High uric acid is a metabolic disorder caused by an increase in uric acid in the blood due to a disturbance in the metabolism of a substance called purine in the body. The daily production and excretion of uric acid in the body are approximately equal.
In terms of production, one-third comes from food, and two-thirds are synthesized in the body. The excretion pathways involve one-third being excreted through the intestines and two-thirds excreted through the kidneys.
Under normal dietary purine conditions, men generally have levels above 420μmol/L, and women above 357μmol/L, diagnosed as hyperuricemia.
Clinically, it is divided into primary hyperuricemia and secondary hyperuricemia. The main cause of primary hyperuricemia is the reduced excretion of uric acid in the body or excessive uric acid production. Most patients only have an elevated blood uric acid level without typical symptoms, clinically known as asymptomatic hyperuricemia.
However, 5%-12% of hyperuricemia can progress to gout because the continuous increase in uric acid in the blood of hyperuricemia patients can lead to the precipitation of uric acid crystals, which can deposit in the joints and kidneys.
Deposition in the joints can lead to recurrent attacks of gouty arthritis, while deposition in the kidneys can cause interstitial nephritis and the formation of uric acid stones, mainly manifested as hematuria, proteinuria, high blood pressure, or progressive worsening of kidney function.
Causes of high uric acid:
– Obesity
Obesity is the most significant and common cause of elevated uric acid. Obesity increases uric acid synthesis and weakens uric acid excretion. Obesity often involves long-term high-fat, high-calorie dietary habits, leading to reduced uric acid excretion and consequently elevated blood uric acid levels, triggering gout.
– Unhealthy Diet
High-protein, purine-rich, and high-fructose diets increase the incidence of hyperuricemia. For example, excessive fructose intake may inhibit the kidneys’ excretion of uric acid, thus easily causing hyperuricemia.
– Excessive Fatigue
Intense exercise and excessive fatigue can cause the body to sweat a lot, leading to vasoconstriction of the body surface and internal organs, including renal vasoconstriction, resulting in reduced uric acid excretion.
– Alcohol Consumption
Beer contains a large amount of purines, with one bottle of beer doubling uric acid levels. Alcohol competes for uric acid metabolism pathways, leading to the retention of blood uric acid. Beer contains carbon dioxide, which is rapidly absorbed, and carbon dioxide is converted into carbonic acid, lowering urine pH and obstructing uric acid excretion.
– Age
The incidence of uric acid and hyperuricemia in males and females increases with age. The high-incidence age groups are middle-aged and elderly males and postmenopausal women (postmenopausal women have reduced estrogen secretion, equivalent to removing the “protective umbrella,” leading to reduced renal clearance of uric acid, causing elevated blood uric acid levels).
– Renal Dysfunction
Disorders in the metabolism of purine substances in the body lead to a continuous decrease in uric acid excretion, and many patients may exhibit abnormal kidney uric acid handling. Other kidney diseases such as glomerular diseases and tubulointerstitial diseases can also lead to high uric acid levels.
– Medication Effects
Diuretics, nicotinamide, aspirin, and other drugs can affect uric acid metabolism in the body, leading to high uric acid levels.
“Big Purine Users” Revealed – Eating regularly will raise uric acid! Doctor’s advice: It’s too late if you don’t watch your diet.
【1】White Pomfret Skin 3509mg/100g
Almost all fish skins have very high purine content, with white pomfret skin having a remarkably high purine content of 3509mg/100g, ranking first in the high-purine food list. White pomfret fish meat and skin both have high purine content, but the skin is more prominent, making white pomfret skin a forbidden food.
【2】Concentrated Meat Gravy 500mg/100g
What are high-purine foods? Unexpectedly, the concentrated meat gravy we often consume is a high-purine food. The purine content of concentrated meat gravy is as high as 500mg/100g, truly a high-purine food. For gout patients or those with bleeding disorders, concentrated meat gravy is considered a high-purine food that can worsen the condition.
【3】Asparagus 500mg/100g
Asparagus, scientifically known as Asparagus officinalis, is revered as the “King of Vegetables” and is listed as one of the world’s top ten famous dishes, holding a high position internationally. Asparagus has higher nutritional value than typical vegetables, fruits, and mushrooms, but it is one of the high-purine foods, with a purine content as high as 500mg/100g.
【4】Soybean Sprouts 500mg/100g
Soybean sprouts are a common ingredient on the dinner table, rich in nutrients and delicious in taste, serving as a source of abundant protein and vitamins. Despite being tasty and delicious, soybean sprouts cannot change the fact that they are high-purine foods. The purine content of soybean sprouts is as high as 500mg/100g. Therefore, patients with chronic metabolic disorders caused by purine metabolism disorders should avoid consuming such high-purine foods.
