Common Symptoms Of Hashimotos Disease
What Is Hashimotos Disease? Hashimotos disease is a disease that affects the thyroid gland and could damage the thyroid function another name for it is Hashimotos Thyroiditis. Hashimoto disease is an autoimmune disorder, and it is a condition in which the immune system attacks a small gland at the base …
Serum Urate And Cardiovascular Mortality
In 1999 the Framingham Heart Study published the results of their ancillary study on the association of serum urate with cardiovascular disease and cardiovascular death. A total of 6,763 Framingham Study participants contributed a total of 117,376 person-years of follow-up. No significant associations were found in men or women after adjustment for cardiovascular risk factors and diuretic use. These results raised the question of an association of serum urate with cardiovascular disease and cardiovascular death probably confounded by other factors in the cardiovascular disease causal pathway .
Other recent studies have provided additional valuable information by studying larger populations and specific groups of individuals. Data from the Vorarlberg Health Monitoring and Promotion Program in Austria were used to study the association between serum urate and mortality from coronary heart disease , from congestive heart failure, and from stroke in 83,683 healthy men followed for 20 years . After adjustment for covariates, men with concentrations of serum urate > 6.7 mg/dl had a significantly greater risk for death from congestive heart failure and from stroke, but not from CHD, when compared with those men in the lower category of serum urate concentration .
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What To Do During An Attack
You should:
- take any medication you’ve been prescribed as early as possible after you notice an attack this should start to have an effect within two or three days
- rest and raise the limb
- avoid knocking or damaging the affected joint
- keep the joint cool remove surrounding clothing and apply an ice pack, such as a bag of frozen peas wrapped in a towel
- ensure you’re well hydrated
Apply the ice pack to your joint for around 20 minutes. Don’t apply ice directly to your skin and don’t apply it for more than 20 minutes at a time because this could damage the skin.
If necessary, you can keep reapplying an ice pack to your skin during an attack, but you should wait until your skin has returned to a normal temperature first.
Gout May Lead To Kidney Disease
This connection is less established, but there is evidence that gout can lead to kidney disease. The belief that gout leads to kidney disease is common among many doctors who specialize in the disease.When you have gout, you have too much uric acid in your blood. As your blood is filtered through your kidneys, uric acid can build up and form urate crystals. As the urate crystals pass through your kidneys, they can cause damage and scars. This kidney damage is thought to lead to kidney disease and failure over time, especially if your gout is left untreated.NSAIDs, some of the most common pain relieving medicines for gout, can also lead to kidney disease over time. Talk to your doctor about how to manage your use of NSAIDs.
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What Else Should I Ask My Healthcare Provider About Gout
Consider asking your healthcare provider:
- What is causing the gout?
- Do I have any joint damage?
- What can I do to prevent future attacks?
- Can any gout medications help me?
- How long will I need to take gout medications?
A note from Cleveland Clinic
Gout is a painful form of arthritis. Extra uric acid in your body creates sharp crystals in the joints, leading to swelling and extreme tenderness. Gout usually starts in the big toe but can affect other joints. Gout is a treatable condition, and the uric acid level can be decreased by medication and lifestyle changes. Talk to your healthcare provider about medications that can reduce uric acid levels. They can also discuss changes you can make to your diet and lifestyle to prevent and reduce gout attacks.
Last reviewed by a Cleveland Clinic medical professional on 11/15/2020.
References
How Does A Doctor Diagnose Gout
If you have sudden or severe pain in a joint, you should talk to your primary care provider . Your PCP may send you to a rheumatologist, a doctor who specializes in gout and other kinds of arthritis.
Healthcare providers consider several things when confirming gout:
- Symptoms: The provider will ask you to describe your symptoms, how often they happen and how long they last.
- Physical examination: Your provider will examine the affected joint to look for swelling, redness and warmth.
- Blood work: A test can measure the amount of uric acid in your blood.
- Imaging tests: You may have pictures taken of the affected joint with X-rays, an ultrasound or MRI.
- Aspiration: The provider may use a needle to pull fluid from the joint. Using a microscope, a team member can look for uric acid crystals or a different problem .
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The Impact Of Gout On Heart Disease
New research reported by the American Heart Association reveals that gout, a type of inflammatory arthritis, is now believed to be a bigger indicator of possible heart disease than previously thought. The risk of death by cardiovascular disease, heart attack or stroke is fifteen percent higher among gout sufferers than among people who never experienced gout. Heart disease is the most common cause of death in the United States.
