I literally used to get laughed out of the clinic, told I was a healthy young male and just needed to exercise more. After a decade of this, I was finally diagnosed with gout, something doctors had just been lying about testing for. No one could believe someone could have gout in their 20s (It's been developing since my late teens and I've generally had arthritis my entire life, since I was a child).
It took a physician's assistant, who happened to see me one day when both of my doctors were on their third extended vacation of the quarter, to hear my plight, take my suggestion of gout seriously, and do the leg work, also revealing to me that "full test panels" don't include uric acid by default and that my doctors had been lying to me about their thoroughness.
The assistant was also massively more knowledgeable about the disease, its history, the history of treatment, etc., and disease in general, than either of the two doctors running the clinic. Really opened my eyes.
This is why, although I know there will be problems with it, we should get AI and blood tests more accessible for individuals. Accessing the healthcare system for "I know I'm not 100% but ... I don't have anything specific wrong like a broken bone" is basically a crapshoot - and a totally stupid one.
I have seen young men get diagnosed with gout, but they were Islanders (Samoans and Maori in my case), who I believe are at a higher risk so doctors are more aware of it
Funny enough I also got diagnosed with gout once in my 20s. I have always had somewhat bad toes/bunions (probably partially genetic, and partially wearing only tight soccer shoes as a kid) and I went to a wedding wearing some new leather shoes that I hadn't broken in yet. The next day I woke up with a fever and horrific pain in the sides of my toes. Went to doctor and they did some tests and were also seemingly surprised at the results indicating gout. They asked me to come back in a week to double check, and by then my symptoms were gone and the tests no longer indicated gout.
> They asked me to come back in a week to double check, and by then my symptoms were gone and the tests no longer indicated gout.
Ha. Do you still have symptoms? If not, yea just a bad initial diagnosis. If you do still have symptoms sometimes though, it should be noted that gout is hard to test for when you're actively experiencing aggravated symptoms, as the uric acid crystals are lodged into your tissue and not freely available in the blood stream / urine. This exacerbated everything quite a lot, as when I was much younger I definitely got uric acid tests done when my symptoms were at their worst.
I wonder if the medical textbooks only mention gout as a historical curiosity and not as a modern day disease. I have an older relative with gout, have met someone in their 30s with gout, and yesterday heard a story about an acquaintance with gout, so it's not that rare anymore.
I think it's just typically seen in older men. In fact, only something like 5% of gout sufferers are women. But a 2023 study says [0]:
> The global gout prevalent cases in individuals aged 15–39 years was 5.21 million in 2019, with the annual incidence substantially increasing from 38.71 to 45.94 per 100 000 population during 1990–2019
So while marginal, it is either getting more prevalent for younger men over the last 30 years, or we are getting better at catching it.
What's interesting is all of the older men I've met with gout describe moderately uncomfortable pains, I was surprised to learn that my case is exceptionally intense, debilitating enough to be a physical handicap at times (along with sciatica, fused discs, flat feet, some other little things and possible fibromyalgia) which has plagued my life since I was in my teens.
It's been a horrendous disease that has greatly impacted my ability to be as active as I'd like, and sometimes during a flare-up it's extremely difficult just to walk to my bathroom. Flare ups sometimes happen constantly and sometimes I get a month or two of reduced symptoms.
Another thing is that I don't eat meat, and I rarely drink, which are the two biggest aggravators of symptoms. When the doc told me I needed to cut those things out I laughed, and they said they were very surprised that my symptoms were so bad given that I already avoid the most offensive foods.
I'm also currently trying to pin down another autoimmune disease. From what I know, I don't speak to him, but my father has been in and out of the hospital his whole life and it took decades to pin it down as lupus. I am wondering if he lacked the butterfly rash because I don't have one, but otherwise have basically every symptom of lupus, but it also could be fibromyalgia or even MS. Combined with the gout though, I feel 40 years older than I am, almost every little tissue and bone and muscle hurts from head to toe (literally toe, gout keeps one of my toes at a constant level of pain).
It took a physician's assistant, who happened to see me one day when both of my doctors were on their third extended vacation of the quarter, to hear my plight, take my suggestion of gout seriously, and do the leg work, also revealing to me that "full test panels" don't include uric acid by default and that my doctors had been lying to me about their thoroughness.
The assistant was also massively more knowledgeable about the disease, its history, the history of treatment, etc., and disease in general, than either of the two doctors running the clinic. Really opened my eyes.