If you’ve never experienced a gout flare-up, understand that there’s absolutely nothing funny about it. The condition, a type of inflammatory arthritis, can feel like exactly that: flames. Shooting, burning, explosive pain – powerful and often sudden.
People with gout commonly feel this searing sensation in their big toe, but it can also affect their ankles, knees, elbows, wrists and fingers. An acute gout flare often starts at night and can last from four to 12 hours. Lingering discomfort can continue for a few weeks. Advanced cases can involve bumps or nodules forming in the body, including under the skin and in the joints, and – on top of all that – kidney stones.
Late last year, on his podcast Bussin’ with the Boys, offensive tackle and three-time NFL Pro Bowler Taylor Lewan went public about a debilitating gout flare that left him ‘always in pain’. Lewan, 34, compared himself to the characters of 127 Hours and the Saw films who cut off their own limbs to free themselves from danger.
‘I would rather tear my ACL and go through nine months of rehab again instead of having gout for a week,’ said Lewan, who did actually tear his ACL during a 2020 game.
Until relatively recently, plenty of people – doctors included – weren’t taking gout seriously, particularly in young men. That may partly be because the condition, which has a history of affecting European royalty, has long been known as ‘the disease of kings’. These wealthy men feasted on rich foods and drank plenty of alcohol, sometimes wearing their diagnosis as a high-society badge of honour.
Basically: gout was seen as an old, rich man's problem.
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Contrary to that image, however, gout can affect people of all ages and backgrounds. Current estimates suggest more than six million men and three million women are living with gout in the US – and the condition is becoming increasingly common among younger people. Cases among 10- to 24-year-olds have risen by more than 20% in recent decades, while projections indicate a 70% increase in global gout cases by 2050.
Perhaps unsurprisingly, gout is also trending online. TikTok and Instagram influencers – yes, gout influencers – share prevention and treatment strategies with their followers. Popular gout videos on TikTok have collectively amassed more than 426 million views. Clips show young stand-up comedians joking about their condition, while Reddit threads debate the nuances of medication. The supply of gout memes is seemingly infinite.
Part of the increase in recorded cases is likely to reflect greater awareness: doctors are getting better at spotting and diagnosing gout. But other factors are at work, too – and scientists are still untangling the complexities of the condition.
For people living with gout, relief can’t come fast enough.
A Real Pain
For Gary Ho, his decades-long battle with gout began when he was 24. He was walking across his university campus when ‘my right ankle started to swell’, he says. ‘It was incredibly painful. It felt like I had broken my foot, but I hadn’t done anything.’
When Ho visited a doctor, his pain was dismissed as overexertion. Ho’s father suggested it might be hereditary – he had gout, as did Ho’s grandfather. But gout, the doctor said, wasn’t a young man’s disease.
‘For 16 years,’ says Ho, ‘I’d go through this cycle of handling the pain as much as I could, going to the doctor, repeating my story, and getting again told that I’m too young. I don’t meet the criteria. “It usually happens to older men. You’re too young to have gout.”’
It’s not as if being young lessens the pain.
‘It’s very dramatic in the majority of cases,’ says Brian Mandell, MD, PhD, a rheumatologist with the Cleveland Clinic and a member of the Gout Education Society’s board of directors.
Gout’s signature pain is caused by sharp crystals, shaped like tiny needles, which form when a complex cellular process goes awry. Your body continuously produces uric acid when breaking down old cells or digesting foods high in purines, compounds found in red meat, organ meat and seafood.
For most people, the bloodstream and kidneys help clear uric acid before it's excreted in urine. In people with gout, uric acid can build up and form those needle-sharp crystals, which tend to accumulate in the body's extremities.
While gout triggers vary, many people report attacks after consuming alcohol – particularly beer – as well as tuna, scallops, steak or drinks containing fructose, all of which are thought to increase uric acid.
Beyond its physically debilitating effects, people living with gout say the condition can affect their relationships and mental health, too.
Justin Radam, a Toronto barber, started experiencing gout flares in his early 30s. While his daughter was learning to walk, Radam, now 40, was struggling with his own mobility.
