Hyperuricemia and gout may be seen in patients with hypo- or hyperthyroidism.
Hyperthyroidism is associated with increased urate production. Clinical gout may require the presence of additional risk factors for gout.
Hypothyroidism is associated with impaired glomerular filtration and decreased excretion of uric acid excretion with accumulation. A patient is who hypothyroid is at increased risk for gout.
A patient with gout should be screened for thyroid disease with a TSH if:
(1) there are clinical findings suggestive of hyper- or hypothyroidism
(2) the gout is unexplained
(3) recurrent gouty flares
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