【5】Nori (Seaweed) 415.3mg/100g
Nori has high nutritional value, is a rare marine ingredient, and is the highest-cultivated seaweed globally. Known for its natural delicious taste suitable for cooking or soup, it is regarded as a high-nutrient seaweed ingredient, widely popular among people. However, being a marine product, nori is rich in purines, with a purine content of 415.3mg/100g.
【6】Scallops 414mg/100g
Scallops are one of the highest-purine meats, a type of seafood shellfish food with relatively high purine content. Prolonged and excessive consumption by healthy individuals can lead to the conversion of purine components into uric acid in the body, causing an increase in internal uric acid levels and potentially disrupting purine metabolism in the body. Therefore, healthy individuals should avoid eating scallops as much as possible.
【7】Foie Gras 377mg/100g
Per 100g of foie gras, there are approximately 377mg of purines, classifying it as a high-purine food not recommended for individuals with high uric acid. After a large amount of purines from foie gras enter the body, they convert into uric acid inside the body. For individuals with high uric acid levels, it is not advisable to consume foie gras when uric acid control is unstable.
【8】Duck Intestines 346mg/100g
Tasty and crispy duck intestines are a common ingredient in our lives. Duck intestines contain protein, B vitamins, vitamin C, vitamin A, calcium, iron, and other trace elements, benefiting the nervous system, cardiovascular system, and digestive system when consumed in moderation. However, duck intestines fall under high-purine foods, with excessive consumption posing a risk of elevated blood uric acid levels and gout onset. Therefore, gout and hyperuricemia patients should avoid duck intestines.
【9】Shrimp 345mg/100g
Shrimp is a high-protein, nutritious food that can strengthen bones, enhance physical fitness, and promote metabolism. However, it is best avoided by gout patients and allergy sufferers. Consumption by gout patients can rapidly increase uric acid levels in the body, leading to hyperuricemia and gout symptoms such as joint redness, swelling, heat, and pain. Shrimp contains approximately 345mg of purines per 100g, classified as a food to avoid for gout patients.
【10】Pig Lungs 272mg/100g
Pig lungs, as internal organ meat, have a high purine content, ranking among the top ten high-purine meats. Excessive consumption can lead to purine accumulation in the body, causing excessive uric acid levels and triggering gout. Various pig internal organs have relatively high purine contents, including pig liver, pig kidneys, and pig heart, all of which are foods to consume sparingly for individuals with high uric acid.
Treatment for primary hyperuricemia mainly includes:
1. General treatment: Control overall calorie intake; restrict alcohol consumption and excessive intake of high-purine foods; increase water consumption to enhance uric acid excretion; use diuretics cautiously, like thiazide diuretics that inhibit uric acid excretion; avoid triggering factors and actively treat related diseases.
2. Treatment for hyperuricemia: The goal of treatment is to maintain normal uric acid levels in the body. Medications mainly include: uricosuric drugs such as probenecid, uric acid synthesis inhibitors like allopurinol, alkaline drugs like sodium bicarbonate, and novel uric acid-reducing drugs such as selective uric acid reabsorption inhibitors.
3. Treatment during the acute phase of gouty arthritis: Colchicine, nonsteroidal anti-inflammatory drugs, and corticosteroids are the first-line drugs for treating acute gouty arthritis and should be used early.
Treatment for intercritical periods and chronic phases of gout: For patients with frequent acute gouty arthritis attacks, chronic gouty arthritis, or gouty stones, adhering to uric acid-lowering treatment is essential.
Principles of treatment for secondary hyperuricemia: The primary focus should be on treating the underlying disease, avoiding or reducing the use of drugs and methods that may cause or exacerbate hyperuricemia, and promptly controlling acute attacks of gouty arthritis.
Extension – What is the difference between hyperuricemia and gout?
Hyperuricemia and gout are different stages of disease development. Initially, the level of blood uric acid in the body is affected by factors such as overeating foods high in purines or decreased uric acid excretion by the kidneys, leading to excessive uric acid production or reduced excretion, causing elevated blood uric acid levels.
When the level rises to a certain degree, usually above 420μmol/L, uric acid salts will crystallize and precipitate in the blood, depositing in the joints and other tissues, causing gout.
Uric acid crystals can deposit in bone, joints, soft tissues, renal tubules, and even blood vessels, leading to different clinical manifestations. Gout is the further development of asymptomatic hyperuricemia.
Gout can be classified into the asymptomatic hyperuricemia phase, which initially presents as high uric acid levels and progresses to gout attacks. Gout attacks can be divided into acute attack phase, intercritical phase, and chronic phase of critical importance.
Therefore, hyperuricemia is the early stage of gout development and a significant cause of gout attacks. Gout is a comprehensive manifestation of joint and renal involvement in the later stages of hyperuricemia.
