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Hyperuricemia
What are the symptoms of hyperuricemia?
Some patients with hyperuricemia are asymptomatic, while others may suffer from complications such as gouty arthritis, gouty nephropathy, and tophi. Gouty arthritis is very common clinically and is primarily characterized by localized joint redness, swelling, heat, and pain. The commonly affected joints include the first metatarsophalangeal joint, ankle joint, and wrist joint. In cases of gouty nephropathy, patients may exhibit high levels of uric acid and increased creatinine levels, which may manifest as frequent urination, nocturia, and swelling of the lower limbs. If gout crystals deposit in the joints, they can form tophi, leading to joint deformities and restricted movement.
What should be noted for hyperuricemia?
Firstly, hyperuricemia is just found during routine physical examinations or blood tests, showing an increase in blood uric acid levels without the occurrence of gout attacks, meaning there are no symptoms of joint pain. At this time, there is no need for special medication, which means uric acid-lowering drugs are not required. However, you need to be cautious and change your lifestyle habits. For example, abstaining from alcohol, controlling the intake of animal organs, seafood, and barbecued foods. Additionally, drinking more water is necessary, and for overweight individuals, controlling weight and losing weight are important considerations. Also, you should avoid intense physical activities as they can trigger gout attacks, but this doesn't mean no exercise at all; slow walking and swimming are fine.
How should one with hyperuricemia adjust their diet?
For the diet of hyperuricemia, it is generally recommended to follow a low-purine diet. What is a low-purine diet? First, try to avoid consuming seafood, animal organs, and other seafood products that contain high purines. Second, it is advised to abstain from alcohol, especially spirits and beer, and it is best not to drink them at all. Third, drink plenty of water, ensuring a daily intake of at least 1500 to 2000 milliliters. Fourth, it is also recommended to avoid consuming traditional long-cooked soups and hotpots.
How to reduce high uric acid in hyperuricemia?
The treatment of hyperuricemia includes lifestyle intervention and medication. Lifestyle intervention involves controlling the total caloric intake of the diet, limiting the intake of high-purine foods, avoiding animal offal, shellfish, hot pots, and not consuming tofu, bean sprouts, and other soy products. Smoking and drinking alcohol should be prohibited. It is advocated to eat alkaline foods and choose melon-type vegetables. Appropriate exercise, such as brisk walking, jogging, and aerobic dancing, should be performed. Weight control is necessary, and obese patients should lose weight. Secondly, medication should be used to lower uric acid levels. Options include drugs that promote the excretion of uric acid and drugs that inhibit the production of uric acid, while also alkalizing the urine.
Are hyperuricemia and high uric acid the same thing?
Firstly, hyperuricemia and high uric acid levels refer to the same concept, defined as blood uric acid levels greater than 420. This condition is described as asymptomatic hyperuricemia, which does not require special treatment at this stage, but it does necessitate changes in lifestyle habits such as abstaining from alcohol, avoiding eating animal organs, seafood, and high-protein foods, not drinking carbonated beverages, and losing weight if obese, to help control body weight. After changing these lifestyle habits, a recheck of the uric acid levels should be done in two weeks to see if there has been a decrease. If the levels have not decreased at that time, sodium bicarbonate tablets can be used to alkalinize the urine. Additionally, increasing water intake to promote the excretion of uric acid and monitoring the dynamic changes in uric acid levels are needed. Once joint pain occurs, which indicates an acute gout attack, proper uric acid-lowering medication is required. (Please undergo medication under the guidance of a professional physician, and do not self-medicate blindly.)
Is hyperuricemia contagious?
Hyperuricemia is not contagious. Hyperuricemia refers to a condition where the concentration of uric acid in the blood exceeds the normal upper limit. Typically, for males and post-menopausal females, a blood uric acid concentration greater than 420 µmol/L, or pre-menopausal females with more than 348 µmol/L, is considered hyperuricemia. Most severe cases of hyperuricemia are due to deficiencies in uric acid metabolism enzymes and fall under the category of liver metabolism disorders. Moreover, mild to moderate hyperuricemia is often associated with obesity, type 2 diabetes, hyperlipidemia, hypertension, arteriosclerosis, and coronary heart disease, among others. It is a type of nucleic acid metabolic disease, and therefore, it is not contagious.
The causes of hyperuricemia
The causes of hyperuricemia can currently be divided into two categories: primary and secondary. The cause of most primary hyperuricemia is not yet clear. A few cases are due to enzyme deficiencies, which are related to either excessive production or reduced excretion of uric acid. There is also idiopathic hyperuricemia, such as familial kidney diseases that are associated with hyperuricemia, among others. Some secondary hyperuricemias, for example, are secondary to some congenital metabolic diseases, such as glycogen storage disease. It can also be due to certain systemic diseases, such as leukemia, multiple myeloma, lymphoma, polycythemia vera, hemolytic anemia, etc. Some cases are physiological increases, such as the intake of foods rich in purines, long-term eating and fasting states can also cause increased blood uric acid. Some medications can also lead to hyperuricemia, such as thiazide diuretics, furosemide, ethanol, immunosuppressants, aspirin, etc., which can also cause hyperuricemia. Therefore, the causes of hyperuricemia are diverse, and some causes are still unclear.
How is hyperuricemia caused?
Hyperuricemia is mostly asymptomatic, meaning there are no uncomfortable symptoms. It is usually discovered during physical examinations or blood tests when the uric acid level is found to be elevated, around 420, which is considered hyperuricemia. What causes it? It is mainly caused by poor lifestyle habits, such as long periods of drinking alcohol, excessive intake of animal organs, seafood, barbecue, and too much protein intake. Additionally, some people may develop high uric acid levels due to prolonged use of diuretics. When hyperuricemia occurs, it is essential to change lifestyle habits, but at this time, no special medication treatment is needed.
Is hyperuricemia dangerous?
Hyperuricemia is generally diagnosed when the blood uric acid level in males exceeds 420 micromoles per liter and in females exceeds 360 micromoles per liter. Some patients with hyperuricemia are asymptomatic, but others may develop gouty arthritis, characterized by local joint redness, swelling, heat, and pain, and even limited mobility. Some patients may develop gouty nephropathy, leading to abnormal kidney function. There are also instances of patients developing tophi, which can cause joint deformity and even limited mobility. Therefore, if hyperuricemia is not controlled promptly, it poses certain risks and may lead to complications such as tophi, gouty arthritis, and gouty nephropathy.
Hyperuricemia treatment agent
Currently, the main treatments for hyperuricemia in clinical practice include the following types. One category is drugs that inhibit uric acid synthesis, primarily allopurinol and febuxostat. Allopurinol is a xanthine oxidase inhibitor, which mainly works by preventing the conversion of hypoxanthine and xanthine into uric acid through the inhibition of xanthine oxidase. Febuxostat, on the other hand, is a newer xanthine oxidase inhibitor and may be more effective than allopurinol in lowering blood uric acid levels. Another category includes drugs that promote the excretion of uric acid, suitable for patients with normal renal function and hyperuricemia. These mainly include probenecid, benzbromarone, and some use of thiazide diuretics, though their effectiveness for hyperuricemia is somewhat controversial. (Specific medications should be taken under the guidance of a physician.)