High Uric Acid Levels: Causes, Treatments, and Lifestyle Tips

Q: High Uric Acid Levels: Causes, Treatments, and Lifestyle Tips

Hello, Ayou： The uric acid level should be maintained below 7.0 mg/dL. <br>The most common sites affected by gout are the joints, particularly the interphalangeal and metatarsophalangeal joints (especially the big toe). <br>During an acute attack, colchicine is typically administ

Regarding the issue of high uric acid levels?

I would like to consult a doctor.
I have a condition of elevated uric acid levels, with values between 11 and 12.
Is the normal value 7? I discovered this issue three years ago when I suddenly experienced severe lower back pain and was unable to move.
After visiting an orthopedic specialist, I was told that the only possibility was gout.
Later, I noticed that my fingers sometimes experience intense pain, and my toes have some discomfort as well.
The lower back is the most frequently affected area.
Currently, I have been prescribed a medication called benzbromarone 50 mg, which I am to take once every two days.
What side effects should I be cautious of with long-term use of this medication? However, I was not informed about how long I should take the medication.

Doctor, is it appropriate for me to engage in more vigorous exercise at this time? Activities like jogging, jumping rope, basketball, weight training at the gym, or yoga? My doctor mentioned that this elevated uric acid level is considered hereditary and cannot be cured, and that I will need to continue taking medication.
He also said that dietary control is not very effective; is that true? Is there a chance for recovery? Should I aim to drink 3500 cc of water daily? When my back starts to hurt, aside from taking pain medication, can I use heat therapy or massage? I apologize for asking so many questions, but I would appreciate your help.

Ayou, 20~29 year old female. Ask Date: 2007/07/30

Dr. Wang Weijie reply Internal Medicine

Hello, Ayou: The uric acid level should be maintained below 7.0 mg/dL.
The most common sites affected by gout are the joints, particularly the interphalangeal and metatarsophalangeal joints (especially the big toe).
During an acute attack, colchicine is typically administered along with analgesics, and once the acute pain subsides, it can usually be discontinued.
The cause of gout is an abnormal metabolism of purines in the body, and controlling it through medication and a low-purine diet is essential.
This includes reducing the intake of organ meats and legumes, and particularly, gout patients should avoid drinking beer.
Increasing water intake to promote uric acid excretion is beneficial.
As for the exercise you mentioned, it is acceptable as long as it is within your physical and mental capacity.
Regarding your concern about lower back pain, heat application and massage can help alleviate the discomfort.
Wishing you good health.

Reply Date: 2007/07/30

More Info

High uric acid levels, or hyperuricemia, can lead to a variety of health issues, most notably gout, which is characterized by sudden and severe pain, redness, and swelling in the joints. Your reported uric acid levels of 11-12 mg/dL are indeed significantly above the normal range, which typically caps at around 7 mg/dL for men. Given your history of joint pain and the diagnosis of gout, it is crucial to manage your condition effectively.

Causes of High Uric Acid Levels
1. Diet: Foods high in purines, such as red meat, organ meats, certain seafood (like sardines and anchovies), and alcohol (especially beer), can increase uric acid levels. While dietary changes can help, they may not be sufficient on their own, especially if genetic factors are involved.

2. Genetics: As your doctor mentioned, genetics can play a significant role in how your body processes uric acid. If you have a family history of gout or hyperuricemia, you may be predisposed to these conditions.

3. Dehydration: Insufficient fluid intake can lead to higher concentrations of uric acid in the blood. Staying well-hydrated is essential.

4. Medications: Certain medications can increase uric acid levels, including diuretics and some chemotherapy drugs.

5. Kidney Function: Impaired kidney function can lead to decreased excretion of uric acid, contributing to elevated levels.

Treatment Options
1. Medications: Benzbromarone, the medication you mentioned, is used to lower uric acid levels by increasing its excretion through the kidneys. While effective, it can have side effects, including gastrointestinal issues and potential liver toxicity. Regular monitoring of liver function and kidney health is advisable while on this medication.

2. Lifestyle Modifications:
- Diet: While your doctor indicated that dietary control might have limited effects, it is still beneficial to avoid high-purine foods and focus on a balanced diet rich in fruits, vegetables, and whole grains.

- Hydration: Drinking plenty of water (aiming for around 3500 cc daily, as you mentioned) can help dilute uric acid levels and promote its excretion.

- Weight Management: Maintaining a healthy weight can reduce the risk of gout attacks.

3. Exercise: Engaging in regular physical activity is important, but you should approach it cautiously. Low-impact exercises like walking, swimming, or cycling are generally safer options. High-impact activities like running or jumping rope may exacerbate joint pain, especially during flare-ups. Always consult your healthcare provider before starting a new exercise regimen.

Managing Gout Attacks
During a gout attack, rest and elevation of the affected joint can help alleviate pain. Applying ice packs can also reduce inflammation. Heat therapy, such as warm compresses, may provide relief for some individuals, but it can vary from person to person.

Long-term Outlook
While hyperuricemia can often be managed effectively with medication and lifestyle changes, it may not be completely reversible, especially if there are genetic factors at play. Regular follow-ups with your healthcare provider are essential to monitor your uric acid levels and adjust treatment as necessary.
In conclusion, while you may need to continue medication for the foreseeable future, a combination of dietary management, hydration, and appropriate exercise can significantly improve your quality of life and reduce the frequency of gout attacks. If you have further concerns or experience new symptoms, do not hesitate to reach out to your healthcare provider for personalized advice.

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