Expert says 'Victorian' 'incredibly painful' illness cases soaring as viewer explains how to catch it early

On BBC Morning Live, Dr Xand van Tulleken said until recently gout was very uncommon
-Credit: (Image: BBC)


An expert has explained how a Victorian illness known as the disease of kings is on the comeback. Speaking on BBC Morning Live, Dr Xand van Tulleken said that in the past it was considered to be reflective of high living - and mainly suffered by the rich.

But he said there was a massive surge of the illness in the UK and said the key issue was the health of a person’s kidneys. And the segment sparked interest from fans with one saying that she knows a way to ‘catch’ early the condition which around 1 in 40 people in the UK suffer from.

Gout can be terribly painful - and one viewer said: “My husband has flare-ups of this - foot in cold water, drink plenty of water and take naproxen. Catch it quick and you can stop it.” It can be triggered by eating a large, fatty meal and one of the ways people can avoid it is by losing weight and changing their lifestyles.

Dr van Tulleken said: “It has risen enormously across the UK. You talk about it as a Victorian illness and that is the association we have - there are sort of famous Victorian cartoons of gout as a demon biting someone’s toe cos it’s so terribly painful.

“It’s a famous disease in Victorians because Queen Victoria had it, and in history, really only famous people, rich people, very prominent people who could afford to eat the kind of foods that would give them gout had it. But in fact, gout was extremely uncommon until fairly recently.”

He explained that in some areas it has risen massively, for example by 121 per cent in South Warwickshire from 2019 to 2023. In Dorset, it has risen by 219 per cent, Liverpool 960 per cent. Dr van Tulleken said: “If any other health condition had risen that much in this time, it would be headline news, but it would be front-page news, so it really, really is extraordinary.”

Dr van Tulleken said the causes of gout are crystals of a chemical called uric acid forming in your joints. Your wee is called urine because it contains uric acid. When you break down foods, one of the by-products you make is uric acid, and you make urine from a chemical called Purines. They’re found in lots of foods, things like meat and fish particularly, but if you have a lot of purines, they can push up your levels of uric acid can make it harder to get rid of and more likely to form crystals in your joint.

“It’s really important to say that lots of things can alter the levels of uric acid in your blood. So if your kidneys are not working as well, they may find it harder to get rid of it.”

The NHS says people have a higher chance of getting gout if they:

  • are overweight

  • drink alcohol

  • have been through the menopause

  • take medicines such as diuretics (water tablets), or medicines for high blood pressure (such as ACE inhibitors)

  • have high cholesterol, high blood pressure, kidney problems, osteoarthritis or diabetes

  • have had surgery or an injury

Things that can trigger a gout attack

  • have an illness that causes a high temperature

  • drink too much alcohol or eat a very large, fatty meal

  • get dehydrated

  • injure a joint

  • take certain medicines

If someone does suffer an attack the NHS says there are things people can do to stop it happening again. It suggests people lose weight but warns to avoid crash diets. It said to speak to a doctor to get eating advice, have alcohol free days, drink plenty of water, exercise regularly – but avoid intense exercise or putting lots of pressure on joints, stop smoking and ask the GP about vitamin C supplements. Also people should avoid lots of sugary drinks and snacks and eating lots of fatty foods.