The End Of Gout Your Ultimate Beginners System
Shelly Mannings The End of Gout is not only a fascinating read its also refreshingly practical.
Shelly gives you two simple quick-starts:
Eat more of these
Eat fewer of these
This simple modification can correct years of gout-causing errors in the eating. And you can start this right away within minutes of acquiring the program.That really helped my problem of What Would Indicate Gout On Uric Acid Level.
The next step is to follow Shellys 7-day plan.
It tightens up the quick start advice and turns it into a solid, follow-along program.
The 7-day plan was the real clincher for me.
I am a pretty average cook Im competent but not at all skilled or adventurous. Turns out I didnt need to be.
The plan takes away all the thinking and gives me, for the first week, something I can simply copy.
After the first 7 days I used Shellys advice to adapt the plan according to my own tastes.
Which was pretty easy the plan is full of options so you can try different foods and see what you like best.
Its all food you can buy in your supermarket. And it includes lots of nice stuff the chocolate and strawberries desserts were real winners in my house!
Other Causes Of Hyperuricemia
For most people, the high levels of uric acid are not a problem until middle-age. Something important to make note of is that in addition to eating high-purine foods, other factors slowly compromise the function of the kidneys.
Your poor kidneys are busy trying to eliminate all the other kinds of acid wastes that result from the modern lifestyle. So it becomes even MORE difficult for them to get rid of uric acid quickly enough to keep the levels within the normal range.
Now, before you start feeling like a victim of your kidneys, let me point out that most peoples health choices are not exactly making life easy for their kidneys! Low blood oxygenation from poor breathing habits or poor air quality, chronic dehydration, overly processed foods or genetically modified foods are just a few of the contributing factors that reduce kidney function over time.
With the addition of more and more toxic environmental chemicals making their way into the inner bodily terrain, the kidneys ability to eliminate the uric acid becomes undermined.
If you want to eliminate more uric acid, youve got to adopt some kidney-friendly habits. To learn more about kidney-friendly habits, I go way deep on this subject in my online video program called Kill Your Gout For Good.
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Tell A Healthcare Provider About:
- Recent intense exercise. If you have recently exercised a lot,this may affect your test results.
- Any allergies you have.
- All medicines you are taking, including vitamins, herbs, eyedrops, creams, and over-the-counter medicines.
- Any blood disorders you have.
- Any surgeries you have had.
- Any medical conditions you have.
- Whether you are pregnant or may be pregnant.
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Increased Risks Of All
Both high and low levels of uric acid were linked with increased risks of death, showing a U-shaped association between serum uric acid levels and all-cause, cardiovascular, and cancer mortality, Korean researchers reported.
In men, for example, the hazard ratio for all-cause mortality among those with the highest level of uric acid was 2.39 when compared with the reference category , while the hazard ratio for those with the lowest levels was 1.58 , according to Seungho Ryu, MD, PhD, of Sungkyunkwan University School of Medicine in Seoul, and colleagues.
Similarly, in women, the hazard ratios for all-cause mortality were 3.77 in the highest uric acid category and 1.80 in the lowest category, the researchers reported in Arthritis & Rheumatology.
Elevated uric acid has been clearly linked with gout and kidney stones, and epidemiologic studies have suggested that it also may contribute to hypertension, cardiovascular disease, metabolic syndrome, and kidney ailments.
However, uric acid is also an antioxidant and low levels can result in oxidative stress and endothelial dysfunction, which can predispose to illnesses such as hypertension and diabetes.
Previous studies looking for associations between uric acid levels and various causes of death have had conflicting results, and have primarily focused on the effects of high levels.
Disclosures
The authors had no disclosures.
Primary Source
Arthritis & Rheumatology
What Happens During A Uric Acid Test
A uric acid test can be done as a blood test or a urine test.
During a blood test, a health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.
For a uric acid urine test, you’ll need to collect all urine passed in a 24-hour period. This is called a 24-hour urine sample test. Your health care provider or a laboratory professional will give you a container to collect your urine and instructions on how to collect and store your samples. A 24-hour urine sample test generally includes the following steps:
- Empty your bladder in the morning and flush that urine away. Record the time.
- For the next 24 hours, save all your urine passed in the container provided.
- Store your urine container in the refrigerator or a cooler with ice.
- Return the sample container to your health provider’s office or the laboratory as instructed.
