Uric Acid and Gout

Uric acid is being frequently tested these days for patients who have joint pains.However patients with no joint pains also sometimes are found to have high uric acid on routine blood tests-asymptomatic hyperuricemia.Do they need treatment?What causes high uric acid and gout?

In this blog I'm going to bust some myths about uric acid and gout

Uric acid is formed from the digestion of purine rich foods like red meat(beef , mutton,pork),sea food ,organ meat like chicken and goat liver,alcohol(especially beer)

Men tend to have higher uric acid levels than women as women excrete uric acid better through their kidneys.Added to this,in many societies men consume more meat and alcohol than women

When uric acid crystallises in the joints of the body-that's when gout happens.Gout is an extremely painful inflammation of small joints especially toes.Crystallization of uric acid in the kidneys can also cause kidney stones and long term kidney damage.

Diagnosing gout and kidney damage due to uric acid can be tricky sometimes.This is because the uric acid levels in the blood may not always be elevated at the time of a gout attack.The most reliable way to diagnose is to take a sample of the synovial fluid of the joint involved and look for uric acid crystals in the fluid

Patients who have been diagnosed to have gout need to cut down drastically on the purine rich foods mentioned above.In addition uric acid lowering medication is needed lifelong for almost all patients.However it is important to note that uric acid lowering medication should not be started at the time of a gout attack as it can worsen the symptoms.Initial symptoms are managed with pain killers and later on once the inflammation subsides,urate lowering medication can be started

Asymptomatic Hyperuricemia

This is when uric acid levels are found to be high in the blood sample ,but the patient has none of the symptoms associated with uric acid disease.Such patients should NOT be started on uric acid lowering medication.Instead the cause for the high uric acid needs to be evaluated -Untreated Hypothyroidism,B12 deficiency ,metabolic storage  diseases ,kidney disease or a high intake of alcohol and red meat(mutton,beef,pork).

Stay informed.Stay healthy.