High uric acid: Why you should never ignore the painful swelling in your joints

34 year old Shikhar Sharma worked out regularly at the gym. He had been complaining of knee pain for quite some time when his trainer suggested he should get his uric acid levels tested. The results showed he had a very high level of uric acid, which was hurting his joints. According to Dr Urmila Anandh, Associate Professor & HOD, Nephrology, Amrita Hospital, Faridabad, “Majority cases of higher levels of uric acid are asymptomatic. It can only be detected through diagnostic tests.”
Why is high uric acid dangerous?

"Uric acid is part of our metabolic functions, but due to changes in lifestyle, and increased use of certain medications, high levels of uric acids is now-a-days a common occurrence. A high level of uric acid in the blood is called hyperuricemia. One of the common reasons for hyperuricemia is dietary habits, which includes consuming a lot of fish, and other non-vegetarian items, coffee, chocolate etc. Other causes include diseases like metabolic syndrome," adds Dr Urmila.

Metabolic syndrome is a combination of signs and symptoms, like diabetes, abnormal levels of fasting glucose, hypertension, obesity and higher levels of uric acid.
Signs of imbalanced uric acid and classic symptoms

High uric acid is seen in patients of chronic kidney disease. It can be said that a high uric acid is an indication of abnormal kidney function.

Dr. Manoj Arora, Principal Consultant & Head, Nephrology & Kidney Transplant Medicine, Max Hospital, Shalimar Bagh shares, “These crystals of uric acid may deposit in joints and can cause gouty arthritis which presents with painful swelling of joint along with redness and difficulty in moving affected joint. Mainly the great toe is affected but other joints can also be involved like the ankle, feet, knee and sometimes hand and wrist.”

What can happen if the condition is left untreated?

High uric acid can cause gout (painful joints) or uric acid stones. “Gout is swelling that develops due to deposition of uric acid in joints. This deposition causes inflammation in small joints, or joints of feet. If gout is not treated, it can damage joints and lead to other deformities.

Another disease that high uric acid can cause is uric acid stones. These stones are usually not seen in X ray and require ultrasound or CT scan to be detected. If these stones are large enough, and are blocking the urinary passage, they can cause kidney damage. Having larger stones for a longer time can cause urate nephrolithiasis,” explains Dr Urmila.

Who is at risk of developing high levels of uric acid?

People with unhealthy lifestyle and dietary habits are at more risk. Certain medicines also raise uric acid levels. If you are obese and have diabetes and hypertension, or have chronic kidney disease, you must keep a check on your uric acid levels. Some genetic abnormalities and enzyme deficiencies in your body can also make you prone to Hyperuricemia.

Tests and diagnosis

Uric acid test can be done as a blood test commonly. Uric acid tests are common in annual checkup.

Line of treatment

As long as the person is asymptomatic, no treatment is needed. But if the uric acid level is very high, one must cut down fish, alcohol, non-vegetarian food items, chocolate and coffee intake. Two common medicines prescribed by the physician are allopurinol and Febuxostat. One must complete the course of these medicines, shares Dr Urmila.

Are there ways to treat it naturally?

Apart from managing your obesity, diabetes, Dr. Manoj Arora recommends some ways to manage uric acid levels naturally:

Drink enough water. Hydration is important.

Shift to a low purine diet. Avoid purine rich food, alcohol beverages, some fish, seafood, shellfish, organ meats like liver, whole pulses, spinach, cauliflower, mushroom.

Boost Vitamin C in your diet

Have cherries and cherry juice

1. What is uric acid?
   Uric Acid is a chemical compound, generated during breakdown of nucleic acids (DNA and RNA). In most mammals, uric acid is transformed into Allantoin. Allantoin is a soluble substance which can be dissolved in water. However, as human beings evolved, they have lost the capability to dissolve this substance.
2. What are the signs of uric acid?
   Severe pain in the joints, joint stiffness, redness and swelling, misshapen joints are some signs of high levels of uric acid.