Hyperuricemia: (High uric acid level) Symptoms, Causes, Treatment & Prevention

 

Hyperuricemia occurs frequently.  Symptoms of kidney stones or gout typically identify them. The best strategy to avoid hyperuricemia (and lower uric acid levels) is to follow a diet low in purines.

What is Hyperuricemia?

The medical term for having a high level of uric acid in the body is "hyperuricemia."

Your body produces uric acid as a waste product when it breaks down purines, which are chemicals found in food and beverages. The majority of uric acid dissolves in blood, travels through the kidneys, and exits the body as urine. If your body retains too much uric acid, you will develop hyperuricemia.

Uric acid crystallizes into sharp clusters when hyperuricemia is present. Gout, a painful type of arthritis, can result from these crystals settling in your joints. Kidney stones can also develop in their buildup in the kidneys.

It is very easy to treat hyperuricemia. You may need to make some adjustments to your daily routine, such as changing your diet or increasing your water intake. To treat any symptoms you're having or to lower your uric acid levels, your doctor may prescribe medication.

The body produces uric acid as a waste product during the breakdown of substances known as purines.  The majority of this uric acid is transported by the blood to the kidneys, where it passes through elimination as urine.  Hyperuricemia is a disorder that can result from the body retaining abnormally high levels of uric acid.

Also Read: Osteoporosis: Symptoms, Causes, Treatment and Prevention

What symptoms of hyperuricemia are present?

In most cases, hyperuricemia is asymptomatic. Until their uric acid levels are high enough to cause kidney stones or gout, most people are unaware that they have it.

A gout attack in one of your joints can cause the following symptoms:

• Intense pain.

• Discoloration or redness.

• Stiffness.

• Swelling.

Even when lightly touched (for example, by your bedsheet covering it), it feels tender.
Warmth or the sensation that the place is "on fire."

Kidney stone symptoms include:

•  Discomfort in your side or lower back.

•  Vomiting or nausea is brought on by the discomfort.

•  Chills or fever.

•  You have blood in your urine.

•  Pain during urination.

•  Having trouble peeing.

•  Requiring more frequent urination.

•  Urine that looks cloudy or has an unpleasant odor.

Why does hyperuricemia occur?

 Hyperuricemia is the result of having too much uric acid in your blood.

 Purines are broken down by your body to produce uric acid.  Purines are found in nature and are safe in moderation.  However, you can gradually increase your uric acid levels by eating foods high in purines regularly.  Purine-rich foods and beverages include:

•  Red meat 

•  Liver and other organ meats.

•  Seafood, particularly sardines, lobster, shrimp, and salmon.

•  Beverages and foods that contain high fructose corn syrup.

•  Alcohol, particularly beer, including beer without alcohol.

 As a side effect, some drugs can raise your uric acid levels, such as:

•  Water pills are another name for diuretics.

•  Immunosuppressive.

Risk factors for hyperuricemia

Anyone can be affected by hyperuricemia. Hyperuricemia is more common in certain demographics, such as those who:

• Are men.

• Possess obesity.

• Drink alcohol regularly.

• Eat foods high in purines regularly.

• Have relatives who suffer from gout or hyperuricemia?

• Become hypothyroidism.

How is a diagnosis of hyperuricemia made?

 By measuring the amount of uric acid in your blood, a medical professional can diagnose hyperuricemia.

 The kidney stone itself may be tested if you pass it or have one surgically removed.

 Do I have gout if my uric acid levels are high?

 It's not a guarantee that hyperuricemia will lead to gout.  Your doctor will collect a sample of your joint fluid during a flare-up of gout symptoms to check for uric acid crystals, which is how gout is diagnosed.  Additionally, they may perform imaging tests on your joints, such as:

• Ultrasound.

•  Computed tomography, or CT, scan.

•  X-rays.

How can hyperuricemia be treated?

If you don't have any symptoms but have high uric acid levels, you may not need treatment for hyperuricemia. Your healthcare provider will decide how frequently blood tests are performed to track any changes in your uric acid levels.

The following strategies can be used to manage elevated uric acid levels and the symptoms they cause:

Diet Control:

 To stop the body's uric acid levels from rising further, it's critical to limit the amount of purines in your diet. 

• Red meat and organ meats.

• Alcohol and drinks sweetened with high fructose corn syrup, like soda.

• Fish, especially shellfish like lobster and shrimp.

Thus, the symptoms of hyperuricemia can be managed by making sure that purine intake is kept under control.

Weight Loss: 

Joint pain and swelling from gout, which is brought on by elevated uric acid, get worse as body weight rises. Losing weight can therefore lessen the strain on these joints, which will lessen the pain.

Gout Treatment

Gout is typically managed with a combination of prescription medication to help lower your uric acid levels and over-the-counter NSAIDs when you're experiencing symptoms. You may require corticosteroids (prescription anti-inflammatory drugs) or colchicine (a medication that prevents gout attacks).

Treatment for kidney stones

Eventually, kidney stones may leave your body through your urine. It's critical to increase fluid intake. Make an effort to consume 64 ounces or more of water each day.

By relaxing the muscles in your ureter, which is the duct that urine travels through to get from your kidneys to your bladder, your doctor may recommend drugs that aid in the passage of stones.

It may be recommended that you drink a lot of water to help kidney stones that are 5 millimeters or smaller pass out through urine.

You may require surgery to remove a kidney stone if it is too big to pass, obstructs your urine, or results in an infection.

Lithotripsy may be used to treat large kidney stones. Surgery is necessary to remove stones larger than 10 millimeters.

Your uric acid levels will determine which medications you require. You may require medications designed specifically to treat kidney stones or gout.

Your doctor may recommend medication to help your kidneys eliminate excess uric acid or break up any crystals of uric acid that have already accumulated in your body.

Prevention of Uric Acid:

Dietary control is the most important strategy for controlling blood uric acid levels. Limiting consumption of purine-rich foods, such as organ meat, tuna, and red meat, will help keep uric acid levels within normal ranges. Reducing consumption of foods and beverages that contain fructose syrup can also lower uric acid levels because the body produces purines as fructose is broken down.

Additionally, losing weight may help some people control their uric acid levels because being overweight or obese raises the risk of having high blood uric acid.

References:

• Xing Y, Yang L, Liu J, Ma H. The Association with Subclinical Thyroid Dysfunction and Uric Acid (https://pubmed.ncbi.nlm.nih.gov/34938334/). Int J Endocrinol. 2021 Dec 13;2021:9720618. Accessed 7/17/2023.

• National Library of Medicine (U.S.). Uric acid — blood (https://medlineplus.gov/ency/article/003476.htm). Last reviewed 5/1/2021. Accessed 7/17/2023.

• George C, Minter DA. Hyperuricemia (https://pubmed.ncbi.nlm.nih.gov/29083565/). 2022 Jul 18. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Accessed 7/17/2023.

• National Library of Medicine (U.S.). Gout (https://medlineplus.gov/gout.html). Last reviewed 3/16/2016. Accessed 7/17/2023.

• https://en.wikipedia.org/wiki/Hyperuricemia