What precipitates a gout attack

Gout has been called the "king of diseases" (due to the extreme pain and disability like no other that it causes) and the "disease of kings" ( due to many a royalty who did have this arthritis). The source of such descriptions I cannot trace currently, but if I am not mistaken, these still appeared in the 9th edition of an important medical book, c1981. The most recent edition of the same, 18th ed., no longer carries such description (shame).

And while excessive intake of most food (red meat, alcohol, shellfish and innards) is the popular cause of such debilitating arthritis, there are other known precipitants in susceptible individuals, that should be checked and removed or replaced, if ever very necessary. There are 3 important ones that are commonly taken and many times necessary:

1. low dose aspirin (dose given as blood thinner to prevent heart attacks)
2. antihypertension drugs containing hydrochlorothiazide ( as a single agent or combined with other drugs for hypertension, prefixed or suffixed in many preparations as "plus" or "co" )
3. anti tuberculosis medicines

Tips on what to do:

1. The heart specialist can replace your low dose aspirin with other blood thinners ( please, only  if you have the real severe, exquisitely painful joint in  gout -usually the big toe, andkle and knee- not any body ache or pain!) 
2. Your doctor can also change your antihypertensive medicines to replace the hydrochlorothiazide part (which is a good drug for hypertension and can be used in non-gouty individuals, of course)
3. Your rheumatologist together with your infectious disease or family doctor can modify your anti tuberculosis medicines.