What is uric acid?
Uric acid is a compound created by the liver from the metabolism of purines, a type of substance present in several foods, especially those of animal origin. Despite this, only 40% of the purines are ingested in food since our own body is responsible for the production of the other 60%.
Uric acid is a natural compound in our body, but menus rich in purine considerably increase the amount of it in the blood.
Elevated uric acid
It is considered high when it is in concentrations above 7 mg / dL of blood in men and 6 mg / dL in women, since until menopause , estrogen facilitates the elimination of the substance, which is made by the kidneys.
When it is high, uric acid is capable of causing problems in the body. It is not a very soluble substance, so in concentrations greater than 7 mg / dL of blood, the acid can lose its solubility and solidify, creating crystals of sodium urate. These crystals are the cause of the problem and are what can cause disease.
The increase in uric acid is related to the kidneys’ ability to eliminate extra liver production. It is estimated that 25% of men have more than 7mg / dL of uric acid in their blood, which does not necessarily mean that there will be a disease, but the chances become greater.
The most frequent case is that the diet contains too many purines. This causes the liver to produce more uric acid than the kidneys can eliminate.
Foods that increase uric acid are mostly of animal origin, like red meats, but alcohol is also able to do that.
Renal failure is capable of causing difficulties in eliminating uric acid, as well as other kidney problems. This causes the substance to accumulate in the blood. It is a rare way to increase uric acid compared to food, which is the most common.
Elevated uric acid will not necessarily show symptoms, but when it does, it causes disease. There is a greater possibility that the symptoms will appear if the patient is overweight.
The symptoms are as follows:
The drop is the primary disease related to elevated uric acid. It happens when uric acid solidifies in sodium urate and enters the joints, causing inflammation. This causes extreme swelling and pain.
It is especially common because the lower the temperature, the more easily uric acid solidifies, and the joints have temperatures of 32 degrees Celsius instead of 37 degrees in the blood.
Thus, when high concentration uric acid passes through a joint, the chances of it becoming sodium urate are greater.
Gout is more frequent in elderly men, although it can affect young people and women. The disease causes bouts of pain that can last for weeks and disappear spontaneously, but can return at any time.
The joint most commonly affected is the big toe, but it can reach other joints and is likely to affect several of them over time if the disease is not treated.
Tophaceous gout is the name given to gout when it has been ignored for a long time.
After approximately 20 years without treatment, sodium urate deposits increase in the joints and also appear on the skin, causing swelling, extreme pain and severe deformation, often in the hands, feet and elbows.
The deposits are now called tophi, which can be large and multiple.
Another risk that exists with elevated uric acid is that of the appearance of kidney stones, the famous and painful kidney stones. Unlike gout, kidney stones caused by uric acid depend more on the acidity of the urine and the amount of acid excreted per day rather than the amount of acid in the blood.
If the urine has a pH constantly below 5.5 (normal values are between 4.6 and 8.0) and more than 1100 mg of uric acid is excreted daily, the risk of kidney stones is greater. This type of uric acid excretion value is only common in people with a concentration of more than 9.0 mg / dL of blood, which is quite high.
Remembering that urinary pH is influenced by food and that the lower the pH number, the more acidic the urine is.
Kidney stones are known to be extremely painful, often classified by patients as “the worst pain I have ever had in my life”. When the stone is immobile in the kidney, it may go unnoticed, but when it enters the ureter, the channel that carries urine from the kidneys to the bladder, and gets stuck there, the pain is excruciating.
It starts suddenly and lasts an average of 4 to 6 hours to pass.
Small enough stones can pass through the urinary system unnoticed until the patient hears the stone hit the toilet. Some may be small enough to pass through the ureter to the bladder and then become trapped in the urethra, causing pain.
Stones between 0.5 and 0.9 cm can pass through the urinary system, causing a lot of pain. Stones over 1 cm in diameter, on the other hand, cannot pass through the urinary system and must be removed surgically.
Large stones can block the ureter completely, causing the kidneys to swell and damage them.
Nephropathy for urate
There may be deposition of uric acid in the kidneys, which causes inflammation and can lead to chronic kidney failure. This happens with the blocking of the renal tubules, which, when blocked, do not let the urine pass, reducing the production. Inflammation can cause fibrosis, which leads to kidney failure.
This condition, however, usually only occurs at very high concentrations of uric acid in the blood. 13 mg / dL in men and 10 mg / dL in women.
There are other diseases that may be related to the high level of uric acid. Studies indicate a relationship between high levels of the substance and conditions such as hypertension, diabetes and cardiovascular diseases. However, there is no evidence that these diseases are caused by uric acid.
It is known, for example, that hypertensive people usually have high levels of uric acid, but this does not mean that the substance is the cause, especially since the reduction of acid values in the blood of patients does not change the condition of hypertension, among others. reasons. Therefore, these connections are, for the time being, only suspicious.
