Tuesday, September 27, 2022

How Does Uric Acid Cause Gout

The Dosage Of Turmeric For Gout

What is gout arthritis? How does uric acid cause inflammation?

Disclaimer There is no particular prescribed dose of turmeric defined for gout. Based on the studies and readers reports we have summarized various ways of taking turmeric which could benefit in this disorder.

The dosage depends on the formulation of the turmeric supplement and the severity of the health condition. Here is the recommended dose:

Cell Damage Due To Acidosis

Unlike the central nervous system, the peripheral nervous system is very vulnerable to chemical and mechanical stress. This means that acids will easily damage the nerves hence causing numbness and tingling. They will be more exposed to the corroding power of the free radicals. In fact, even the central nervous system can be a victim if you suffer from extreme acidosis. These acids are supposed to have no effect against the brain, but with too many acids the blood-brain barrier, composed of mostly endothelial cells, can be breached. Needless to say, this can be fatal.

Furthermore, continuous damage of cells will also result in more damaged insulin receptors. This makes the cells reject glucose which forces the blood to absorb more sugar. The high level of sugar in the blood makes it thick and this can cause a greater blood supply shortage and may result in diabetes.

Innate Responses To Uric Acid And Particles

It has long been recognized that sites of tissue necrosis become inflamed: vessels vasodilate, fluid leaks cause oedema, and leukocytes infiltrate the site of injury. The net effect of this process is that the soluble and cellular innate immune defenses are delivered to the tissue where cells are dying. This response can help to limit the injurious process and ultimately to promote repair. On the other hand, inflammation causes symptoms and can itself cause damage to the tissue. Indeed, inflammation is thought to underlie or contribute to the pathogenesis of a number of medically important diseases, including ones associated with cell death .

The release of DAMPs by dying cells stimulates tissue-resident macrophages to produce proinflammatory mediators that drive the inflammatory response., The molecular species of DAMPs that trigger these acute responses are not fully known, but include uric acid. As mentioned above, the biologically active form of uric acid is thought to be crystallized MSU that forms when intracellular stores of uric acid are released into the extracellular environment. As noted earlier, nucleation of MSU crystals in other situations, such as in gout, stimulates robust inflammation. Gout could, therefore, be viewed as a disease that is triggered when a normal bioactive mediator is overproduced and generated inappropriately .

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Risk Factors For Gout

Obesity, excessive weight gain, especially in youth, moderate to heavy alcohol intake, high blood pressure, diabetes, and abnormal kidney function are among the risk factors for developing gout. Certain drugs and diseases can also cause elevated levels of uric acid. Also, there is an increased prevalence of abnormally low thyroid hormone levels in patients with gout.

The Role Of Physical Activity In Prevention Of Gout

Easy Home Remedies to Control Uric Acid Levels &  Gout

Along with diet, physical activity can help with weight loss, and gout has been associated with being overweight.7 in patients with well-established gout, especially if X-rays have demonstrated joint damage in the foot, a low-impact exercise program is reasonable. An exercise program combined with diet in gout can reduce risk for attacks.7 If an attack seems to be coming on in the lower extremity, patients are well-advised to try to get off their feet, since impact seems to worsen gout attacks. Clues to an attack of gout coming on include local swelling, heat, redness, and tenderness in a joint, especially in the foot, ankle, or knee. Some patients have fever and chills as the first warning that an attack of gout is coming on.

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Allopurinol And Renal Impairment

One of the only ways allopurinol will be forbidden from therapy in gout is related to renal impairment. Patients with kidney damage can have life-threatening complications when they start using allopurinol, either in the acute or the chronic phase. Renal injury is a risk factor to develop a condition called allopurinol hypersensitivity syndrome.

Allopurinol hypersensitivity syndrome is a severe systemic reaction to allopurinol. It includes symptoms such as fever, skin manifestations, eosinophilia , and multiorgan dysfunction. There is a 25% mortality in patients who develop this syndrome, which is quite high and alarming. Thus, even though there are guidelines to prevent this from happening, doctors might prefer to use other urate-lowering alternatives in this group of patients.

