High Uric Acid: Gout, Genetics, and Long-Term Treatment

Q: High Uric Acid: Gout, Genetics, and Long-Term Treatment

Question 1： The definition of hyperuricemia is a serum uric acid concentration greater than 7.0 mg/dL in men and greater than 6.0 mg/dL in women. <br>Uric acid is a risk factor for the development of gout; however, the relationship between hyperuricemia and acute gout remains unc

Uric acid and metabolism issues?

Hello Dr.
Hsiao,
Question 1: Around the age of 20, I was diagnosed with high uric acid levels, approximately double the normal range, which led to gout (in my toe).
The doctor mentioned it might be hereditary, but my family members do not exhibit any symptoms of gout, which surprised me.
Previously, I had blood tests due to gastroenteritis, and the doctor informed me about my elevated uric acid levels, advising me to take urate-lowering medication long-term.
He warned that if I do not take the medication, I could face kidney inflammation or even stones as I age.
Dr.
Hsiao, do I really need to take urate-lowering medication for an extended period? Are there any side effects? Is it harmful to my body?
Question 2: I am petite with a baby face, and people often think I am still in middle or high school, not realizing I have already completed my military service and entered the workforce.
I am under 165 cm tall and weigh less than 55 kg.
My parents are around 160 cm tall, but my brother is 170 cm.
I tend to eat slowly but can consume a lot, and I often have late-night snacks...
yet I do not gain weight.
Dr.
Hsiao, what could be the underlying issue? Is there a way to improve this situation?

Xiao Weiwei, 20~29 year old female. Ask Date: 2012/10/14

Dr. Xiao Yongxun reply Internal Medicine

Question 1: The definition of hyperuricemia is a serum uric acid concentration greater than 7.0 mg/dL in men and greater than 6.0 mg/dL in women.
Uric acid is a risk factor for the development of gout; however, the relationship between hyperuricemia and acute gout remains unclear.
Hyperuricemia is often associated with hypertension, type 2 diabetes, dyslipidemia, central obesity, and coronary artery disease; these issues require further medical research.
Generally, conditions that necessitate long-term treatment include recurrent acute attacks, kidney stones or kidney disease, and tophi.
Regarding the need for long-term medication, it is advisable to discuss with your attending physician based on your individual constitution and examination results.
As for the side effects of medications, different urate-lowering drugs have various effects and side effects; in medicine, the decision to prescribe is made after weighing the benefits and risks.
In other words, if there is no need for prescription, it should not be prescribed; if it is necessary, one must accept the potential risks of side effects.
Please make this decision in consultation with your attending physician.
Question 2: Issues related to height and weight are extensive, involving genetic factors, environmental influences, nutritional status, lifestyle, medical conditions, and medication use.
Generally, if physiological conditions are mature and normal, there should be no significant problems; thus, no special measures are required.
If there are still concerns, it is recommended to discuss them with your attending physician before deciding whether further examination and intervention are necessary.

Reply Date: 2012/10/14

More Info

Hello! Thank you for your questions regarding high uric acid levels and related health concerns. Let's break down your inquiries into two main parts: the management of high uric acid and its implications, and your personal health concerns regarding height and weight.

Understanding High Uric Acid and Gout
1. Long-term Medication for High Uric Acid:
It is indeed common for individuals with high uric acid levels to be prescribed long-term medication, especially if they have experienced gout attacks. Gout is a form of inflammatory arthritis characterized by sudden, severe pain, redness, and swelling in the joints, often starting with the big toe. The primary goal of uric acid-lowering therapy is to prevent these painful attacks and reduce the risk of long-term complications such as kidney stones and chronic kidney disease.

The medications typically prescribed include allopurinol or febuxostat, which help lower uric acid levels in the blood. While these medications can be very effective, they may also have side effects. Common side effects include gastrointestinal issues, skin rashes, and, in rare cases, more severe allergic reactions. Regular monitoring by your healthcare provider is essential to manage any potential side effects and to ensure that your uric acid levels are within a safe range.

2. Genetic Factors and Family History:
You mentioned that your doctor indicated a genetic component to your high uric acid levels, even though your family members do not exhibit symptoms of gout. Genetics can play a significant role in how your body processes uric acid. Conditions such as primary hyperuricemia can occur without a family history of gout. This means that while your family may not show symptoms, you could still have a genetic predisposition to elevated uric acid levels.

Personal Health Concerns
1. Height and Weight Issues:
You described yourself as petite, with a height of under 165 cm and a weight of less than 55 kg. It's important to note that body composition and metabolism can vary significantly among individuals. Factors such as genetics, diet, and physical activity levels all contribute to one's body weight and shape. If you find that you are eating a lot but not gaining weight, it could be due to a high metabolic rate or other underlying health issues.

If you are concerned about your weight and height, it may be beneficial to consult with a healthcare provider or a nutritionist. They can help assess your dietary habits, lifestyle, and overall health to determine if there are any underlying conditions that need to be addressed. Additionally, they can provide guidance on how to achieve a healthy weight if that is your goal.

2. Improving Your Health:
To improve your overall health, consider focusing on a balanced diet rich in whole foods, including fruits, vegetables, lean proteins, and whole grains. Regular physical activity is also crucial, as it can help maintain a healthy weight, improve muscle tone, and boost overall well-being. If you have specific concerns about your eating habits or metabolism, a registered dietitian can provide personalized advice.

Conclusion
In summary, managing high uric acid levels often requires long-term medication, especially if you have experienced gout. While there may be side effects, regular monitoring can help mitigate risks. Regarding your height and weight, consulting with a healthcare provider can help identify any underlying issues and provide strategies for improvement. Remember, maintaining a healthy lifestyle is key to managing both uric acid levels and overall health. If you have further questions or concerns, don't hesitate to reach out to your healthcare provider for personalized advice.

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