According to a survey by the Ministry of Health, Labor and Welfare, 20% of adult males today are said to have hyperuricemia.
There may be some people who are pointed out to have uric acid levels at a medical checkup and just leave it as it is. Hyperuricemia has few subjective symptoms, and your internal organs may be undermined without you even knowing it.
In this article, we will introduce the causes of hyperuricemia and gout, their complications, and the treatments and preventions of concern.
Now is the time to start worrying about your uric acid level. Know your uric acid level and start with prevention that you can practice in your daily life.
table of contents
1. What is hyperuricemia that causes gout
Hyperuricemia refers to a condition in which blood levels of uric acid are high.
Uric acid is a waste product that is produced when purines contained in food and body tissues are metabolized in the liver.
According to the Ministry of Health, Labor and Welfare, it is estimated that over 11 million people suffer from hyperuricemia, a precursor to gout. Because female hormones have the function of excreting uric acid from the kidneys, males tend to be affected overwhelmingly.
Since hyperuricemia is asymptomatic, there are many cases in which the onset of hyperuricemia is noticed when the pain of gout is triggered.
Below is a detailed explanation of numerical targets for uric acid levels, so please refer to it.
reference:Gout and Uric Acid Foundation
2. Diseases to be worried about when hyperuricemia worsens
Hyperuricemia, which progresses unnoticed, causes complications such as severe pain called "uric acid deposition disease" and organ damage after several years.
2-1. gout
Gout is a highly frequent cause of hyperuricemia.
It is said that gout attacks occur most often at the base of the big toe, where the severe pain causes swelling and makes it difficult to wear shoes.
2-2. renal impairment, such as renal failure
Renal damage occurs when urate produced by hyperuricemia deposits in the kidney.
When renal function declines, the body cannot excrete uric acid out of the body. As a result, urate builds up in the kidneys, leading to further kidney damage.
Exacerbation of hyperuricemia is often accompanied by lifestyle-related diseases such as hypertension and diabetes, which accelerate kidney damage.
Below, the Japanese Society of Nephrology explains in detail, so please check if you want to check in more detail.
reference:General Incorporated Association - Japanese Society of Nephrology
2-3. Urolithiasis
Urolithiasis occurs when stones form in the urinary tract (kidneys, ureters, bladder, and urethra) due to hyperuricemia.
Urolithiasis is characterized by inability to stand up, thrashing, and severe pain in the side or back. If it is a small urinary calculus of 10 mm or less, it may be excreted spontaneously, so wait for excretion by drinking water or taking medicine.
For calculi that are not discharged, there are methods of breaking calculus by applying shock waves from the outside of the body and surgery under an endoscope. The recurrence rate of urinary tract stones is as high as 50%, and it is necessary to prevent recurrence by improving lifestyle habits.
Please refer to the Japanese Endocrinological Society for further details.
reference: The Japan Endocrine Society
3. Difference between hyperuricemia and gout
The main difference between hyperuricemia and gout is hyperuricemia, which is the persistently high uric acid level. Chronic hyperuricemia leads to gout.
The progression of hyperuricemia can be divided into the following three stages.
- Asymptomatic hyperuricemia period: period when uric acid level is high but there is no gout attack
- Gout attack period: Severe pain and swelling appear in the joint at the base of the big toe
- Chronic nodular gout stage: Symptoms progress and symptoms such as arthritis become chronic
Early hyperuricemia is asymptomatic and does not require treatment. On the other hand, if a gout attack appears, drug therapy is mandatory.
4. Causes and treatment of hyperuricemia and gout
The causes of hyperuricemia and gout are disordered lifestyles, especially diet.
Below is an example of the main causes.
<Cause>
- Excessive intake of purine-rich foods (mostly fish eggs, liver, and crustaceans)
- Drinking
- overeating and obesity
- strenuous exercise
<Treatment method>
- improvement of lifestyle
- Symptomatic treatment to relieve inflammation and pain during gout attack
- “Uric acid production inhibitors” that suppress the production of uric acid and “uricosuric agents” that promote the excretion of uric acid
Drug therapy may be necessary if lifestyle changes do not lower uric acid levels. Since a sudden drop in serum uric acid levels is likely to cause gout attacks, uric acid-lowering drugs are started at the lowest dose.
Other treatment options are described in detail at the following clinical laboratory centers:
reference:Hiroshima City Medical Association Clinical Laboratory Center
5. Prevention method
If uric acid levels can be lowered to normal levels through lifestyle changes and drug therapy, complications such as pain and kidney damage due to gout attacks can be prevented.
<Prevention method>
- Avoid alcohol and foods high in purines
It has been reported that people who drink one can of beer daily have an increase in serum uric acid levels of 0.5 to 1.0 mg/dl over a period of 6 years. Let's actively make time to rest the liver by setting liver-rest days.
- weight control
Approximately 60% of gout patients are obese, and uric acid levels tend to increase with increasing obesity.
- actively drink water
Increased urine volume due to water intake promotes the excretion of uric acid. Drink water or tea, as sugary drinks increase uric acid levels.
6. Summary: Hyperuricemia and gout are all about lifestyle
For hyperuricemia and gout, it is possible to lead a daily life while stabilizing uric acid levels through lifestyle modification and drug therapy.
In other words, when it is pointed out that the uric acid level is rising, it is also a chance to review your daily life. Controlling uric acid levels to 6 mg/dl or less not only helps prevent hyperuricemia and gout, but also prevents lifestyle-related diseases such as obesity and diabetes.
The uric acid level can be said to be a numerical value that reflects one's own lifestyle. Maintaining a healthy lifestyle and getting to know your health through regular checkups will change your future. I hope this article will help you to live a pain-free and peaceful life.
Supervision: Dr. Yasushi Tsuda