Andrew, this isn’t a complete response to your situation. I’ll just handle your main question. Then, if you need clarification, we can get the fundamentals right before tackling other issues. So, here’s my response to “do we know of a list of potential triggers?”
List of triggers for gout attack:
1. The immune system sees too many uric acid crystals than it can handle, so it sends out signals for reinforcements (more white blood cells needed).
There is only one trigger for a gout attack. Creating white blood cells is a painful process for most people. White blood cells are very good, but they can’t kill inanimate invaders like uric acid crystals. They engulf the crystals, which hides them from our immune system, so inflammation slowly stops.
So, another question is: what triggers uric acid crystals to become visible to our immune system? That’s a list of 2:
1. New crystals grow. This can’t happen if your uric acid is 4.9mg/dL. So, we’ll forget it, unless you are exposed to prolonged intense cold. Uric acid crystallizes easier at lower temperatures.
2. Old crystals dissolve.
You absolutely need old crystals to dissolve. That is the only way to recover from years of excess uric acid. Everything we do to control gout has to involve lowering uric acid below the crystallization point. That has consequences. Just like recovering from a toothache, there’s a process that’s probably going to hurt. That’s why good doctors warn you that lowering uric acid can trigger a gout attack. Good doctors prepare you with gout pain therapy for as long as you need it.
As old crystals dissolve, they shed the coating that hid them from our immune system. Often, this goes unnoticed. Sometimes, there are enough partially dissolved uric acid crystals to trigger a gout attack. That’s why we need gout pain therapy until most of the old crystals have dissolved.
That’s the logic of gout triggers. Like the logic of gun triggers, you have to ask the right question. It’s nothing to do with the size or shape of the gun. It’s nothing to do with what the gunman ate for his dinner.
Is there a bullet in the gun?