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Risk Factors For Gout
A number of references by Choi et al have identified, explained, and reviewed the risk factors for the development of gout.11-13 Nonmodifiable risk factors include being a male or a postmenopausal female, genetic influences, end-stage renal disease, and resulting major organ transplantation. Its prevalence increases with age, from 1.8/1,000 in people under the age of 45 years to 30.8/1,000 in those over age 65.8 Elevated serum urate levels are also associated with increased risk.8 Hypertension is a definite risk factor, as a significant percentage of patients with hyperuricemia will develop hypertension. Hyperuricemia and gout have been linked to other disease states including metabolic syndrome, cardiac disease, stroke, and renal disease.8 The risk of gout correlates with truncal obesity, as measured by body mass index and waist-to-hip ratios.8,11
Avoidable risk factors include diet and medications. Foods that have been implicated in causing gout are red-organ meats, seafood, and foods containing high-fructose corn syrup. Fructose has been recognized as a cause of hyperuricemia.8,14-16 Choi et al conducted a small prospective study that investigated the ability of diets high in fructose to induce higher serum urate levels relative to diets high in glucose or low in carbonates.16 High alcohol intake, especially beer, is also a risk factor. The presence of guanosine in beer has been identified as the cause of gouty attacks.
Overproduction Of Uric Acid
Purines, which are later metabolized to uric acid, enter a common metabolic pathway by which either nucleic acid or uric acid is produced. Normal production of uric acid is considered to be 600 mg per day in men with normal renal function on a purine-free diet.4 Overproduction of uric acid may occur because of an abnormality in the enzymes that regulate purine metabolism. Two such abnormalities have been documented. An increase in the activity of phosphoribosylpyrophosphate synthetase results in increased uric acid synthesis. A deficiency of hypoxanthine-guanine phosphoribosyltransferase also increases serum uric acid levels.9
A practical approach is to obtain a 24-hour uric acid determination without dietary restriction. A patient on a regular diet who excretes more than 800 mg of uric acid per 24 hours is considered an overproducer.4
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Looking For Reference Ranges
You may be able to find your test results on your laboratorys website or patient portal. However, you are currently at Lab Tests Online. You may have been directed here by your labs website in order to provide you with background information about the test you had performed. You will need to return to your labs website or portal, or contact your healthcare practitioner in order to obtain your test results.
Lab Tests Online is an award-winning patient education website offering information on laboratory tests. The content on the site, which has been reviewed by laboratory scientists and other medical professionals, provides general explanations of what results might mean for each test listed on the site, such as what a high or low value might suggest to your healthcare practitioner about your health or medical condition.
The reference ranges for your tests can be found on your laboratory report. They are typically found to the right of your results.
If you do not have your lab report, consult your healthcare provider or the laboratory that performed the test to obtain the reference range.
For more information, please read the article Reference Ranges and What They Mean.
How Do I Get Ready For The Test
Typically, you donât need to do anything special. In some cases, your doctor may tell you not to eat or drink anything for 4 or more hours before the test. Your doctor will also let you know if you need to stop taking any medicines.
Make sure to tell your doctor about any medicines, herbs, and supplements you take, including over-the-counter, prescription, and illegal drugs. Any of these, including medications that make you pee more often , vitamin B-3, and aspirin, can affect your results.
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Younger People With Hyperuricemia
Once upon a time, gout was considered the Disease of Kingsrich and old men. Interestingly, the real story behind that is the wide-spread occurrence of gout due to lead poisoning. The aristocrats had access to lead in many forms, and their eating and drinking implements were made from it. They also enhanced the flavors of their foods with lead acetate.
The modern day epidemic of gout and the pre-gout condition of hyperuricemia follows the same graph as obesity, diabetes, heart disease, and cancer. We will soon see childhood gout just as we are seeing childhood diabetes. Personally, I now interact with people every day who are in their 30s and 40s who say they got gout for the first time ten or twenty years ago! Dont let this be you.
Elevated levels of uric acid, hyperuricemia, and gout at any stage, can be pinned on the poor quality, denatured, processed foods of our times. Couple that with massive amounts of toxic chemical substances in our air, water, household products, cosmetics, and more. Poor kidney function, hyperuricemia and gout are all just a foregone conclusion without vigilant gout prevention.
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.
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Genetic And Physiological Diversity
Primates. In humans and higher primates, uric acid is the final oxidation product of purine metabolism and is excreted in urine, whereas in most other mammals, the enzyme uricase further oxidizes uric acid to allantoin. The loss of uricase in higher primates parallels the similar loss of the ability to synthesize ascorbic acid, leading to the suggestion that urate may partially substitute for ascorbate in such species. Both uric acid and ascorbic acid are strong reducing agents and potent antioxidants. In humans, over half the antioxidant capacity of blood plasma comes from hydrogen urate ion.
