I started having some pain and swelling in my big toe and ankle. The doctor thinks it might be gout. How can I know for sure?

Early stages of gout can be completely without symptoms. It is a condition caused by too much uric acid in the blood. This is called hyperuricemia. Not everyone with elevated uric acid develops gout.

Age, genetics, chronic alcohol use, and obesity are factors that can change someone from being symptom-free to having acute gout. Other risk factors include the use of thiazide drugs and exposure to lead.

Your physician relies on your symptoms and the presence of any risk factors to guide the diagnosis. A blood test will show if your urate level is elevated. The longer you have hyperuricemia, the greater your chances of developing gout.

X-rays can also offer helpful clues but usually these are more definitive in later, chronic stages of gout. A quick response to treatment is often the best way to confirm the diagnosis. Diet and urate-lowering drugs are the first steps in therapy.

Your doctor will also continue monitoring your blood levels of urate. The goal is to get it down below nine mg/dL.