“Emperor Disease” may claim your life anytime!

In the ancient times, westerners regarded gout as an ordeal similar to “the devil is biting my feet”. And throughout history, many renowned emperors had suffered from gout, hence the “Emperor Disease” or “Noble Disease” nickname.

Improved living standards bring along increased risks of falling ill! The menacing “Emperor Disease” is invading the world on a rising trend. According to statistics published by the Right Diagnosis from Healthgrades website, about 909,000 out of 30.3 million Malaysians suffered from hyperuricemia (excess of uric acid in the blood) in 2015. What is getting alarming is that if this group of people is ignorant about the lurking danger of hyperuricemia, they would become a likely target for the stealthily yet deadly killer – gout!

1 in 363 suffers from Gout

(Source: NIAMS)

Increase to 17,700,000 people

(2021 Prediction)

Based on statistics surveyed, the number of gout sufferers has been on the rise between 15-30 times for the past 15 years. In the United Kingdom alone, the number of gout sufferers in 2012 soared by 60% in comparison with the statistics for 1997.

In the United States, 1 in every 363 people suffers from gout.

According to statistics released by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), 275 in every 100,000 people suffer from gout. It is estimated that by year 2021, there would be some 17.7 million people suffer from gout. The alarming figure truly warrants the call for increased health awareness!

In Hong Kong, about 213,000 out of its dense population of 7.1 million suffer from gout. Apparently, the global invasion of gout is creeping up stealthily and deadly at the same time. The lurking danger must not be overlooked!

Population: 7,100,000

(Hong Kong)

Gout: 213,000 people

(Hong Kong)

In the past, gout was relatively rare in Asia among Asians. But, since the turn of the 20th century after the 1990s, many nations like Japan, Taiwan, China and even Malaysia were going through rapid economic development that resulted in significantly improved living standards closely associated with the excessive-meat-consumption-induced hyperuricemia. Given the absence of symptoms in hyperuricemia, a misdiagnosis is usually the case. When gout-induced attacks on the joints surface a few years later, the organ damage has been done.

The "culprits" behind gout attacks

“You are what you eat!” – a saying that rings true with gout sufferers. One of the main culprits is excessive eating and drinking. Excessive consumption of foods high in purines such as seafood, meat, alcohol and beans bears bad consequences. This is simply because the excessive presence of purines will significantly increase the density of uric acid in the body. Making it worse, the lack of exercise hampers the discharge of the excessive uric acid build-up and over time, uric acid crystal deposits are formed, which triggers gout attacks. About 20%-30% of the uric acid in the body is ingested from the food we eat while the remaining 80% of it is produced by the waste of our body. Therefore, unrestrained eating or drinking (binge eating or drinking) is one of the most devastating habits that stimulates and accelerates the harmful accumulation of uric acid.

Gout and the "3 Highs" are closely related

You may not be aware that gout and obesity, hypertension (high blood pressure), hyperlipidemia (high cholesterol), coronary heart disease and diabetes are all closely related. For instance, patients with hypertension often use diuretics to control their blood pressure levels, but this will lead to extracellular fluid loss, which in turn increases the re-absorption of urates by kidney tubules. Chronic hypertension triggers atherosclerosis (hardening of the arteries), which will result in renal function deterioration (kidney failure) and the decrease of uric acid excretion. This simply translates into the increase of uric acid density, hence leading to gout attacks.

For overweight people, the major culprit is overeating, which leads to the accumulation of excess subcutaneous, abdominal and visceral fat. When the body is tired or hungry, it burns the stored fat to release energy (calories) to support body movement. The irony is that ketones are produced when the body burns fat for energy, which hinders the excretion of uric acid. Instead, this will increase the hyperuricemia levels that triggers gout attacks.

More alarmingly, Malaysia tops the list as the most overweight nation in Southeast Asia, with approximately 12 out of 30 million Malaysians (about 40%) being overweight. And out of this, 5.1 million of them (about 17%-18%) are obese. This obviously makes Malaysia the fattest country in Southeast Asia.


More alarmingly, Malaysia tops the list as the most overweight nation in Southeast Asia, with approximately 12 out of 30 million Malaysians (about 40%) being overweight. And out of this, 5.1 million of them (about 17%-18%) are obese. This obviously makes Malaysia the fattest country in Southeast Asia.

Now, what can we derive from these ever increasing year-by-year figures? And given the fact that those diseases or risk factors such as diabetes, obesity and high blood pressure trigger gout attacks easily, does this mean the number of gout sufferers is significantly on the rise as well?

The Excruciating Pain

Gout is the kind of arthritis that strikes with the most severe or intense pain. It usually flares up for the first time on the big toe joint, driven by the sharp uric acid crystals deposited there. A gout attack comes in the form of a sharp, stabbing or tingling pain, with redness, fever and swelling symptoms. Acute gout attacks often occur at night when the immune system is going through the detoxification process. The gout pain keeps you awake and sleeplessness makes pain worse.

In addition to the big toes, gout may also attack the insteps, ankles, heels, knees, wrists, fingers, elbows, etc. If left untreated, acute gout attacks would recur repeatedly. More than 60% of the gout sufferers would experience a second attack within a year.


Chances of gout recurrence

More common in men than in women?

Gout patients are mostly men over the age of 30, but due to the bad dieting and sleep habits of the modern people, gout victims are getting younger apparently. Clinical treatment has even involved patients as young as 20 years old, which is a very worrying health risk.

Although both the incidence and prevalence of gout are significantly higher among men than women, the latter also risk developing gout especially after menopause. Therefore, regardless of gender, the probability of developing gout increases along with the rise of the uric acid density.

Hyperuricemia is a health killer!

Gout brings along tremendous suffering that adversely affects our life. In severe or worst cases, it’s likely to result in death. Therefore, gout symptoms must not be ignored. For the sake of your health, please practise healthy eating habits while cutting down on alcohol, and drink plenty of water and exercise regularly. If you are diagnosed with hyperuricemia, gout is already creeping up on you stealthily! Gout may be coined the “Emperor Disease”, it can only connote worsening scenarios. It’s hyperuricemia that you must avoid in the first place.

Health Tips

  • The main culprit behind hyperuricemia is the presence of high blood uric acid levels.
  • For adult male, uric acid levels exceeding 7.0 mg/ dL (milligrams per decilitre) means hyperuricemia.
  • For adult female (before menopause), the normal uric acid levels are below 6.0 mg/ dL.
Gout and uric acid blood analysis
Serum Uric Acid (SUA) levels (mg/ dL) Probability of first gout incident Probability of gout recurrence
< 6 0.5 0.8
6 -6.9 0.6 0.9
7 - 7.9 2.0 4.1
8 - 8.9 4.1 8.4
9 - 9.9 9.8 43.2
> 10 30.5 70.2

Doctor's advice

Reducing uric acid is key to gout treatment

  • Embrace a healthy diet and avoid organ meats.
  • Drink plenty of water every day.
  • Limit alcohol and fat intake.
  • Maintain a healthy weight.

Self Test

Do you belong to the high-risk group of hyperuricemia?


Let us know if you have any questions