‘I would be having a flare-up, and I’m lying there in bed with my foot elevated. That was one thing that would just kill me – being like, “No, baby, Dad can’t play with you right now.”’
When he was younger, Ho says he felt pressure to power through gout flares, even when doing so made him the butt of the joke.
‘I can still remember when I was hanging out with my boys in Austin in our younger days, going around listening to live music. At times I’d be on my crutches, or I’d hobble and try to keep up with them,’ he says.
‘They were trying to support me in the best way they could, but they would call me “gimpy” or “gout boy”. They thought it was endearing, but deep down inside, I’m like, Man, you don’t understand the thing. Like, if you tell me you have a migraine or your back is hurting, I would not be laughing.’
Like snoring or balding, gout has a reputation – at least among people who don’t have it – for being funny, which is bizarre considering how debilitating its symptoms can be.
Research into gout's psychological impact has found that patients can trivialise or conceal their diagnosis for fear of judgement, sometimes even being in denial about their symptoms.
Gout’s stigma ‘led patients to avoid seeking help from a general practitioner’, a 2025 study found. In one survey of more than 1,000 gout patients, over a quarter reported that their self-esteem had taken a hit as a result of the condition.
Quite the turnaround for a disease people once boasted about having.
‘The Disease of Kings’
Gout is one of the oldest recognised diseases, first recorded by the Egyptians in 2640 BCE – and even early doctors saddled people with the condition with a stigma.
Greek physician Hippocrates wrote about gout in the fifth century BCE, calling the condition the ‘unwalkable disease’ and an ‘arthritis of the rich’. Only certain people contracted gout, Hippocrates theorised; unlike rheumatoid arthritis, which he perceived to plague the poor, gout affected the affluent.
Gout’s stereotype as ‘the disease of kings’ endured in part because plenty of royalty did have it.
A 2025 study in The Lancet Rheumatology found likely cases in the records of Charles V, Holy Roman Emperor, who developed gout in his 20s. He shared the condition with his son Philip II of Spain, as well as England’s Henry VII, Henry VIII, Queen Anne and George IV.
By the ninth century, the illness had become something of a status symbol, immortalised in fables as an affliction of idle nobility whose lives were full of excess. To those with less money, gout was comeuppance for living large.
Today, pop culture often still treats gout as a sneaky fat joke.
A 2021 study found that in films and TV shows set in the modern day, 79% of references to gout were intended to be funny. Gout has appeared in Game of Thrones, The X-Files, Friends, The Big Bang Theory, Everybody Hates Chris, The Jeffersons and Seinfeld.
In a 1999 episode of King of the Hill, 12-year-old Bobby Hill develops gout after eating too much liver.
‘My doctor says it’s very rare,’ Bobby tells his class. ‘I’m the only kid under 70 to get this outside of the Gout Belt in the lower Balkans.’
If that joke were written today, Bobby might have several classmates with the condition.
In the social-media age, gout jokes run rampant on TikTok and Instagram. Self-deprecating comedians with gout collect laughs about how eating shrimp can cripple a man and how the condition most definitely does not make you feel like a king.
Comedian Steve Furey has worked gout into his stand-up routine, which he cuts into clips for his social accounts. Furey, 37, began experiencing gout flares in his early 30s.
His doctors also didn’t initially suspect gout because of his age. Some even implied he was lying about his symptoms to obtain pain medication, he says. Others suggested his knee pain might be cancer. A biopsy later revealed the mysterious lump to be a golf ball-sized uric acid deposit.
Furey says the humour of gout comes from the contrast between its reputation as an ailment of hard-partying kings and its reality as an everyday condition.
‘It’s not a rich person’s disease,’ he says. ‘It’s a dockworker’s disease. It’s a comedian’s disease.’
Though Furey says he isn’t trying to become ‘the gout guy’, he’s heard from a huge number of men on social media who are relieved to hear their condition discussed openly.
‘They finally feel seen,’ he says.
The social-media surge has increased awareness of gout. But experts are concerned that online communities are also spreading dangerous misinformation.