Read more: Low uric acid: what can it be? What are the symptoms?
High uric acid in pregnancy
Uric acid, in early pregnancy, is reduced by the body itself, and rises again in the third trimester of pregnancy. However, especially if the pregnant woman has high blood pressure , uric acid rising during the first or second trimester of pregnancy can increase the risk of pre-eclampsia .
This is a disease characterized by high blood pressure during pregnancy and which can progress to eclampsia , which can cause seizures , coma and death, in addition to the loss of the baby or the premature birth of the child.
Preeclampsia is a serious condition and needs to be treated urgently.
The diagnosis of symptoms can be made by the general practitioner, nephrologist and rheumatologist, through blood tests that check the amount of uric acid present in the body.
Reducing uric acid is possible with dietary control and medication. Treatment is not always necessary, as it is possible that elevated uric acid does not cause any symptoms.
Drug treatment is used if there is any disease related to uric acid (kidney stones, gout, urate nephropathy) and is not recommended in most asymptomatic patients, but it should be done, even without symptoms, if there is a concentration of more than 8, 0 mg / dL accompanied by excretion of 1100 mg of uric acid per day in the urine, or in cases where there is a concentration greater than 13 mg / dL in men or 10 mg / dL in women.
Medicines can be used to control uric acid in the blood, either to reduce production or to increase excretion.
- Allopurinol .
- Probenecida ;
NEVER self-medicate or stop using a medication without first consulting a doctor. Only he will be able to tell which medication, dosage and duration of treatment is the most suitable for his specific case. The information contained in this website is only intended to inform, not in any way intended to replace the guidance of a specialist or serve as a recommendation for any type of treatment. Always follow the instructions on the package insert and, if symptoms persist, seek medical or pharmaceutical advice.
Living with elevated uric acid when it has symptoms is a matter of discipline. The most common symptom is gout. It causes extreme pain in the joints. Diet is the easiest way to keep the amount of seizures under control.
Avoiding foods that increase uric acid in the blood (see more in “Prevention”) can prevent gout attacks, as well as kidney stones and other possible symptoms of excess substance in the blood.
Losing weight can help prevent symptoms, in addition to reducing uric acid.
With treatment, uric acid levels can be reduced and it is possible to live a normal, pain-free life. Just follow the doctor’s directions. With the use of the indicated medications and changes in eating habits, the complications caused by the condition become much more rare.
The complications that can be caused by untreated high uric acid can be summed up in the evolution of the diseases it causes.
Gout, in addition to causing severe pain, can spread to different joints in the body, causing more and more suffering to the patient as time goes by. In addition, it can develop into a topical gout, which leaves the joints deformed and extremely painful due to the accumulation of sodium urate crystals.
Kidney stones bring extreme pain. In addition, if the stone is large enough, it can obstruct the channel through which the urine should pass. This can lead to serious damage to organs such as the kidneys or bladder.
Nephropathy for urate
Being the most serious of the conditions that can occur due to the accumulation of uric acid, urate nephropathy can block kidney channels , leading to serious damage to the organ, which can cause severe kidney failure.
It is not possible to reduce the body’s own purine production. Therefore, preventing uric acid from rising in the blood is a matter of diet. There is no need to cut, but reducing purine-rich foods can help to reduce risks.
This is only necessary if the uric acid concentration in your blood is above ideal.
Beef, bacon, pork, veal, kid, lamb and giblets (liver, heart, kidney, tongue) are rich in purine and increase the level of uric acid in the blood.
Fishes and sea food
Salmon, sardines, trout, cod, fish eggs, caviar, seafood, oysters and shrimp can increase the risks related to uric acid. These foods have a lot of purine.
Turkey, chicken and goose are also rich in purine.
Sources of uric acid, should be avoided by those who want to reduce the level of the substance in the blood.
Beans, wheat, peas, nuts, peanuts and hazelnuts, in addition to others, have purine and should be reduced or avoided.
Beer has more purine than other alcoholic beverages due to fermentation. However, alcohol itself is a source of purines and should be avoided.
Many foods contain the substance and making these dietary changes can be quite difficult. However, there is still a lot of food without purine.
Fruits, vegetables, rice, potatoes , vegetable oils, whole grain breads, eggs, milk and dairy products do not contain purine. These foods can be used in the diet of those who have high uric acid.
Diuretics are also recommended to clean the blood, as urinating more often helps with blood filtration. Foods like artichoke , apple and watermelon can help with this.
Drinking 1.5 to 2 liters of water a day helps the kidneys to eliminate uric acid in the urine. This can reduce the risks related to the substance. In addition, staying hydrated is always good for your health.
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