Primary gout vs secondary gout?

[Keith Taylor (GoutPal Admin)]

The way I'm understanding this is that primary gout=hereditary and secondary gout=external/internal factors (ie diet, kidney problems, obesity, etc). I would think that secondary gout would be easier to control and manage?  Am I assuming incorrectly?

[Keith Taylor (GoutPal Admin)]

Your definitions seem OK to me, but in practice they seem to get confused. I've seen secondary gout quoted when it is identified after another disease, but no link established.

Logically, if gout is secondary to some other condition, then treating that condition will cure the gout. If the other condition cannot be treated, then uric acid lowering (usually allopurinol) is the answer.

One significant point is that treating the primary condition may not be a complete answer. We've discussed elsewhere how gout attacks are much more likely to happen once you get uric acid crystals in your body.

[cjeezy]

I guess the best thing…like you've said is to have regular UA monitorings to ensure UA levels below 6.5.  Personally I think I'm going to order the UASure kit so I can test mine often (and I'll reference GP ).  Better to spen $150 at once instead of $40 a pop at a Dr (plus bloodwork fees)!

[zip2play]

cjeezy,

Interesting idea but I think the lines betweeen the two get fuzzy. I am CERTAIN my gout was secondary to overuse of thiazide diuretics but then the question remains, is there a hereditary proclivity that ALLOWED the secondary gout where someone else might have eaten the same tons of thiazide and never got gout.

As for recognizing the secondary quality of gout it might not be so simple to remove its cause. Problem arises from the seeming fact that once uric acid is laid down in joints it is almost impossible to be completely free of it and thus it may be indistinguishable from PRIMARY gout forevermore.

[cjeezy]

I see your point Zip.  I was just thinking more on the lines of people who have only had 1 or maybe 2 gout attacks in their lifetimes.  Since acquiring this disease, I've run into at least 4 or 5 people that have told me that they had a couple bad bouts within 10- 20yrs, but for the most part they never have any issues (and are not on a Rx).  Was thinking that maybe a secondary factor caused their attacks.  I dunno, just my 2 cents

[zip2play]

Or perhaps what they thought were very rare gout attacks were something else. I think gout attacks tend to breed gout attacks and would consider someone with just one or two real gout attacks a decade a rarity indeed.

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