk Factors for Gout

• Diet: Consuming foods high in purines, such as red meat, shellfish, and sugary drinks, can increase uric acid levels.
• Obesity: Excess body weight is associated with higher uric acid levels.
• Medical Conditions: Hypertension, diabetes, and metabolic syndrome can increase the risk of gout.
• Genetics: A family history of gout can make you more susceptible.

Understanding Venous Thromboembolism (VTE)

The National Heart, Lung, and Blood Institute describes venous thromboembolism (VTE) as a serious medical condition that encompasses two potentially life-threatening conditions: deep vein thrombosis (DVT) and pulmonary embolism (PE).

DVT occurs when a blood clot forms in the deep veins of the body, typically in the lower leg, thigh, or pelvis. If the clot breaks loose, it can travel to the lungs and cause a pulmonary embolism (PE), a blockage that can be fatal if left untreated. VTE requires prompt medical attention to prevent severe consequences, and understanding the risks and symptoms of DVT and PE is crucial for early detection and effective treatment.

Symptoms of DVT

• Leg Pain or tenderness: especially in the calf
• Swelling: usually in one leg
• Red or discolored skin: The affected area may also feel warm

Symptoms of PE

• Shortness of breath: Sudden and unexplained
• Chest pain: That may become worse when breathing deeply or coughing
• Rapid heart rate: Also known as tachycardia
• Coughing up blood: A sign of severe complications

Risk Factors for VTE

• Prolonged Immobility: long flights or bed rest
• Surgery or injury: Particularly involving the legs or hips
• Certain medical conditions: Cancer, heart disease, and inflammatory bowel disease
• Medications: Hormone replacement therapy and birth control pills
• Genetics: A family history of blood clots

The Link Between Gout and VTE

Recent research suggests a connection between gout and an increased risk of VTE, verifying that inflammation and increased levels of uric acid associated with gout may contribute to the development of blood clots. A study published by the American College of Rheumatology found that individuals with gout had a higher likelihood of developing VTE compared to those without gout. Specifically, the researchers found a significant increase in VTE risk in the 90 days following a gout flare, with the highest risk occurring in the first 30 days.

Another study published by Arthritis Research Canada found a significant connection between gout and life-threatening blood clots and that increased risk is present both before and after gout diagnosis, likely due to gout-associated inflammation. Interestingly, the risk pattern in gout is similar to that seen in other inflammatory arthritic conditions.

These findings emphasize the importance of VTE risk assessment in gout patients and strict adherence to treatment guidelines. Proper gout management could potentially reduce the risk of gout flares and, consequently, the risk of life-threatening blood clots.

If you suspect deep vein thrombosis, call CVR’s DVT hotline at 877-SCAN-DVT (877-722-6388) to access their same-day DVT rule-out service.

Ways to Prevent, Manage, and Treat Gout

Lifestyle Changes

• Diet: Limit intake of purine-rich foods, alcohol, and sugary beverages. Incorporate low-fat dairy, whole grains, and plenty of water.
• Weight Management: Achieving and maintaining a healthy weight can help reduce uric acid levels.
• Exercise: Regular physical activity can improve overall health and reduce the risk of gout attacks.

Medications

• Anti-Inflammatory Drugs: Nonsteroidal anti-inflammatory drugs (NSAIDs) can help manage pain and inflammation during gout attacks.
• Urate-Lowering Therapies: Medications such as allopurinol can reduce uric acid levels in the blood.
• Colchicine: This medication can reduce inflammation and pain during a gout attack.

Ways to Prevent, Manage, and Treat Venous Thromboembolism

Lifestyle Changes

• Stay active: Regular exercise and avoiding prolonged periods of immobility can reduce the risk of blood clots.
• Healthy diet: A balanced diet can help maintain a healthy weight and reduce the risk of clotting.
• Hydration: Staying well-hydrated can help prevent blood from becoming too thick.

Medications

• Anticoagulants: Blood thinners such as warfarin or newer oral anticoagulants (NOACs) can prevent clots from forming or growing.
• Compression stockings: These can help improve blood flow in the legs and reduce the risk of DVT.

Seeking Medical Attention for VTE

If you experience pain, swelling, warmth, or redness in your leg or have difficulty breathing, it is crucial to seek immediate medical attention. These symptoms could indicate a serious condition like DVT and should not be ignored, especially if you have risk factors. Early diagnosis and treatment can greatly improve outcomes.

Center for Vein Restoration (CVR) provides same-day rule-out service for DVT and next-day diagnosis and treatment plan options. Call our hotline at 877-SCAN-DVT.

For non-high-risk VTE or PE, direct oral anticoagulants and vitamin K antagonists (VKAs) are effective treatments that thin the blood to prevent further blood clots.

When to See a Doctor for Gout

• Severe Joint Pain: Especially if it is sudden and intense.
• Recurring Attacks: Frequent gout attacks can lead to joint damage.
• Presence of Tophi: Hard, uric acid deposits under the skin.

When to See a Doctor for Venous Thromboembolism

• Symptoms of DVT: Such as leg pain, swelling, or redness.
• Symptoms of PE: Such as shortness of breath, chest pain, or coughing up blood.
• Recent Surgery or Immobility: Especially if accompanied by symptoms of DVT or PE.

What Should You Do If You Suspect Venous Thromboembolism

Instead of facing long waits at the emergency room, Center for Vein Restoration (CVR) offers a convenient outpatient option for those worried about deep vein thrombosis (DVT). With CVR’s efficient process, patients can:

• Get evaluated and diagnosed for potential DVT on the same day
• Receive test results promptly, without delay
• Start anticoagulation medication immediately if a DVT is confirmed
• Receive ongoing monitoring and care until it is safe to stop anticoagulant therapy

Call CVR’s DVT hotline at 877-SCAN-DVT (877-722-6388) to access their same-day DVT rule-out service.

If you suspect a venous thromboembolism (VTE), which includes deep vein thrombosis (DVT) or pulmonary embolism (PE), you should take the following steps:

1. Don't ignore symptoms: Even if you're unsure, getting checked out is better. VTE can be deadly if left untreated. For DVT, be aware of leg pain, swelling, warmth, and redness. For PE, watch for sudden shortness of breath, chest pain, rapid heartbeat, and coughing up blood.
2. Seek immediate medical attention: VTE can be life-threatening, so it's crucial to get medical help right away. Go to the emergency room or call emergency services.
3. Inform medical staff about your gout: Tell the healthcare providers about your gout diagnosis and any recent flares, as this information is relevant to your risk assessment.
4. Follow medical advice: If diagnosed, adhere strictly to the treatment plan provided by your doctor, which may include anticoagulant medications.

Remember that blood clots can be life-threatening, and early intervention is essential. That’s why Center for Vein Restoration (CVR) offers a same-day DVT rule-out service. Our hotline is 877-SCAN-DVT (877-722-6388).