Most cases of gout are caused by poor elimination of uric acid by the kidneys, but it can be hard to know why it is happening. The specific problem with the kidney is usually never found. Certain conditions, such as dehydration, can cause excess levels of uric acid. Other medications can also affect the level of uric acid in the blood. It is important to make sure your health care provider knows all the medications you are using, both prescription and nonprescription.
Some people have high uric acid blood levels for years and never have any symptoms.
The arthritis usually occurs before tophi or kidney stones develop. These sudden attacks are sometimes related to physical illness, trauma, or excessive alcohol use. The tophi do not cause any symptoms unless they open and drain. They are often not painful. Depending on their location, they may limit the movement of joints.