Tuesday, August 24, 2010

uric acid in the blood and these are deposited in small joints

Hyperuricemia is a metabolic disorder of purine, which appears excessive uric acid in the blood and these are deposited in small joints, whose disease is called gout. This deposition can cause destruction of joint tissues leading to chronic arthritis.

With progression of disease symptoms occur more frequently and more prolonged. An injury or a trivial exercise than usual can trigger episodes of swelling and joint pain, and questions arise with crises related to the excesses of food, drink or exercise.

Obesity is usually associated with this disorder. Fasting or a diet low in carbohydrates, can also precipitate a crisis.

Since the purine metabolism is altered, it is recommended to avoid foods very rich in this substance in order to avoid metabolic stress and help the treatment even with the need for medication.

Foods allowed include:

Cereals and derivatives
Milk and milk products
Vegetables except asparagus, mushrooms, peas, spinach, beans and lentils should be used sparingly (1 serving - 1 / 2 cup) per day or 5 days a week (depending on condition)
Butter or margarine
White bread, biscuits
Coffee, tea, chocolate
Gelatin desserts, ice cream
Foods that should be eaten sparingly include:

Fish (one weekly portion)
Birds (a small portion of about 80 grams per day)
Beef (a small portion of about 80 grams per day)
Egg (3 units per week)
Pulses (beans beans, 1 / cup daily)
The foods are strictly forbidden:

Broth in tablets
Anchovy, Mussels, Sardines
Heart, Kidneys, Liver
Fermented foods
Alcoholic beverages, especially beer
Tomato sauce

Sorting Out The Myths

More importantly, how does a person begin to sort the myths from the facts and decide what to buy at the grocery store? According to the University of Washington, Department of Orthopedics:

Obesity can be linked to high uric acid levels in the blood. People who are overweight should consult with their doctor to decide on a reasonable weight-loss program. Fasting or severe dieting can actually raise uric acid levels and cause gout to worsen.

Usually people can eat what they like within limits. People who have kidney stones due to uric acid may need to actually eliminate purine-rich foods from their diet because those foods can raise their uric acid level.
Consuming coffee and tea is not a problem but alcohol can raise uric acid levels and provoke an episode of gout. Drinking at least 10-12 eight-ounce glasses of non-alcoholic fluids every day is recommended, especially for people with kidney stones, to help flush the uric acid crystals from the body.
Foods Higher In Purines

Johns Hopkins lists foods which are higher in purines

Foods very high in purines include:

Foods moderately high in purines include:

Gout Medications

Experts at Mayo Clinic suggest that medications for gout have reduced the need for dietary restrictions, but some modification can decrease the severity or frequency of gout attacks. Dietary modification may also be preferred by people who cannot tolerate gout medications.

How To Treat Gout With Diet And Medication
More Reading:

Gout Diet: Foods To Eat
It is well known that a person with gout should avoid purine-rich foods. What should they eat though? What foods will lower the risk of another gout attack?
Gout: Avoiding Purine-Rich Foods
Along with specific prescribed medications, people with gout are usually advised to reduce their intake of purine-rich foods. That dietary recommendation begs the question, what foods are purine-rich?
Gout Prevention And Treatment
Options for preventing and treating gout.

Gout Diet: Foods To Avoid

Diets which are high in purines and high in protein have long been suspected of causing an increased risk of gout (a type of arthritis caused by high levels of uric acid in the body which form crystals in the joints, resulting in pain and inflammation). Results from a study led by Dr. Hyon K. Choi, reported in the March 11, 2004 issue of The New England Journal of Medicine, offer an interesting twist.

Choi's research team followed 47,150 men with no prior history of gout over a 12-year period. The conclusion: during the 12 year period of assessment, 730 men were diagnosed with gout.

Study participants who consumed the highest amount of meat were 40 percent more likely to have gout than those who ate the least amount of meat.
Study participants who ate the most seafood were 50 percent more likely to have gout.
In this specific study, though, not all purine-rich foods were associated with an increased risk of gout. There was no increased risk associated with a diet which included:

Even though these foods are considered high in purines. Choi's team also found that low-fat dairy products decrease the risk of gout and overall protein intake had no effect. Ultimately, diets shown to be connected to gout are the same kinds of diet linked to cardiovascular disease.

Recommendations For Seafood Should Be Individualized

At this point, it may seem like it gets confusing. Isn't seafood typically recommended as part of a diet which is healthy for the heart? Yet research has revealed that there is a strong, undeniable link between seafood and gout. How does Choi reconcile what seems like conflicting information? He believes "recommendations for seafood should be individualized."

How can I prevent gout?

Individuals often learn what causes their own gout attacks. As previously discussed, certain foods with high concentrations of purines can be avoided. Drinking alcohol should be moderated. Prescription and non-prescription medications should be reviewed with your doctor (it is important that you not discontinue a medication without consulting your doctor, as an untreated condition such as high blood pressure may be worse than a gouty attack). Other common causes of a gouty attacks include dehydration, injury to a joint, surgery, and a febrile illness. Prevention should focus on avoidance of these situations. If surgery is needed, discuss with your doctor whether prophylactic medication to prevent a gouty attack is appropriate.

What is the treatment of a gouty attack?

Initial treatment for a gouty attack is usually with a nonsteroidal anti-inflammatory medications (NSAIDs). These medications, such as over the counter Motrin, or more potent prescription versions, are not always well tolerated by some patients. In those who cannot use NSAIDs, a steroid medication can also be used, either injected or oral. Another medication, colchicine, is very effective in the immediate treatment of a gouty attack, but often causes nausea and stomach upset, so many patients do not tolerate this drug. Future attacks of gout can be prevented by taking a medication called allopurinol. This medication is started after the gout attack has ended (usually after a few days).

Getting to know Gout

In spite of the agony and havoc it can cause, uric acid is a normal constituent of the human body. Ordinarily about one-third of the uric acid in our system comes from food, especially foods like those noted earlier that are rich in purines. The rest we produce ourselves through ordinary metabolism.The body converts purines to uric acid.
The level of uric acid in the blood fluctuates in response to:dietfluid intakeoverall health statusother factorsMen normally have somewhat more uric acid than women do (although the difference begins to narrow after menopause), and in both sexes it tends to increase with advancing age.


igher-than-normal amounts of uric acid in the blood, a condition called hyperuricemia, is quite common and only rarely warrants medical treatment. On the other hand, sustained hyperuricemia is the primary risk factor for gout. It’s safe to say that, while not all people with hyperuricemia develop gout, virtually everyone with gout is hyperuricemic.It works this way:At normal and even somewhat elevated levels, uric acid stays in solution in the blood. It moves through the circulation, gets filtered by the kidneys, and is excreted in the urine.When, however, blood uric acid levels rise above a certain concentration (which varies with temperature and blood acidity), it forms needle-like crystals that lodge in or around a joint.In response to irritation caused by uric acid crystals, the skin covering the affected area rapidly becomes tight, inflamed, swollen, and red or purplish.These classical signs of inflammation, together with sudden and extreme pain, strongly suggest an acute attack of gout. The diagnosis is confirmed by laboratory finding of uric acid crystals in fluid taken from the affected joint.