In a nutshell, the main goal of allopurinol is to lower uric acid levels in chronic gout patients. There is current debate on the matter, but the majority of doctors agree that initiating allopurinol in patients recently diagnosed with acute gout is not recommended and does not have any benefit. It is only maintained in patients with chronic gout under treatment with allopurinol, and the only side effect doctors will try to avoid is allopurinol hypersensitivity syndrome, which is more common in patients with renal impairment.

References:

Drug and Therapeutics Bulletin Editorial Office. . Latest guidance on the management of gout. BMJ, 362, k2893.

How To Prevent Eye Complications

The best way to manage any symptoms of gout is to keep healthy levels of uric acid in the blood. This goal can be achieved with medication and make dietary changes. Your doctor will recommend the best treatment plan for acute attacks and maintenance.

You should limit or even avoid foods that are high in purine . Choose more often complex carbohydrates from whole grains, fruits and vegetables and fewer refined carbs from white bread and cakes. Limit foods sweetened with high fructose corn syrup such as soft drinks. Drink plenty of water because it will help you remove the uric acid from the body, while avoid alcohol .

If you need to lose some extra pounds, do so, but be careful, and use a combination of exercise and a healthy diet. Avoid crash diets or low carb diets-they can trigger problems because there is a risk of ketosis .

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The Difference Between Acute And Chronic Gout

The first step we should take is to differentiate acute and chronic gout. They are different manifestations of the same disease. Gout is not only diagnosed after blood tests with high levels of uric acid. This is called hyperuricemia. The diagnosis of gout requires a physical and functional examination to evidence that the articulations of the patient are being affected by such levels of uric acid in the blood. Otherwise, hyperuricemia is not diagnosed as gout.

Circled in Red is a Patient with Gout caused by Excessive Allopurinol

Acute gout is characterized by severe pain located in the toes or hands, but not limited to them. The symptoms appear suddenly, sometimes in the middle of the night, and become unbearable and very severe.

The area becomes swollen, red, tender, and very warm because theres a severe inflammatory process triggered by uric acid crystals. Pain in acute gout may last for hours, days, and sometimes a whole week. But after the attack has gone, the patient does not display any symptoms.

Diagnosis And Management Of Gout

Does Alcohol Cause Gout? – Uric Acid & Alcohol Addiction Explained

JOEL R. PITTMAN, PHARM. D., and MICHAEL H. BROSS, M.D., University of Mississippi Medical Center, Jackson, Mississippi

Am Fam Physician. 1999 Apr 1 59:1799-1806.

Gout is a disease resulting from the deposition of urate crystals caused by the overproduction or underexcretion of uric acid. The disease is often, but not always, associated with elevated serum uric acid levels. Clinical manifestations include acute and chronic arthritis, tophi, interstitial renal disease and uric acid nephrolithiasis. The diagnosis is based on the identification of uric acid crystals in joints, tissues or body fluids. Treatment goals include termination of the acute attack, prevention of recurrent attacks and prevention of complications associated with the deposition of urate crystals in tissues. Pharmacologic management remains the mainstay of treatment. Acute attacks may be terminated with the use of nonsteroidal anti-inflammatory agents, colchicine or intra-articular injections of corticosteroids. Probenecid, sulfinpyrazone and allopurinol can be used to prevent recurrent attacks. Obesity, alcohol intake and certain foods and medications can contribute to hyperuricemia. These potentially exacerbating factors should be identified and modified.

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The Relationship Between Gout Numbness And Tingling

Inflammation and the painful feeling of burning sensation are always a given to an individual with gout. These two symptoms of gout are sometimes being accompanied by the feeling of numbness and tingling. Isnt it an annoying set of painful symptoms? But, arent you curious about the relationship of gout with the feeling of numbness and tingling? In case you do, then take note of the things you will learn with the succeeding paragraphs.

