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Hyperuricemia
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.)
What fruits to eat for hyperuricemia?
For patients with hyperuricemia, we generally need to limit the intake of high-purine foods, such as crab and animal offal. Moderate consumption of medium-purine foods, such as meats and fish, is acceptable. Low-purine foods like vegetables, fruits, milk, and eggs can be safely consumed. For example, fruits like grapes, pears, grapefruits, kiwis, and dragon fruits are all acceptable to eat. However, many patients with hyperuricemia also have other metabolic abnormalities, such as high blood sugar. In such cases, it is important to monitor the quantity of fruit intake because excessive consumption can lead to fluctuations in blood sugar levels. Therefore, fruits can be safely consumed by those with hyperuricemia, but attention must be paid to any additional metabolic abnormalities that may be present.
Can people with hyperuricemia eat eggs?
In the case of hyperuricemia, we primarily recommend a low-purine diet to prevent the onset of gouty arthritis. As for the nutritional content of eggs, they are considered a food with a moderate level of purines. Therefore, when uric acid levels are relatively high, it is still possible to consume them in moderation. Aside from diet, it is also necessary to drink plenty of water or to alkalize the urine using baking soda tablets even if there is a transient increase in blood uric acid levels. If sufficient water is consumed, it is less likely for deposits to form in the joints. If deposits do not easily form, it also relatively reduces the possibility of triggering inflammatory responses, thus preventing the occurrence of gouty arthritis. Therefore, it is possible to consume an appropriate amount of eggs, but it is also important to drink plenty of water and appropriately alkalize the urine.
Hyperuricemia Complications
Common complications, the first is the effect on joints, manifested as local joint redness, swelling, heat, and pain, and even mobility impairment, usually referring to gouty arthritis. The second complication is the effect on the kidneys, resulting in hyperuricemic nephropathy, where the patient will experience abnormal kidney function. The third complication is the formation of gouty tophi, where many patients have deposits in the joints, leading to the occurrence of tophi and causing joint mobility impairment. Therefore, hyperuricemia needs to be treated promptly to prevent these complications.
Can people with hyperuricemia eat wood ear mushrooms?
People with hyperuricemia can eat wood ear mushrooms. As wood ear mushrooms are considered a low-purine food, containing approximately 8.8mg of purines per 100 grams, they can be consumed during hyperuricemia. For hyperuricemia, it is necessary to restrict some high-purine foods, such as animal offal, clams, crabs, oysters, and sardines. Some meats, seafood, peas, and spinach, which also contain a certain amount of purines, can be consumed in moderation. Wood ear mushrooms are a low-purine food and are generally not restricted. Thus, people with hyperuricemia can eat wood ear mushrooms.
Pre-symptomatic hyperuricemia
Hyperuricemia in the preclinical phase can be asymptomatic, only showing fluctuating or persistent hyperuricemia during blood tests. From the increase in uric acid to the onset of symptoms, it can generally take several years to decades. Additionally, some changes in the kidneys due to the deposition of uric acid can cause manifestations of gouty nephropathy. Early stages may present intermittent proteinuria and increased urine foam. As the condition progresses, the kidney's concentrating ability may decrease, resulting in increased nighttime urination. Further progression can lead to renal insufficiency, elevated creatinine and urea nitrogen, and possibly swelling and hypertension. In severe cases, acute renal failure may occur, showing symptoms of oliguria or anuria. This type of uric acid nephropathy is primarily due to the deposition in the kidneys, causing episodes of kidney stones and back pain, with stone episodes also accompanied by hematuria. Therefore, the main presentations are associated with the deposition of uric acid in the kidneys during the preclinical phase of hyperuricemia.
What should be avoided with hyperuricemia?
Foods to avoid for hyperuricemia include those high in purines. Here is a list of foods that are high in purines: 1. Seafood, such as some shellfish, shrimp, crab, and certain fishes. 2. Broths that have been simmered for a long time, as they tend to contain higher levels of purines. 3. Certain mushrooms should be consumed less, such as shiitake and straw mushrooms. 4. Animal organs should be avoided as much as possible. 5. Alcohol, especially strong spirits and beer, should be avoided; instead, it's important to drink plenty of water, ensuring to consume 1500 to 2000 milliliters daily.
What foods should be avoided with hyperuricemia?
Hyperuricemia generally requires a low-purine diet. So, what foods should be avoided? First, seafood and sea fish, as they have a high purine content and should not be consumed. Second, avoid animal organs like chicken and duck kidneys. Third, abstain from alcohol, especially strong spirits and beer, which tend to raise uric acid levels, so it's recommended to avoid them. Fourth, it is advised not to consume long-cooked broths, such as those commonly enjoyed in Guangdong where the broth is simmered for several hours, as these also have high purine content. Fifth, limit intake of some bean products and various mushrooms, as these should also be consumed minimally.
Dietary Guidance for Hyperuricemia
For hyperuricemia, it is generally recommended to adopt a low-calorie diet, control weight, and try to maintain an ideal weight. Secondly, avoid high-purine foods and opt for a diet low in purines. The third point encourages the use of some alkaline medications and strict abstinence from alcohol. The fourth point is to reduce the intake of fructose-rich beverages. The fifth point is to avoid drinking strong tea, coffee, cocoa, and other such beverages. The sixth point emphasizes the need to drink more water, recommending a daily water intake of at least 2000 milliliters.