The human body functions constantly round the clock each day without fail. Even while we sleep or rest, the brain commands, the blood flows, the heart pumps and the gut digests the food. Whenever we eat, the body pulls out the good stuff like proteins and vitamins and sends away the waste.
Typically, one of those waste products is uric acid. The accumulation of uric acid in blood creates various problems in the body leading to serious health issues. Here is a brief overview about the basic points we need to know to keep the uric acid level under control.
What is Uric acid?
Uric acid is a heterocyclic compound of carbon, nitrogen, oxygen, and hydrogen with the formula C₅H₄N₄O₃. It forms ions and salts known as urates and acid urates, such as ammonium acid urate. Uric acid is a product of the metabolic breakdown of purine nucleotides, and it is a normal component of urine.
How is uric acid formed?
Uric acid is produced by the breakdown of purines; chemicals that enter the bloodstream during digestion of food or from normal breakdown of some of the body's cells. It is the byproduct of protein digestion. The production of uric acid can be controlled by the amount of protein metabolized by the body. The alkalinity of the body and urine pH becomes a component in the quantity of uric acid produced.
What is the normal level of Uric acid?
Normal uric acid levels are generally considered to be
2.4-6.0 mg/dL (female)
3.4-7.0 mg/dL (male).
What causes high uric acid levels?
Most of the time, a high uric acid level occurs when the kidneys do not eliminate uric acid efficiently. If the body makes too much uric acid, or if the kidneys aren't working well, uric acid can build up in the blood. Uric acid levels can also increase due to other reasons like consuming high-purine food or taking medicines like diuretics, aspirin, and niacin.
An overproduction of uric acid occurs when proteins are broken down into their byproducts- purines being one, and an excess breakdown of the cells containing purines occurs.
What is hyperuricemia?
Hyperuricemia is a condition with an excess of uric acid in the blood. Uric acid passes through the liver, and enters the bloodstream. Most of it is excreted through urine, or passes through the intestines during bowel movements to regulate normal levels.
What are the factors that cause high uric acid level?
Major factors that may cause a high uric acid level in blood include:
Diuretics (water retention relievers)
Intake of too much alcohol
Genetics (inherited tendencies)
Hypothyroidism (underactive thyroid)
Niacin, or vitamin B-3
Renal insufficiency (inability of the kidneys to filter waste)
Tumor lysis syndrome (a rapid release of cells into the blood caused by certain cancers or by chemotherapy for those cancers)
What Is the role of purines?
Purines are building blocks for RNA and DNA and are found in various quantities in proteins. They are significant to blood uric acid levels as well. Purines are nitrogen-containing compounds, which are made inside the cells of the body (endogenous), or come from outside of the body, from foods containing purine (exogenous). Purine breaks down into uric acid.
What happens when uric acid level is elevated?
Increased levels of uric acid may accumulate in the tissues, and form crystals. This may cause high uric acid levels in the blood. Uric acid crystal formation may occur when the blood uric acid level rises above 7 mg/dL. Problems, such as kidney stones, and gout (collection of uric acid crystals in the joints, especially in the toes and fingers), may occur.
If untreated, high uric acid levels may eventually lead to permanent bone, joint and tissue damage, kidney disease and heart disease. Research has also shown a link between high uric acid levels and type 2 diabetes, high blood pressure, and fatty liver disease.
Purine rich food
Organ meat like liver, heart, brain and meat like bacon, beef, turkey, pork goose etc
Gravy made with meat or meat stock,
Vegetables like asparagus, spinach, cauliflower, dried beans and peas, mushrooms.
Alcoholic beverages (all types)
Some fish, seafood and shellfish, including anchovies, sardines, tuna, mussels, codfish.
How Uric acid level is detected?
A blood sample is taken and tested to determine the level of uric acid. If you pass a kidney stone or have one surgically removed, the stone itself might be tested to see if it is a uric acid stone or a stone of a different type.
Symptoms of high uric acid level
Joint pain or soreness
Swelling in a joint or red skin around a joint
Swelling and pain in a big toe, ankle, or knee
Joints that are hot to the touch
Swelling and pain that affects only one joint in the body
Skin that looks shiny and is red or purple
Severe pain along the lower back, which may repeatedly get worse and then get better. The pain may also travel to the genitals.
Urgent need to urinate repeatedly
Blood in urine
Steps to lower the uric acid levels naturally
Limit purine-rich foods
Avoid sugar and sugary drinks as much as possible
Add fiber to diet
Check medications and supplements
When to Contact a doctor
Localized joint pain (especially in a toe or finger joint), that is red and inflamed.
Shortness of breath, chest pain or discomfort; should be evaluated immediately.
Feeling the heart beat rapidly (palpitations).
Bleeding that does not stop after a few minutes.
Any new rashes on skin - especially if one has started new medications.
(The author is a director, TGL Foundation and an editor - Anthropology Today- The Intl Journal, Sr Director FWO)