This article explains the relationship between gout, numbness and tingling. Keep reading and be well informed.

Turmeric Counteracts Side Effects Of Painkillers

Turmeric has gastroprotective properties- it protects from acid reflux, the formation of gastric ulcers, and inflammation of the gut or gastritis.

This property of turmeric protects from long term side effects of painkillers which can involve gastric inflammation and bleeding.

What does this mean?Turmeric when used as an adjunctive treatment protects from gastric side effects caused by conventional medication.

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Turmeric Act As An Anti

A study conducted by Mubin Mustafa Kiyani et al. aimed to evaluate turmeric nanoparticles as an anti-gout agent.

After synthesizing turmeric nanoparticles, a mice model with induced gout via monosodium urate crystals was used for assessment.

Oral administration of turmeric nanoparticles showed significant results through joint diameter measurement, changes in biochemical parameters, such as lipid profile, renal, and liver function tests.

T-NPs showed a significant reduction in uric acid levels, and this proves that turmeric can be used as a potential anti-gout agent with minimum to negligible toxicity.

The article from Bioorganic and Medical Chemistry Letters presented a work that showed that curcumin weakly binds to xanthine oxidase and during its degradation products showed effective inhibitory activities against xanthine oxidase.

What it means

Curcumin is found to have influence over modifying the uric acid cycle, which helps in classifying it as a potential anti-gout agent. Experiments have proved its efficiency in reducing uric acid levels and their mechanism in preventing uric acid secretion in the body.

Juices To Remove Uric Acid From Body And Relieve Gout Pain

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The high level of uric acid in the body is caused when the kidneys can’t effectively remove it through urine. This happens because of two conditions, either when we consume foods more in uric acid content or when there is some problem in kidney function.

However, high uric acid level mostly occurs when we eat foods rich in proteins or uric acid. The excess uric acid is removed by the kidneys, but some of it still remains in the body.

This uric acid in the blood gets accumulated in the body’s joints, mostly in finger joints such as toes, ankle, knee, wrist, elbow. This condition is known as gout.

In this condition, there is much pain, redness and inflammation of the area, where the uric acid gets accumulated.

Gout is most common among middle-aged men and can happen when we they don’t have a control on our diet such as eating lots of meat, liver, onions, beans, peas, mushrooms, etc, that are rich in purines.

Some other factors which cause high uric acid level in the body are drinking too much of alcohol, weight gain, diabetes and hypothyroidism.

Have a look at some of the best juices that help in the removal of uric acid from the body.

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Uric Acid And Comorbidities Of Gout

Patients with gout frequently have a number of comorbid conditions, which can include renal disease, hypertension, diabetes mellitus, metabolic syndrome, cardiovascular disease, lipid disorders and respiratory symptoms.,, Some of these comorbidities, such as renal disease, can contribute to the pathogenesis of gout by elevating serum levels of uric acid in other words, some comorbidities may be a cause rather than an effect of elevated levels of uric acid. In other cases, however, the possibility has been raised that high uric acid levels or gout, or both, might contribute to the development of comorbidities, possibly including hypertension, metabolic syndrome and atherosclerosis. Determining cause and effect of gout and its comorbidities, and elucidating the mechanisms underlying these epidemiological associations, is not trivial and at this point is unresolved. Some of these associations are briefly reviewed below, and interested readers are referred to more in-depth reviews published elsewhere.,,

It Improves Metabolic Health

Turmeric is great for metabolic health in a number of ways:

Maintaining a healthy metabolism is very vital in reducing gout because each of these factors contributes to high uric acid and thereby treating these can help prevent gout.

What does this mean?Curcumin can bring about significant improvements in metabolic health which if impaired serves as a risk for developing high uric acid levels and gout.

