High uric acid or Gout – Time to understand it better

The high uric acid level is usually diagnosed incidentally while undergoing blood tests for any other condition. It is rapidly becoming a common abnormal finding on a routine test. It occurs more commonly in men. Usually, it affects men above 30 years and women usually get affected after menopause.

Why should we worry about high uric acid levels?

  1. About one-third of patients with high uric acid levels may develop intense pain and redness of joint called Gout. Gout is a type of arthritis which results from uric acid crystals formed inside or around the joint. Gout can be acute or chronic.

Other conditions which may occur due to uric acid crystals are kidney stones and uric acid associated kidney disease.

  1. High uric acid is itself associated with a higher risk of developing heart disease, high blood pressure, chronic kidney disease and metabolic syndrome (a combination of obesity, high blood pressure and difficult to control diabetes).

What is the cause of high uric acid levels?

 High uric acid occurs when the body produces an excessive amount of uric acid by the breakdown of a chemical called Purine.

  1. High uric acid levels as a result of a change in diet and lifestyle are rapidly becoming the commonest cause of high uric acid level in our modern society.
  2. Diabetes, high blood pressure, chronic kidney disease, obesity, under-functioning thyroid and high levels of cholesterol in the blood can also increase the chances of developing gout.
  3. Sometimes rare genetic disorders can lead to very high uric acid levels. Other relatively rare causes include tumors, certain medications, and vitamin deficiency.

How to treat or prevent gout or high uric acid changes?

  1. Following lifestyle changes can also help reduce your risk of experiencing further attacks of gout or reduce uric acid level.
  • Avoid foods containing high purine such as red meat, offal, oily fish, seafood and foods containing yeast extract.
  • Avoid sugary drinks such as soft drinks.
  • Maintain a healthy weight

Diet- aim for a healthy balanced diet

Avoid crash diet or try high-protein

Low-carbohydrate diets.

Regular exercise – consider swimming if you have arthritis

  • Drink plenty of water – staying well hydrated will reduce the risk of crystals forming in your joints and kidney stone formation
  • Cut down on alcohol – Beer and spirits should be avoided. Do not binge drink.
  1. Medical treatment

For acute gout (joint pain)- treatment is divided into focus on relieving intense joint pain followed by prevention of future episodes with medications.

An asymptomatic high uric acid level greater than 8 mg/dl, warrants further workup, lifestyle changes and medications.

Your doctor may consider medications such as Allopurinol, Febuxostat for prevention of gout and lowering uric acid levels. Medications should be taken under strict medical supervision.

Dr. Tarun Kaushik I Senior Consultant Nephrology and Kidney Transplantation I Dharamshila Narayana Superspeciality Hospital, Delhi

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