Humans. The normal concentration range of uric acid in human blood is 25 to 80 mg/L for men and 15 to 60 mg/L for women . An individual can have serum values as high as 96 mg/L and not have gout. In humans, about 70% of daily uric acid disposal occurs via the kidneys, and in 525% of humans, impaired renal excretion leads to hyperuricemia. Normal excretion of uric acid in the urine is 250 to 750 mg per day .
Dogs. The Dalmatian dog has a genetic defect in uric acid uptake by the liver and kidneys, resulting in decreased conversion to allantoin, so this breed excretes uric acid, and not allantoin, in the urine.
Invertebrates. Platynereis dumerilii, a marine polychaete worm, uses uric acid as a sexual pheromone. The female of the species releases uric acid into the water during mating, to induce males to release sperm.
How A Uric Acid Blood Test Is Done
The process of obtaining a blood sample for testing is called venipuncture.
Your doctor or another healthcare provider takes blood from a vein, usually from your inner elbow or the back of your hand.
First, they sterilize the area with an antiseptic. They then wrap an elastic band around your arm to allow blood to fill the veins.
They next insert a needle into your vein. The blood is collected in an attached vial. Once the blood has been collected, the healthcare provider will untie the plastic band and remove the needle from the vein.
Finally, theyll apply pressure to the site of the needle entry and bandage it if necessary.
For infants and young children, the healthcare provider may make a small cut on the arm and use a test strip or slide to collect a small sample of blood. Theyll then clean the area and bandage if necessary.
Once collected, the blood is sent to a laboratory for analysis.
1.5 to 6.0 milligrams/deciliter for women and 2.5 to 7.0 mg/dL for men. However, the values may vary based on the lab doing the testing.
Low levels of uric acid are less common than high levels and are less of a health concern.
Hyperuricemia is defined as a blood uric acid level greater than 6.0 mg/dL in women and greater than 7.0 mg/dL in men. According to the American College of Rheumatology , your target level of uric acid should be less than 6.0 mg/dL if you have gout.
High uric acid levels in your blood can also indicate a variety of other causes, including:
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How Hyperuricemia Develops
It is normal to have a low level of uric acid in the bloodstream. Uric acid levels may get too high when one or more of the following occurs:
- The kidneys are not able to adequately filter and flush out uric acid from the bloodstream
- A person eats foods and beverages that are high in purines
- The body produces too much uric acid
When the body produces too much uric acid, there is typically a genetic cause.
Avoid High Purine Foods
Todays standard diet makes it hard to avoid purines. To avoid uric acid buildup, you need to avoid foods that are high in purines such as seafood, organ meats, processed foods, and beer. In addition, you should also avoid alcohol and saturated fats since these inhibit your bodys ability to metabolize purines properly.
Beer is the worst alcohol to drink for gout because it both contains alcohol and yeast which is high in purines. If you have gout or hyperuricemia, you should completely avoid beer or just drink in moderation, preferably with just organic beer.
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How Is It Used
The uric acid blood test is used to detect high levels of this compound in the blood in order to help diagnose gout. The test is also used to monitor uric acid levels in people undergoing chemotherapy or radiation treatment for cancer. Rapid cell turnover from such treatment can result in an increased uric acid level.
The uric acid urine test is used to help diagnose the cause of recurrent kidney stones and to monitor people with gout for stone formation.
What Affects The Test
High uric acid values may be caused by:
- Individual differences in the way your body produces or gets rid of uric acid.
- Conditions, such as:
- Kidney disease or kidney damage.
- The increased breakdown of body cells that occurs with some types of cancer or cancer treatments, hemolytic anemia, sickle cell anemia, or heart failure.
- Other disorders, such as alcohol use disorder, pre-eclampsia, liver disease , obesity, psoriasis, hypothyroidism, and low blood levels of parathyroid hormone.
- Starvation, malnutrition, or lead poisoning.
- A rare inherited gene disorder called Lesch-Nyhan syndrome.
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How It Is Done
The health professional who takes a sample of your blood will:
- Wrap an elastic band around your upper arm to stop the flow of blood. This makes the veins below the band larger so it is easier to put a needle into the vein.
- Clean the needle site with alcohol.
- Put the needle into the vein. More than one needle stick may be needed.
- Attach a tube to the needle to fill it with blood.
- Remove the band from your arm when enough blood is collected.
- Put a gauze pad or cotton ball over the needle site as the needle is removed.
- Put pressure on the site and then put on a bandage.