The Rest of the Story

Last week's article covered the basics of uric acid, what happens when it is elevated, the causes of the elevation, and how to decrease uric acid in your system. Today's article will cover another side of uric acid and, in the words of Paul Harvey, or in this case, Dr. David Perlmutter, "the rest of the story."

Uric acid has been downplayed as a little know metabolic waste product that has little to do with our overall health unless it becomes so high that gout and renal stones occur, as discussed last week. Based on that statement, that is how most practitioners today have been educated on the effects of uric acid in our bodies.

This week's goal is to unfold the metabolic effects of elevated uric acid levels, how to monitor uric acid, and some additional natural ways to address the excess levels before these high levels further degrade your health. 

We are going to take a step backward and look at the inner workings of our bodies and the formation of uric acid, and what happens when it starts to increase. Purines are directly converted into uric acid, our body naturally produces about 2/3 of them, and the other 1/3 is obtained externally in our diet. Purines alone are not bad, but when they become elevated, they become a concern.

A study looking at heart disease found that elevated uric acid correlated with increased blood pressure. The high uric acid causes oxidative stress, constricts blood vessels, and constant elevation of uric acid causes lasting injury and inflammation in the kidneys, making them unable to ride our bodies of excessive salt, causing increased blood pressure. They found that 90% of patients with newly diagnosed high blood pressure had high uric acid and when treated with allopurinol, 85% of the patient's blood pressure normalized. The study and ongoing research prove that high uric acid is a problem for all of us. 

Our bodies have evolved, and most mammals have an enzyme called uricase which breaks down uric acid so that elevations don't occur. Humans do not have that enzyme, and I will lay out the theory as to why we don't.

Thousands of years ago, when food was not always available like today's, man would eat as much as possible when food was plentiful. During times when fruit and meat were abundant, we would gorge ourselves. Meat contains purines, and the fructose in fruit is converted to purines as well, elevating our uric acid. Without uricase to break down uric acid, our bodies would start to store the excess calories from fructose into fat. This excess fat would allow us to survive during lean times. A yearly cycle of increased fat, then fat is used for survival, and the cycle continues.

Herein lies the concern, we do not have times when food is unavailable for us to eat. There are no lean times where we need to draw on our fat stores because food is always plentiful, so our bodies continue to pack on fat that never gets tapped into unless we consciously try to eliminate the fat.

A major hit to our dietary habits was the increased consumption of high fructose corn syrup from 1970 to 1990, which increased by 1000% during this period. This surge coincided with increased obesity and other health conditions aggravated by elevated uric acid levels.

Consuming fructose is associated with impaired glucose tolerance, insulin resistance, high blood fats, and high blood pressure. Fructose does not trigger the production of insulin and leptin, and these two hormones are responsible for regulating our metabolism; therefore, diets containing high amounts of fructose lead to obesity and the metabolic backlash that follows. Fructose also increases uric acid, which leads to other health issues.

Studies show that men with a uric acid above 7mg/dl and women above 5mg/dl significantly increased all-cause mortality and cardiovascular mortality, meaning those with increased uric acid are more likely to die from diseases than those with a lower uric acid level. However, the optimal level seems to be less than 5.5mg/dl. Elevated uric acid = inflammation, and as you know, inflammation is a driver for most diseases and illnesses, from cardiovascular disease to Alzheimer's disease.

What do we do with this information? The first thing would be to measure our uric acid and find out if you are a person that has elevated uric acid without the typical gout symptom. Testing can be done in your doctor's office with a blood test. They now have at-home uric acid monitors similar to those used to test blood glucose.

Simple steps that apply to anyone, not just those with high uric acid, include exercising, getting adequate sleep, staying hydrated by drinking ½ your body weight in ounces of water per day, reducing stress, and decreasing sugar and processed food consumption.

Last week I talked about using allopurinol and febuxostat, prescription medications, to lower uric acid. There are natural products that can also help reduce levels.

 Quercetin is a polyphenol with an antioxidant and anti-inflammatory benefit which is helpful in the fight against inflammation. The actual use of uric acid is a natural xanthine oxidase inhibitor, like allopurinol. Any product inhibitor of xanthine oxidase will naturally lower uric acid levels. A dose of 500mg of Quercetin daily should get the job done.

Luteolin is another natural xanthine oxidase inhibitor; additionally, it has been shown to prevent the dysfunction of beta cells in the pancreas. If the effects of the beta cells diminish, your body's ability to produce insulin helps with blood sugar regulation. Taking 100mg daily seems to be a good dose for luteolin.  (You will notice that both of these are link to the same product that contains both ingredients which helps with compliance.)

You all know of my love for omega 3 fatty acids, and DHA or docosahexaenoic acid is the omega 3 that can be beneficial for patients with elevated uric acid. DHA has anti-inflammatory benefits and is especially helpful in treating the brain. Fructose can harm the brain, and it appears that DHA is protective for the brain and offsets the destructive effects of fructose. A dose of 1000mg per day is recommended.

Vitamin C at a small dose of 500mg per day helps lower uric acid levels by increasing urinary excretion and decreasing kidney reabsorption. Because it is a potent antioxidant, it can help lower the tissue damage caused by high uric acid.

To summarize this article; elevated uric acid is a huge health concern, you need to get it tested, high fructose corn syrup should be avoided at all cost, and there are ways to lower the uric acid burden and gain back your health.

My staff and I would like to help you with questions regarding uric acid and finding suitable treatment options to lower the burden, so call or stop to schedule a consultation. Please visit my website at www.irsfeldpharmacy.com to see this and other archived articles in the blog section. Until next time, be vigilant about your health!!