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Stimulation Of The Nlrp3 Inflammasome

The identification of NLRP3 as a sensor for MSU crystals and other irritant particles initially presented a bit of a puzzle, because this NLR protein seemed to be in the wrong cellular compartment to be able to sense the particles. The NLRP3 inflammasome is an intracellular complex that resides in the cytosol of cells. By contrast, the stimuli discussed above that trigger this complex are large macroscopic particles that, when present in the body, are initially located outside of cells. This raises the interesting question: how do these extracellular particles trigger the intracellular NLRP3 inflammasome? The first step in the process occurs when phagocytes ingest these particles ., Suppression of phagocytosis by treating macrophages in vitro with cytochalasins or colchicine blocked urate-induced NLRP3 activation. ,, as an aside, this mechanism might explain in part why colchicine is an effective therapeutic agent for acute attacks of gout, although this drug also affects other components of the inflammatory response. Once the particles are in phagosomes, they can stimulate the NLRP3 inflammasome by way of at least two different mechanisms, one of which involves reactive oxygen species and another involves phagosomal proteases .

ROS and cathepsins involved in NLRP3 inflammasome activation

How Can I Manage My Gout And Improve My Quality Of Life

What is gout arthritis How does uric acid cause inflammation

Gout affects many aspects of daily living, including work and leisure activities. Fortunately, there are many low-cost self-management strategies that are proven to improve the quality of life of people with gout.

For gout in particular:

  • Eat a healthy diet. Avoid foods that may trigger a gout flare, including foods high in purines , and limit alcohol intake .

CDCs Arthritis Program recommends five self-management strategies for managing arthritis and its symptoms. These can help with gout as well.

  • Talk to your doctor. You can play an active role in controlling your arthritis by attending regular appointments with your health care provider and following your recommended treatment plan. This is especially important if you also have other chronic conditions, like diabetes or heart disease.
  • Lose weight. For people who are overweight or obese, losing weight reduces pressure on joints, particularly weight bearing joints like the hips and knees. Reaching or maintaining a healthy weight can relieve pain, improve function, and slow the progression of arthritis.
  • Protect your joints. Joint injuries can cause or worsen arthritis. Choose activities that are easy on the joints like walking, bicycling, and swimming. These low-impact activities have a low risk of injury and do not twist or put too much stress on the joints. Learn more about how to exercise safely with arthritis.
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    Whats The Outlook For People With Gout

    Untreated gout can lead to permanent joint damage. The buildup of uric acid in the joints and soft tissue is called tophus. Some people with gout can also develop other health problems, such as severe arthritis, kidney stones and heart disease. Its important to discuss your symptoms with a healthcare provider.

    Uric Acid As A Danger Signal

    Cell damage and necrosis is potentially dangerous to an organism it is the manifestation of some underlying pathological process or agent that is injuring cells. As such, it is in the interest of the host to try to limit and repair such damage. If the injurious agent is a microbe, the immune system has a number of molecular sensors, such as Toll-like receptors , NOD-like receptors and RIG-like receptors , to detect and respond to pathogens. The danger hypothesis additionally proposes that the immune system has also evolved mechanisms to monitor the health of cells, a concept that is now accepted as correct. The innate immune system performs this monitoring function by surveying the extracellular environment for the presence of a subset of molecules that are normally sequestered in the interior of cells but that are exposed upon loss of integrity of the plasma membrane. Rupture of the cell membrane is an invariable consequence of necrosis. Therefore, by monitoring the environment for the release of intracellular molecules the immune system can detect and respond to injurious processes that pose a danger to the host, and thereby attempt to limit and repair any damage. The intracellular molecules whose release signals danger are referred to as danger signals or damage-associated molecular patterns . Uric acid, it turns out, is one of these DAMPs.

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    What Is The Prognosis Of Gout

    Gout is a chronic condition. Left untreated, patients may suffer from recurrent painful and disabling acute attacks of gout. Joint damage and other complications of gout may occur. However, excellent treatments for gout are available, and most patients respond very well to gout treatment with a good prognosis.

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