Your arthritis or osteoarthritis could actually be… high uric acid!

Uric acid is produced as an end product of purine, nucleic acid, and nucleoprotein metabolism. The kidneys store and excrete about 2/3 of the uric acid produced daily, making it an indirect marker of renal function as well. The remaining 1/3 is excreted in the stool.  When excess levels of uric acid build up in the blood, a person is diagnosed with hyperuricemia.

Two factors cause hyperuricemia or high uric acid levels:

  • A sufficient amount of purines are naturally made by the body to serve functions in DNA, RNA, and neurotransmission. When too much purine comes from dietary choices high in purines such as red meats, poultry, seafood, lentils and other legumes, anchovies, and beer, these dietary purines are converted to uric acid.
  • In about 90% of the cases of high uric acid, poor urinary excretion is the primary cause, with excess uric acid production accounting for just 10%.

About 5% to 8% of adult males have high levels of uric acid but present with no symptoms. Uric acid levels above 8.6 mg/dL in men or 7.1 mg/dL in women are classified as hyperuricemia (although some laboratories and research groups use different limits).

A long-term buildup of uric acid results in solid deposits of a salt called monosodium urate monohydrate—forming  crystals in the joints, soft tissue, and organs throughout the body. 

Affecting millions of people, high uric acid levels can lead to the arthritic inflammation behind painful attacks of gout and other diseases related to high uric acid like renal failure or leukemia. When the serum uric acid level exceeds 9.0 mg/dL, the probability of developing clinical gout is 6 times higher.

Please note that gout, a very painful inflammatory disease caused by high uric acid levels, is associated with higher risks of cardiovascular disease and mortality.

Gout is best known for causing excruciating pain focused in the big toe. However, gout can also attack the following structures:

  • Knees
  • Fingers
  • Elbows
  • Achilles tendons
  • Instep of the feet 
  • Ankles
  • Heels
  • Wrists

A recent pilot study published in the Journal of Clinical Rheumatology, found that 52% of individuals with asymptomatic hyperuricemia -meaning those that have high levels of uric acid but feel no symptoms of it-  and 68% of gout patients, also have knee osteoarthritis.

Because dietary purines from dark meat, organ meats, pork, shellfish, legumes, or anchovies (which are amongst the foods with the highest content of purines) is one of the main causes of increased uric acid levels, these foods should therefore be limited or eliminated from the diet. Other animal proteins that are low in purines must be consumed instead to avoid severe nutritional deficiencies. Please focus on vegetables, fruits, diary products, eggs, fish, nuts and seeds, and discontinue the red meats and other foods mentioned above. Concentrated sugar-free tart cherry juice is fantastic to combat the inflammation caused by gout. I highly recommend Tart Cherry Concentrate by Traverse Bay Farms along with a comprehensive functional medicine program that investigates the epigenetics and the cardiovascular status of the individual.

Other factors like alcohol, certain pharmaceutical medicines, other established illnesses, or stress, can also trigger gout attacks. If your blood chemistry profile shows high uric acid levels, you must take action to avoid gout, cardiovascular disease, or kidney disease. High uric acid levels in a blood chemistry profile is an indicator of cardiovascular trouble. Usually over ¾ of patients with heart disease and high triglycerides will present with elevated levels of uric acid. This means these individuals present with high inflammatory markers and their general health is at risk. 

If you have been diagnosed with arthritis, fibromyalgia, or any migrating joint pain or stiffness/inflammation, and your body has not responded favourably to the treatment you’re receiving, you must consider checking for uric acid levels to rule out or confirm hyperuricemia and gout. 

Again, please don’t forget that if this is the case, your cardiovascular system will need special attention. An increased uric acid level is associated with chronic inflammatory states including those in the vascular system in the form or atherosclerosis.

In functional medicine we know that there is a common pattern of increased uric acid level (>5.9 or 351umol/dl) with an increased triglyceride (>200 or 2.26mmol/L), in relation to total cholesterol (>220 or 5.69mmol/L), a decreased HDL (<45 or 1.16mmol/L) and an increased LDL (>120 or 3.1mmol/L), atherosclerosis is probable.

Homocysteine levels are also frequently increased with atherosclerosis. 

In conclusion, individuals with hyperuricemia will have high radical activity and oxidative stress. Dietary and lifestyle change must be applied immediately and retesting a few months into the treatment must be respected to monitor improvement.

There are of course fantastic solutions for all of the above health problems with functional medicine that are 100% natural and nutrition & lifestyle based.

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