Living With Gout And Kidney Disease
When you have both gout and kidney disease, treating gout can be difficult because some medicines, such as NSAIDs, are not safe for the kidneys. Some of the most common medicines for acute and chronic gout should be adjusted or avoided when you have kidney disease. Learn more about the medicines for gout here.Additionally, some people with kidney disease take medicines that may increase their risk of gout. For example, diuretics and beta-blockers, two common medicines for high blood pressure can contribute to gout attacks. Tell your doctor about all the medicines you take so they can suggest a treatment that works best for you.If you have both gout and kidney disease, there are certain things you can do to keep both conditions under control and improve your general health.
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Serum Urate And Macrovascular Disease
Evidence of an association between serum urate levels and surrogate markers of atherosclerosis, such as the carotid intima-media thickness , is starting to emerge. In a cross-sectional study of 234 healthy postmenopausal women there was a significant association between serum urate and IMT, independent of factors such as blood pressure, serum glucose, serum lipids, creatinine, smoking, and diuretic use . Thirty patients with hypertension and hyperuricemia had their carotid IMT compared with that of 25 patients with hypertension but without hyperuricemia, and compared with 25 aged-matched healthy control individuals . Patients with both hypertension and hyperuricemia had significantly greater carotid IMT than either control group, and in the overall population the carotid IMT was significantly associated with levels of serum urate. A significant association between serum urate and IMT persisted after multivariate adjustment in a group of 120 obese children .
How Can I Manage My Gout And Improve My Quality Of Life
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.
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Why Does The Cardiovascular Risk With Gout Differ By Sex
Heart disease risk differs by sex in the general population. Women have a lower risk of heart disease compared to age-matched men in the pre-menopausal yearsa protective effect of oestrogen. This benefit is lost in post-menopausal years and therefore the risk of heart disease in post-menopausal women catches up with men’s risk of heart disease. Despite the differences in prevalence rates, the same risk factors for heart disease are key in both men and womenthat is, smoking, diabetes, hypertension, hyperlipidaemia, and family history of heart disease. The early evidence from the current study and some others indicates that the increase of heart disease risk might differ slightly by sex, the association being stronger in women compared to men. The absolute risk of any cardiovascular disease was 24.0/1000 person-years in men and 23.1/1000 person-years in women with gout, compared with 19.2 and 14.8/1000 person-years in men and women without gout, respectively. This shows that there is a difference in the risk of cardiovascular disease by sex in patients without gout and that this sex difference in cardiovascular disease risk is abolished in men and women with gout. It is possible that systemic inflammation induced by gout in women, who otherwise have a lower prevalence of cardiac risk factors than age-matched men, is more atherogenic than that in men. Studies are needed to test whether there are sex-based differences in the pathogenesis of gout-associated heart disease.
Ua And Inflammatory Response
UA has been a focus of research not only for its role in oxidative stress, but also for its relation to various inflammatory diseases. Atherosclerosis is a chronic immuno-inflammatory cardiovascular disease. A large body of evidence suggests that elevated UA levels are strongly associated with the occurrence and development of atherosclerosis. High intracellular UA concentrations promote the expression of inflammatory markers, such as nuclear factor B , growth factors, vasoconstrictive substances , and chemokines via activating mitogen-activated protein kinases . Additionally, hyperuricemia promoted macrophage M1/M2 polarization, which could be reversed by ULT . In the development of obesity and cardiorenal disease, UA tends to enhance the pro-inflammatory response of M1 and inhibit the anti-inflammatory response of M2 . M1 macrophages secrete inflammatory cytokines, leading to insulin resistance and cardiac dysfunction . On the contrary, M2 macrophages secrete interleukin-10 , which inhibits cardiomyocyte hypertrophy and myocardial fibrosis . Furthermore, in a randomized, open, parallel-controlled study involving 176 patients with T2D and asymptomatic hyperuricemia, allopurinol effectively lowered sUA, improved insulin resistance, reduced serum high-sensitivity C-reactive protein level, decreased carotid intima-media thickness, and ameliorated the exacerbation of atherosclerosis .
