Uric Acid Levels: Insights on Gout and Health Management

Q: Uric Acid Levels: Insights on Gout and Health Management

Hello, thank you for your question. <br>Here are my responses： <br>1. <br>I have been losing weight for over a month, with my weight dropping from 104 kg to 97 kg. <br>I would like to know if my lowest uric acid level in my life, which is 5.6 mg/dL, is due to dietary control or b

Interpretation of Uric Acid Levels

Hello, Doctor.
I am 175 cm tall and weigh 97 kg.
I have had high blood pressure since I was 16 years old.
I do not drink alcohol but often stay up late.
On March 15, I sprained my left ankle; at the time, there was no pain or swelling.
However, on March 17, I experienced pain when walking or touching my left ankle.
I visited an orthopedic doctor on March 19, who examined my ankle and reviewed my health report from six months ago.
He noted that my uric acid level was 6.9 mg/dL, indicating hyperuricemia.
He prescribed pain relief, anti-inflammatory medication, gout medication, and steroids, advising that I could stop taking them if I felt better in two days.

On March 24, after researching gout for several days, I realized that my symptoms did not match many clinical presentations; my foot was neither swollen nor warm, and I did not see significant improvement after taking the medication for five days.
Therefore, I stopped the medication without the doctor's consent (which was very inappropriate).
On March 27, although my foot felt much better, I sought a consultation with a rheumatologist for reassurance.
The doctor confirmed that I did not have any significant symptoms.
Since I had blood tests scheduled with my cardiologist on the same day (March 27), the doctor advised me to return if there were any abnormalities in the results.
On March 29, I checked my report through the National Health Insurance translation service, and my uric acid level was 5.6 mg/dL.
I would like to ask you: 1.
I have been losing weight over the past month, dropping from 104 kg to 97 kg.
I would like to know if my lowest uric acid level is due to dietary control or the gout medication I stopped taking on my own.
Can I feel reassured with a uric acid level of 5.6 mg/dL? 2.
I have to stand for long periods at work, and I still occasionally feel discomfort.
Do I need to schedule a follow-up appointment?
Thank you, Doctor.

Jinzhang Nanshi, 30~39 year old female. Ask Date: 2024/03/29

Dr. Gao Jiankai reply Internal Medicine

Hello, thank you for your question.
Here are my responses:
1.
I have been losing weight for over a month, with my weight dropping from 104 kg to 97 kg.
I would like to know if my lowest uric acid level in my life, which is 5.6 mg/dL, is due to dietary control or because I previously stopped taking my medication for gout on my own.
Can I feel reassured? --> I believe it is reasonable to temporarily refrain from medication and observe whether joint pain symptoms reoccur.
2.
Due to my job requiring prolonged standing, I still occasionally experience discomfort.
Is it necessary for me to return for a follow-up appointment? --> I recommend that you consult with a rheumatologist to discuss your condition.
The physician can assess your joint status and determine whether you can extend the interval between follow-up visits or if a follow-up is necessary.

The Allergy, Immunology, and Rheumatology Department at Changhua Hospital is here to support you.

Reply Date: 2024/03/29

More Info

Understanding uric acid levels and their implications for health is crucial, especially for individuals who may be at risk for conditions like gout. Based on your recent experiences and health history, let's delve into your questions regarding uric acid levels, potential causes for fluctuations, and the management of your symptoms.

1. Uric Acid Levels and Their Fluctuations: Your recent uric acid level of 5.6 mg/dl is within the normal range, which typically is considered to be between 3.5 and 7.2 mg/dl for men. The decrease from 6.9 mg/dl to 5.6 mg/dl could be attributed to several factors, including dietary changes, weight loss, and possibly the cessation of medications like the anti-gout medication you were taking. Weight loss can significantly impact uric acid levels, as excess body weight is a known risk factor for hyperuricemia (high uric acid levels). When you lose weight, your body may metabolize stored purines (which break down into uric acid), leading to lower uric acid levels.
It’s also important to note that stopping medication without medical supervision can lead to unpredictable changes in uric acid levels. However, since your current level is normal, it suggests that your body is managing uric acid effectively at this time. Nonetheless, it’s essential to maintain a balanced diet low in purines (found in red meats, organ meats, and certain seafood) and to stay hydrated, as these factors can help keep uric acid levels in check.

2. Symptoms and Follow-Up Care: Regarding your ongoing discomfort in your ankle, it’s wise to monitor your symptoms closely. While the absence of swelling and heat is a good sign, persistent pain could indicate other issues, such as a strain or sprain from your earlier injury. Given that you have a history of high blood pressure and have been experiencing discomfort, it would be prudent to follow up with a healthcare provider, especially if the pain persists or worsens.
A rheumatologist or a specialist in musculoskeletal disorders can provide a more comprehensive evaluation to rule out any underlying conditions that may not be related to gout. They may recommend imaging studies, such as an X-ray or MRI, to assess the integrity of the joint and surrounding tissues.
In summary, your recent weight loss and dietary changes likely contributed to the decrease in uric acid levels, and your current level of 5.6 mg/dl is reassuring. However, it’s essential to remain vigilant about your symptoms and consider follow-up care to ensure that any underlying issues are addressed. Regular check-ups and open communication with your healthcare providers will help you manage your health effectively.

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