Uric acid and gout: Where are we going wrong?

DOES URIC ACID HAVE ANY FUNCTION IN THE BODY?

Uric acid is more of an immune system stimulant, is needed for endothelial functions and regulates immune responses. Basically, it works like an antioxidant. In humans, over half the antioxidant capacity of blood plasma comes from uric acid. You would find it concentrated in the liver, vascular endothelial cells and in human nasal secretions, where it acts as an antioxidant. The problem happens when its levels go higher.

WHAT HAPPENS WHEN ITS LEVELS GO HIGHER?

When the body cannot expel excess levels of uric acid into the bloodstream, it crystallises and settles in common joints, mostly the big toes, ankles, wrists, knees, smaller joints and even elbows. That’s why you experience body aches all over and get inflammatory conditions like gout.

Elevated levels of uric acid cause the formation of kidney stones, which can damage the organ if left untreated. Even if it doesn’t form stones, it can still damage the kidneys. High uric acid can lead to the development of hypertension and once you control it, you can manage your blood pressure levels well and reduce the risk of heart attacks, disease and stroke. In fact, high levels of uric acid, with co-morbidities like high cholesterol, diabetes, abdominal obesity and obstructive sleep apnea, can lead to complications.

WHAT IS THE NORMAL RANGE OF URIC ACID?

Normal values range between 3.5 to 7.2 milligrams per decilitre (mg/dL). It is usually 6 for women, 7 for men and does not require medication unless you develop gout, kidney stones. But medication is a must if your figures are higher than 9.

WHAT ARE THE RISK FACTORS OF URIC ACID?

Though there could be some genetic predisposition towards uric acid pile-up, the most important reasons have got to be diet and alcohol.

Diet and alcohol: Since uric acid is formed as a result of the breakdown of a compound called purine, one has to watch out for foods that come enriched with it. High purine foods are mostly animal derived, be it red meat, organ meats and seafood which includes anchovies, sardines, mussels, scallops, trout and tuna. In alcohol, beer and whiskey contribute the most to purines, wine is the least. Avoid sweetened carbonated beverages and fructose corn syrup for the same reason. All of these interfere with the body’s ability to expel uric acid. For a long time, most advisories also asked patients to stay away from purine-rich plant foods like spinach, beans, peas, and tomatoes but latest research shows that their contribution to raising uric acid levels in the bloodstream is negligible. In fact, wholegrains, legumes, fruits, fibrous food, coffee and vitamin C have been known to have a protective effect.

Weight: Being overweight or obese can contribute to elevated uric acid levels.
Medication: Certain medicines increase uric acid like the TB medicine Pyrazinamide, diuretics, BP medication, angiotensin-converting enzyme (ACE) inhibitors and beta blockers.

Age and sex: Gout occurs more in men than women. But after menopause, women’s uric acid levels approach those of men.

Just remember that it is important to monitor uric acid levels regularly and to take steps to manage them if they become elevated. Sometimes a little adjustment does all the trick.