Gout's Social-Media Problem
Because this is 2026, you can find more than 170,000 posts tagged #gout on TikTok.
Among images of impossibly swollen toes and feet, you’ll discover countless recommendations for preventing and managing the condition, courtesy of white-coat-wearing medical professionals, immaculate ‘wellness warriors’ and those haunting AI-generated videos – many of them trying to sell a supplement, detox formula or other product conveniently available through TikTok Shop.
‘Would you like a complete, seven-day drink plan to prevent gout?’ asks one robotic AI voice. ‘Write “yes” in the comments and I’ll send it to you.’
For young people living with gout, it’s only natural that they might turn to #gouttok for answers. More than half of Gen Z respondents in a 2024 survey reported seeking health advice on TikTok, with a third describing the platform as their primary source of health information.
But when a New Zealand research team analysed TikTok’s most popular gout videos last year, they found that only 24% of the people discussing gout were health professionals.
Those 116 videos, which had collectively amassed more than 426 million views at the time of the study, frequently discussed gout management inaccurately. Among the main pieces of misinformation were claims that dietary fixes or herbal remedies could treat the condition.
Dietary changes are, at best, a partial solution.
While eating a healthy diet, losing weight and exercising regularly may decrease the frequency and intensity of gout flare-ups, ‘doing those things does not mean that your gout is going to go away’, says Mandell.
Herbal supplements, meanwhile, aren't a substitute for evidence-based treatment. Slicing ginger root and applying it to gouty joints, as one TikTok video recommends, will do nothing to stop a flare.
Cherry juice, another popular TikTok remedy, might help lower urate levels, but not enough to help most people with gout, Mandell says.
‘The downside of taking those approaches is you’re basically still undertreating the disease itself.’
And if you’re undertreating the disease, you risk allowing it to get worse.
What Actually Helps Gout?
Despite gout’s long history, scientists and doctors are still working to understand exactly what causes it, how best to prevent it and how to treat it.
One constant is that gout requires professional medical care. That’s largely because treatment ‘gets complicated very quickly because of all the associated comorbidities’, says Mandell.
Researchers are linking gout’s rise among younger people to increases in other health issues in the same population, including obesity, diabetes, cardiovascular disorders and metabolic syndrome.
Insulin resistance is currently increasing steeply among adolescents, and scientists are studying its role in uric acid build-up. Sedentary lifestyles, also on the rise among adolescents, have been linked with gout.
But this can create a vicious cycle: people with gout may want to be active, but exercising can become extremely difficult during a flare-up.
Modern diets may also play a role. Researchers have found associations between gout and fructose, a sweetener frequently added to foods in the form of high-fructose corn syrup. Ultra-processed foods, including processed meats and fast food, have also been linked to gout.
And the current focus on consuming large amounts of protein may present problems for some people predisposed to gout: diets high in red meat and/or seafood are associated with a greater risk of developing the condition.
Then there’s alcohol. While overall alcohol consumption in the US has been falling, around 27% of men aged 18 to 25 have reported binge drinking. Alcohol can trigger gout, with studies suggesting beer and spirits are particular culprits.
But then there are cases such as William Haire, who was diagnosed at 39 and has been living with gout for six months.
When he woke up with intense pain in his toe, he assumed it was a delayed reaction to hurting himself at the gym the previous day.
It was a doctor at an urgent-care clinic who diagnosed him with gout.
‘I was kind of surprised that I got it, because I eat pretty clean, I work out a bunch, and I don’t drink very often,’ Haire says.
His family doesn’t have a history of the condition – he asked around – and he believed he was living a healthy lifestyle.
He tried medication to manage his symptoms but stopped taking it and instead doubled down on dietary changes.
‘The seafood I did eat, I’ve cut out. I’m drinking even less than I was before, in terms of how often and how much.’
He’s cautiously optimistic that his first flare-up will also be his last. But, as with much of gout, there are no guarantees.
The good news is that while researchers continue working to understand why gout develops, there are proven ways to treat its symptoms.
Some prescription medicines can treat gout flares by reducing the inflammatory response to uric acid crystals, helping to reduce pain and inflammation during an attack.
