Uric acid is insoluble compound which is a breakdown product of nitrogenous metabolism. It is produced from the natural breakdown of body’s cells and from the foods we eat. It is excreted from the body through kidneys mainly and discharged in urine and small amount in the stool as well. If the kidneys can’t expel it from the blood regularly, and this expands the level of uric acid in the blood which can cause further damage to body tissue.
Causes of High Uric Acid Levels
The body goes into a particular state known as huperuricemia as a result of being exposed to an over-abundance of uric acid. High uric acid levels usually happen when your kidneys aren’t working properly to eliminate uric acid efficiently. But there are factors that can cause your kidneys to be overworked:
- Diuretic medications, like water pills
- High alcohol consumption
- Drugs that suppress the immune system
- Niacin, or vitamin B-3
- Proteinaceous (Purine-rich diet, including liver, game meat, anchovies, sardines, gravy, dried beans and peas and mushrooms)
- Tumor lysis syndrome(TLS) is a group of metabolic abnormalities that can occur as a complication during the treatment of cancer, where large amounts of tumor cells are killed off (lysed) at the same time by the treatment, releasing their contents into the bloodstream.
Of all the side effects one can develop from having too much uric acid in the system, gout is by far the most common and one of the most painful. The more animal-based proteins a person eats, the more uric acid is produced through the breakdown of purines, a byproduct of protein digestion, explains the University of Maryland Medical Center. When the excess uric acid is not removed by the kidneys, it forms crystals that end up in the joints of the feet and hands, especially the big toe joint. The crystals are very sharp edged and press on tender tissues beneath the skin causing excruciating pain, inflammation and swelling known as gouty arthritis. Gout is found more commonly in men, but women and teens are developing it due to the high amounts of animal products consumed in the diet.
When a person eats high quantities of proteins that are not properly metabolized, the result is an over-abundance of uric acid in the blood. Generally washed from the body through the kidneys, if excess uric acid is present and can’t be properly excreted, a condition known as metabolic acidosis forms, according to MedlinePlus.com. Metabolic acidosis may lead to rapid breathing accompanied by confusion and lethargy, and lead to shock and death. A low-grade, chronic state of acidosis can develop as a result of long-term, ongoing consumption of a high protein diet.
Too much uric acid in the urine can cause urate kidney stones, which are formed when uric acid crystallizes in the kidneys and is deposited there forming various sized stones. The stones may range in size from grains of sand to large chunks that resemble rocks on the ground. These stones get caught in the ureters as the person is attempting to pass urine. This is a serious, extremely painful condition. Once you have had urate kidney stones, you are highly prone to developing them again, according to the Royal Infirmary of Edinburgh’s Renal Unit. If you change your diet and reduce or eliminate the amount of animal protein you consume, your risk for developing new stones is greatly reduced. Those most prone are Caucasian males living in a hot climate, who are between the ages of 30 and 60. They generally have high blood pressure and a family history of kidney stones.
How to diagnose
We need some tests to diagnose if the level of uric acid is high. Most commonly, the test is used to:
- diagnose and monitor people with gout
- monitor people who are undergoing chemotherapy or radiation treatment
- check kidney function after an injury
- find the cause of kidney stones
- diagnose kidney disorders
You may need a uric acid test if:
- you have joint pain or swelling that may be related to gout
- you’re currently undergoing chemotherapy
- you’re about to start chemotherapy
- you have frequent kidney stones
- you’ve been diagnosed with gout in the past
Another option for uric acid testing is to test your urine over a 24-hour period. Sometimes your doctor will recommend both to confirm a diagnosis.
Preparing for a Uric Acid Blood Test
The following may interfere with your uric acid test results:
- certain medications, such as aspirin and ibuprofen (Motrin)
- high levels of vitamin C
- dyes used in X-ray tests
Tell your doctor about any prescription or over-the-counter medications or supplements you’re taking.
You may need to fast (refrain from eating or drinking) for four hours before the test.
What Do the Test Results Mean?
Uric acid levels can vary based on gender. According to the Clinical Reference Laboratory (CRL), normal values for women are 2.5 to 7.5 milligrams/deciliter (mg/dL) and 4.0 to 8.5 mg/dL for men. However, the values may vary based on the lab doing the testing.
According to the American College of Rheumatology (ACR), your target level if you have gout is a blood uric acid level of less than 6 mg/dL. Low levels of uric acid are less common than high levels and are less of a health concern.
High levels of uric acid in your blood typically indicate that your body is making too much uric acid or that your kidneys aren’t removing enough uric acid from your body. Having cancer or undergoing cancer treatment can also raise your uric acid levels.
High uric acid levels in your blood can also indicate of a variety of conditions, including:
- gout, which involves recurring attacks of acute arthritis
- bone marrow disorders, such as leukemia
- a diet high in purines
- hypoparathyroidism, which is a decrease in your parathyroid function
- kidney disorders, such as acute kidney failure
- kidney stones
- multiple myeloma, which is cancer of the plasma cells in your bone marrow
- metastasized cancer, which is cancer that has spread from its original site
The blood uric acid test isn’t considered a definitive test for gout. The only test that can absolutely confirm the presence of gout is testing a person’s joint fluid for monosodium urate. However, your doctor can make an educated guess based on high blood levels and your gout symptoms. Also, it’s possible to have high uric acid levels without the symptoms of gout. This is known as asymptomatic hyperuricemia.
Low levels of uric acid in the blood may suggest:
- Wilson’s disease, which is an inherited disorder that causes copper to build up in your body tissues
- Fanconi syndrome, which is a kidney disorder
- liver or kidney disease
- a diet low in purines
Treatment: (Treatment source: webmd.com)
You use medicine to treat an attack of gout and to reduce the uric acid in the blood. Reducing uric acid helps reduce how often you have attacks.
Note: Always consult a specialist doctor for treatment. Here in this article treatment is solely for education and learning purpose.
Medicine treatment for gout usually involves some combination of short- and long-term medicines.
Short-term medicine relieves pain and reduces inflammation during an acute attack or prevents a recurrence of an acute attack. These medicines may include:
- Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, indomethacin, or naproxen. Do not take aspirin, which should never be used to relieve pain during a gout attack. Aspirin may change uric acid levels in the blood and may make the attack worse. Be safe with medicines. Read and follow all instructions on the label.
- Corticosteroids, which may be given in pills or as a shot for cases of gout that don’t respond to NSAIDs or colchicines.
If treatment is started right away, relief from symptoms often occurs within 24 hours.