Avoiding or lessening the pain of a gout attack is usually straightforward—cut down on meat, seafood, alcohol and fructose, and take supplements like tart cherries, curcumin and quercetin that block uric acid formation. But sometimes this doesn’t work. A new study from Stanford University provides a possible explanation why.

Gout is an excruciatingly painful form of arthritis caused by the buildup of uric acid crystals in the joints. Research shows that compounds called purines found in meat, seafood and alcohol—particularly beer—are converted to uric acid in the body.  More recently, fructose found in fruits, juices and in high fructose corn and agave syrups has also been linked to gout episodes. And now, according to a study published in August 2012 in the Annals of Internal Medicine, even tiny amounts of lead can increase risk of gout attacks.

Lead poisoning blocks the excretion of uric acid from the body and increases gout risk. Knowledge of this link dates back to ancient times.  Ancient Romans frequently suffered from gout because of widespread lead toxicity.  Some modern medical historians even blame lead poisoning for the fall of the Roman Empire.  Modern scientists tell us that high lead levels—above 80 micrograms per deciliter (mcg/dL)—increase gout risk by a factor of 8. The new study reveals that even miniscule lead levels, as low as 1.2 mcg/dL, still increase risk. That equals about one part per hundred million.

The researchers analyzed data from 6,153 people, comparing their blood lead levels with whether or not they had symptoms of gout or blood markers associated with gout. The study participants were divided into four groups according to the amount of lead in their blood. The group with the lowest lead levels averaged 0.89 mcg/dL. The group with the highest level averaged 3.95 mcg/dL. The researchers found that for each doubling of lead quantity, the risk of gout increased by 74 percent. Overall, the risk in the high-lead group was 3.6 times more than the low-lead group.  

According to the Stanford researchers, “… there is no such thing as a safe lead level.” In an unrelated study, Harvard researchers reported earlier this year that lead levels as low as 2 mcg/dL lower IQ in children. Yet current U.S. government standards say levels below 10 mcg/dL are acceptable.