Uric acid is a chemical compound produced naturally by the body through the breakdown of purines, which are present in many foods and drinks. The kidneys are responsible for excreting uric acid from the body in urine form. However, when the body produces excessive uric acid or the kidneys remove it effectively, it can accumulate in the bloodstream and lead to hyperuricemia. Hyperuricemia can cause various health problems, including gout, kidney stones, and chronic kidney disease. Maintaining a healthy lifestyle and diet is essential to keep uric acid levels in check and prevent these health complications.
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| Happy patient after excess uric acid treatment |
Why do we need uric acid, and what are the normal levels?
The body naturally produces uric acid when it breaks down purines found in food or created during metabolism. Uric acid is vital as it helps protect cells from damage caused by reactive oxygen species. The kidneys filter and eliminate uric acid from the body, but excessive levels can lead to health problems like gout, kidney stones, and kidney disease.
The frequency range of uric acid in the blood is between 3.4 and 7.2 mg/dL for men and between 2.4 and 6.0 mg/dL for women. However, these levels may vary depending on the laboratory or the measurement unit. Maintaining a balanced diet, staying hydrated, and exercising can help keep uric acid levels within the normal range and prevent potential health complications.
What may happen in hyperuricemia and hypouricemia?
Hyperuricemia and hypouricemia are medical conditions caused by abnormally high or low uric acid levels in the blood, respectively.
- In hyperuricemia, the excess uric acid can crystallize and accumulate in the joints, leading to painful inflammation and swelling, a condition called gout. Hyperuricemia can also cause kidney stones, which can be painful and may require medical intervention to remove.
- Hypouricemia characterizes a rare condition wherein the blood shows abnormally low uric acid. A genetic disorder, certain medications, or kidney disease can cause hypouricemia, a rare medical condition characterized by low uric acid levels in the blood. Hypouricemia may increase the risk of neurological and cardiovascular disorders like seizures and strokes.
In both cases, one can seek medical advice to properly diagnose and treat the underlying condition causing the abnormal uric acid levels.
How do the doctors control it?
- Prescribing medications: Doctors can prescribe medications that help lower uric acid levels in the blood, such as allopurinol and febuxostat.
- Lifestyle modifications: They may advise the patient to make lifestyle changes like reducing alcohol intake, avoiding high-purine foods, and losing weight if necessary.
- Hydration: Staying hydrated can help prevent the buildup of uric acid in the blood, so doctors may recommend drinking plenty of water.
- Regular monitoring: Doctors may monitor the patient's uric acid levels regularly to ensure the treatment is effective and to adjust the treatment plan if necessary.
- Treating underlying conditions: Hyperuricemia can be a symptom of an underlying condition, such as kidney disease or metabolic syndrome. Treating these conditions can help control uric acid levels in the blood.
How excessive uric acid is a hazardous and painful condition?
- Excessive uric acid can form crystals in the joints, causing a painful condition known as gout.
- Gout attacks can cause severe pain, swelling, and redness in the affected joint.
- Hyperuricemia can also cause kidney stones, which can be painful and may require medical intervention to remove.
- Chronic hyperuricemia can lead to kidney issues, fatal and potentially life-threatening conditions.
- High uric acid levels may also increase the risk of developing cardiovascular disease, as it can lead to inflammation and damage to the blood vessels.
How does allopurinol work in hyperuricemia?
Allopurinol is a medication commonly used to treat hyperuricemia.
Here's how it works:
Allopurinol blocks the activity of an enzyme called xanthine oxidase, which is involved in the production of uric acid in the body.
- By inhibiting xanthine oxidase, allopurinol reduces the amount of uric acid produced in the body, leading to lower levels in the blood.
- Allopurinol can take several weeks to affect uric acid levels, as it works by blocking the production of new uric acid rather than removing existing uric acid from the blood.
- Doctors use allopurinol in people with chronic hyperuricemia or gout, and it may be prescribed for long-term use to prevent future gout attacks.
- However, allopurinol can have side effects, such as skin rashes, liver problems, and low blood cell counts, so use it under the guidance of a healthcare provider.
What are the recent developments and medicines to control hyperuricemia?
- Febuxostat: A medication that works similarly to allopurinol by inhibiting xanthine oxidase, which reduces the production of uric acid in the body. Febuxostat 40mg is effective in lowering uric acid levels and gout attacks.
- Probenecid: A medication that works by increasing the excretion of uric acid from the body. Doctors sometimes use probenecid in combination with allopurinol or febuxostat to further reduce uric acid levels in the body.
- Lesinurad: Lesinurad is a newer medication that works by blocking a protein in the kidneys involved in the reabsorption of uric acid, which leads to increased excretion from the body and lower levels in the blood. This process increases the amount of uric acid that is excreted from the body, leading to lower levels in the blood.
- Pegloticase: Pegloticase is an intravenous medication that converts uric acid into a more easily excreted form. Doctors use it in people with severe gout that has not responded to other treatments.
- Herbal remedies: Researchers have studied certain herbs like celery seeds, nettle tea, and tart cherry juice for their potential to lower uric acid levels. While some preliminary evidence suggests they may be effective, more research is needed to confirm their safety and effectiveness.
There is no specific surgery to prevent hyperuricemia. Doctors manage hyperuricemia through lifestyle modifications and medications to lower uric acid levels in the body. In severe cases of gout, joint damage or deformities may require surgical intervention. However, the focus of the treatment can be on managing the consequences of hyperuricemia rather than preventing it.
What are the foods and precautions for hyperuricemia?
Diet and precautions for hyperuricemia:
- High-purine foods such as red meat, organ meats, seafood, and alcohol
- Foods high in fructose, like sweetened beverages and fruit juices
- Processed foods and refined carbohydrates
Foods to consume in moderation:
- Whole grains and complex carbohydrates
- Low-fat dairy products
- Plant-based protein sources such as beans, lentils, and tofu
- Vegetables, especially those rich in vitamin C, like bell peppers and broccoli
- Fruits in moderation, especially those with low fructose content such as berries and citrus fruits
- Stay hydrated by drinking plenty of water to help flush out uric acid from the body
- Maintain a healthy body weight, as obesity is a risk factor for hyperuricemia
- Exercise regularly to help maintain a healthy weight and improve overall health
- Limit alcohol consumption
- Talk to a healthcare provider about medications to manage hyperuricemia, if necessary.