The role of uric acid levels in Gout

Gout is a very common form of arthritis that is characterized by inflammation of, usually, one of the smaller joints. Most commonly it is the joint of the big toe that is affected. Gout occurs principally in individuals that have increased uric acid levels in their bloodstream. This excess of uric acid, deposits in the joints forming needle shaped crystals that inflame the locality. This causes paroxysms or episodes of severe pain, swelling, redness and warmth in the affected joint, generating great discomfort in the sufferer.

Why do uric acid levels increase in the blood?

Uric acid is a breakdown product of purines, a type of protein. Purines are building stones of our DNA, present within each and every cell of our body, and play important roles in our cardiovascular and digestive system. Purines are naturally present compounds in many of the animal and plant foods we eat.

There are diverse factors that influence uric acid levels in the blood. With Purines naturally being part of our food chain, there are implications that our dietary habits can have on the uric acid levels in our blood. However diet appears to be only a small factor promoting the development of gout. Dietary management much more is a tool to control attacks and diminish the frequency of inflammatory flare-ups. Cutting down the consumption of alcohol, meat, certain types of fish, and sugars, particularly fruit sugars, and instead upping the intake of vegetables can markedly reduce the incidence of acute gout attacks. However, diverse conventional medications, such as diuretics, immune-suppressing drugs and certain vitamins can likewise cause gout. Health issues also play a role. Obesity, psoriasis, hypothyroidism, and certain tumors can promote the formation of gout.

A separate focus has to be taken on the kidneys. The kidneys, as in an insufficiency, can be cause and victim of elevated levels of uric acid in the blood. An insufficiency of the kidneys can promote the increase of uric acid in the blood since the excretory function of the kidneys is impaired. Likewise, this insufficiency, leading to the decreased filtration function of the kidneys, promotes the accumulated uric acid to form stones in the kidneys.

However, gout is foremost, a metabolic disease, whose cause is genetic.

The symptomatology of gout:

The pre-stage of gout is referred to as Asymptomatic hyperuricemia. This describes the time before the very first attack, when the individual is not aware that he will ‘get’ gout. He has no symptoms, but uric acid in the blood is high and crystallization is taking place at the specific joint.

When however an acute attack happens, the inflammation at the affected locality causes pain, warmth, tenderness, swelling and redness. The pain can be severe, and while commonly affecting the joint of the big toe, can affect the joints of ankles, knees, elbows, wrists or fingers. The acute flare up commonly begins at night, can take up to 12 hours to peak, and can take several days to subside before finally wearing off. While some people only ever experience one single attack, it is more common for people to have repeated attacks.

There is a stage or phase, that is termed Interval gout. This refers to the pain free period between flare ups. During this time, albeit being free of pain, the gout is advancing in the form of low-level inflammation that is progressively damaging the affected joint.

Gout becomes chronic if a patients uric acid levels remain high for an extended period of time, for numerous years. The damage caused in this time can lead to loss of mobility in the affected joint.

Can attacks be prevented?

Yes. Avoiding triggers is paramount. There are lifestyle changes can help reduce the incidence of flare ups. Alcohol, fatty foods, meats, sugary drinks are all known to be high in purines and thus increase uric acid levels. Using healthy plant oils, eating more vegetables and increasing fluid intake can help prevent attacks.

Conventional medical practitioners commonly prescribe drugs such as NSAID’s (non-steroidal anti-inflammatory drugs) and corticosteroids to keep gout in check.

In the homeopathic sphere, remedies such as Antimonium crudum, Arnica, Belladonna, Benzoic acidum, Berberis vulgaris, Calcarea fluorica, Colchicum, Ledum palustre, Lycopodium, Rhododendron, Sabina, or Urtica uhrens, have been used successfully in treating elevated levels of uric acid, gout and preventing flare ups.

Bibliography:

https://www.medicinenet.com/gout_gouty_arthritis/article.htm

https://www.webmd.com/arthritis/ss/slideshow-gout

https://www.medicalnewstoday.com/articles/144827.php

https://www.arthritis.org/about-arthritis/types/gout/what-is-gout.php

https://www.arthritis.org/about-arthritis/types/gout/articles/purine-foods-gout-attack.php

http://www.whfoods.com/genpage.php?tname=george&dbid=51

http://www.ukgoutsociety.org/PDFs/goutsociety-allaboutgoutanddiet-0113.pdf

http://www.kidneyfund.org/kidney-disease/chronic-kidney-disease-ckd/complications/gout/