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Ua And Insulin Resistance/diabetes
Insulin resistance is closely related to diabetes, obesity, hyperlipidemia, hypertension, hyperuricemia, and other metabolic disorders. Current studies confirm that oxidative stress and inflammation may be the pathophysiological basis of insulin resistance. Hyperuricemia can promote oxidative stress in many cell lines. The rise of ROS level can induce insulin resistance. Oxidative stress may be the cause of insulin resistancerelated cardiovascular complications because overgenerated ROS and insulin resistance may lead to cardiac dysfunction . Our team’s research shows that high UA can increase ROS production and inhibit insulin-induced glucose uptake in H9c2 and primary cardiomyocytes, and N-acetyl-L-cysteine pretreatment can reverse the inhibitory effect of high UA on glucose uptake . The molecular mechanism may be that high UA increases the phosphorylation of insulin receptor substrate 1 and inhibits the phosphorylation of Akt, which was blocked by N-acetyl-L-cysteine . Hence, high UA can induce insulin resistance in cardiomyocytes in vitro and in vivo.
High Uric Acid Levels Linked To Future Risk For Heart Failure Researchers Say
Eswar Krishnan
A simple $2-blood test may allow doctors to predict whether a patient is at risk of developing heart failure sometime in their future, according to new research from the Stanford University School of Medicine.
Our study shows that high levels of uric acid significantly increase your risk of developing heart failure later in life, said Eswar Krishnan, MD, assistant professor of immunology and rheumatology. The novelty is that the test for measuring this is very cheap and easily available.
The study appears online in August in the journal Circulation: Heart Failure.
Uric acid naturally occurs in the body as a byproduct of many different foods. High levels are best known as a cause for a type of arthritis known as gout. Krishnan, who authored the study, became interested in the relationship between uric acid levels and heart failure while researching gout and heart attacks. This was a detour of sorts for me, he said.
While high levels of uric acid are also known to be a marker for adverse prognosis for people already diagnosed with heart failure, no previous study had convincingly linked high levels of uric acid and future cases of the disease.
Nearly 5 million Americans suffer from heart failure, a disease that weakens the ability of the heart to pump blood through the body. It reduces life expectancy, affects quality of life and can eventually be fatal. While medications sometimes help, currently the only known cure is a heart transplant.
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Who Should Diagnose And Treat Gout
The disease should be diagnosed and treated by a doctor or a team of doctors who specialize in care of gout patients. This is important because the signs and symptoms of gout are not specific and can look like signs and symptoms of other inflammatory diseases. Doctors who specialize in gout and other forms of arthritis are called rheumatologists. To find a provider near you, visit the database of rheumatologistsexternal icon on the American College of Rheumatology website. Once a rheumatologist has diagnosed and effectively treated your gout, a primary care provider can usually track your condition and help you manage your gout.
Causes Of Night Sweats
Night sweat, also known as excessive perspiration or sweating at night, is a very uncomfortable feeling or condition. Even though it is a core part of how the body regulates its temperature and is considered normal, excessive sweating in the middle of the night is another case. Night sweat happens …
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A Heart Healthy Diet Helps Prevent Gout
Certain foods that contribute to cardiovascular disease also increase the risk of gout. Red meat, excessive alcohol and foods with high fructose content are bad for both. An eating plan known as DASH is described by the National Heart, Lung and Blood Institute as a flexible plan that will create a heart healthy diet. The Arthritis Foundation endorses it as a way to help control gout. Recommended foods are fruit, vegetables and whole grains, as well as fat-free or low-fat dairy products. Fish, poultry, nuts, beans and vegetable oils are encouraged in the plan.
In addition to recommended foods are those to be eliminated or, at least, avoided. They include sugar filled deserts or soft drinks, fatty meats, full-fat dairy products and tropical oils, like coconut and palm oils.
NHLBI reports that the DASH plan lowers blood pressure and LDL cholesterol, the cholesterol that builds up in arteries.
Note: A physician or cardiologist should be consulted before starting any diet or exercise plan.
Kidney Disease Can Lead To Gout
When you have chronic kidney disease , your kidneys do not work as well as they should to filter wastes out of your body. Uric acid is a waste product that is naturally found in your blood. When you have kidney disease, your kidneys cannot filter out uric acid as well as they should. Too much uric acid building up in the body may cause gout.Most people with early stage kidney disease do not know they have it. Gout can be a warning sign of kidney disease. Ask your doctor if you should be tested for kidney disease when you have gout.
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