One of them, colchicine, can be taken in lower doses for longer periods to help prevent severe attacks or used during an acute flare. Other medications, including allopurinol, are prescribed for long-term daily use and reduce the production of uric acid. People beginning allopurinol may also be prescribed colchicine during the first few months.
With medication and moderation, Furey has been able to find long-term relief.
‘I can still go out to my friend’s birthday and have some cocktails and feel pretty good and have a steak that night. You just can’t do that very often.’
People with gout can also identify and cut back on foods that appear to trigger their individual flare-ups. Gout specialists sometimes recommend Mediterranean and DASH-style diets.
But food isn’t the whole story. A cocktail and a steak might not trigger a flare in one person but could cause agony in another.
Weight is another factor, and researchers have also begun examining GLP-1 weight-loss drugs in relation to gout. The drugs have proved highly effective for treating obesity and a range of associated conditions, some of which are comorbidities of gout.
Complicating that picture, however, are recent studies suggesting GLP-1 users might face a slightly higher risk of gout – a possible consequence of rapid weight loss.
Then there’s genetics.
‘There are multiple factors that go into who is going to develop gout flares, who is going to have elevations in their blood level of uric acid,’ Mandell says. ‘It’s in part a genetic disease.’
While some people's kidneys may excrete uric acid efficiently, others may struggle to do so. Genetics may even influence sensitivity to uric acid.
The genetics help explain the whole ‘disease of kings’ story.
The previously mentioned Lancet Rheumatology study of monarchs with gout found evidence of the disease passing from one generation to the next.
‘Surprisingly, society (and medicine) chose to attribute gout to poor diet and alcohol when…the first demonstration that gout is a genetic disease was there in plain sight,’ the researchers wrote. ‘The “disease of kings” was not inherited by titles and wealth, but by genes.’
Like Ho, Radam also learned that gout ran in his family.
‘I’m of Filipino descent, and it’s very common among Filipinos,’ he says. (Research has found higher rates of gout diagnoses among some Asian populations.)
His dad experiences gout flares. Among his Filipino community, Radam says gout can feel ‘almost like a given. You can joke about it, but it’s gonna be true for a large percentage of the guys and some of the women.’
At this point, the usual advice might be to ask your relatives whether there's a history of gout in the family. But given that many people may have lived with gout for years without receiving a proper diagnosis, that conversation isn't always straightforward.
That's one reason some people living with the condition are turning to another source of understanding and support: real-world meet-ups.
Tackling the Stigma
At 40, Ho finally saw a rheumatologist who diagnosed him with gout. A blood test revealed that his uric acid levels were dangerously elevated and, through dietary changes, exercise, medication and regular check-ins with a gout specialist, he says he now has the condition under control and is back to an active lifestyle.
Ho says his years of unnecessary pain weighed on him. He knew other people were still undiagnosed and living through the same experience.
Seeking to form a support group, he and his rheumatologist placed a newspaper advert for a Saturday-morning gout meet-up in Austin.
‘We had five couples show up,’ Ho says. ‘It was five wives dragging their husbands to a Saturday morning meeting to talk about gout. And they were grumpy. They were so grumpy.’
But over coffee and doughnuts, everyone began opening up.
‘We started talking about pain and what we go through. And we bonded that morning. We bonded, and after that meeting, I thought, This is it. This is what has been missing.’
Though only five men attended Ho’s first gout support meet-up in 2015, the network soon grew, moving online later that year and obtaining non-profit status in 2021.
Today it’s the Gout Support Group of America, a social and educational hub with more than 17,000 members.
Participants won’t find miracle cures in the group, Ho says. Gout is a lifelong condition. But they will find answers – hopefully much faster than Ho did after his first flare-ups.
‘I want to share that there is genuine hope for those living with gout that they can regain their quality of life,’ he says. ‘They can regain their quality of life, be happy, be normal, eat whatever they want in moderation, and not live in fear.’
And people of all ages are welcome.
Kelly Weill is a freelance writer who covers disinformation. She’s the author of Off the Edge: Flat Earthers, Conspiracy Culture, and Why People Will Believe Anything.
