High uric acid is a metabolic disease caused by disorders of purine metabolism in the body, leading to an increase in uric acid in the blood. Increased uric acid can easily induce gout, joint disease, kidney disease, etc.

There are 170 million people in our country with hyperuricemia. This is data from the 2018 China Gout Status Report White Paper. The data shows that there are more than 80 million gout patients, and the disease is caused by hyperuricemia. The incidence rate is about 13.3, of which the incidence rate of gout is 1.1, and the prevalence and number of patients are increasing every year. What "abnormal signals" will the body of people with high uric acid receive?

1. Joint pain, redness and swelling

A large amount of uric acid crystals deposited in the joint cavity can induce gouty arthritis. Symptoms include knife-like pain, joint redness and swelling, and local skin temperature increase. In severe cases, it may even affect walking.

The first metatarsophalangeal joint (the joint connecting the big toe to the sole of the foot) is most common when the first attack occurs.

2. Edema

High uric acid also has a certain impact on human metabolism, so people with high uric acid are often prone to edema due to metabolic problems. It gives people the feeling of getting fat. If you obviously have not gained weight, but overall you look like you have gained weight, then you should pay attention. This means that there is something wrong with your health.

3. Sudden oliguria or anuria

The deposition of uric acid crystals in the kidneys can lead to acute and chronic uric acid nephropathy and urinary tract stones. A large amount of uric acid crystals are deposited in the renal tubules and other parts of the body, causing acute urinary tract obstruction and sudden symptoms such as oliguria, anuria, and acute renal failure. Therefore, once this happens, we should also be alert to high uric acid. People with high uric acid in the body should avoid 4 kinds of food, otherwise gout will come to you

1. Pork liver. Pork liver is a high-purine food. If eaten, the uric acid content will quickly exceed the standard, which can easily lead to gout.

2. Fat. The purine content of fatty meat is very high, and it also contains a large amount of saturated fatty acids, which will cause the uric acid level in the body to rise rapidly and increase the risk of gout.

3. Seafood. Seafood is also a high-purine food. After eating it, it is likely to cause the uric acid level to rise rapidly, which poses a great safety hazard to the body's health. Therefore, if you don't want gout to occur, you should eat as little as possible.

4. Wine. All kinds of drinks contain a large amount of alcohol, and alcohol will cause uric acid to accumulate in the body, which is not conducive to the excretion and metabolism of uric acid, and will aggravate the condition of gout. Who is the “champion” in lowering uric acid?

1. Turnip multigrain powder

Turnip multigrain powder is made from Xinjiang turnip, Hericium, yam, Maitake flower, chickpea, mulberry, wolfberry and other ingredients The powder can help metabolize excess uric acid in the body and improve gout.

Turnip is a vegetable rich in organic active alkali produced in Xinjiang. It is rich in organic active alkali, which can increase the solubility of urate and effectively promote uric acid excretion. In addition, it also contains nineteen kinds of amino acids, proteins and other substances, which can provide comprehensive nutritional regulation to the kidneys and repair damaged kidney cells.

Eating turnip alone has a mediocre taste and is not as effective as eating turnip grain powder, so turnip grain powder has become the choice of most patients with high uric acid. Besides turnip cereal powder, what other methods are there to reduce uric acid?

1. Replenish water

Replenishing water for people with high uric acid can help excrete excess uric acid from the body. It is recommended that patients with high uric acid have a daily urine output of about 2000-3000 ml, so the daily water intake should also be between 2000-3000 ml. People with high uric acid must remember to drink more than 2000 ml of water.

2. Keep moving

Exercise can speed up the dissolution and metabolism of uric acid, and also help strengthen the body.

And when you are dehydrated due to sweating, you must replenish water in time, because insufficient body water will lead to reduced urine output, which may induce acute gout.

3. Regularly check blood uric acid levels

Regularly checking blood uric acid levels can help early judgment of kidney damage. People with high uric acid should be checked every 1 to 3 months. If the blood uric acid level is stable several times in a row, the check interval can be appropriately extended.

In the past, people asked more about how to lower blood pressure, blood sugar, and blood lipids. In recent years, more and more people are considering how to "lower uric acid." This is similar to After our living standards improve, it is related to the increasing number of patients with hyperuricemia and gout due to high uric acid.

According to statistics, there are currently almost 200 million people suffering from hyperuricemia in our country. Basically, if 10 people go for a physical examination, they will find that one person has high uric acid, and this number is still Rising year by year.

However, at first, people did not pay much attention to high uric acid, because it basically does not cause any uncomfortable symptoms and has basically no impact on everyone’s life, and not everyone will eventually develop into uric acid. Gout, clinical symptoms such as acute arthritis, gouty kidney and tophi occur.

However, with the research and clinical discovery of hyperuricemia, this hyperuricemia often occurs together with our obesity, hypertension, atherosclerosis and coronary heart disease, and will increase. or even aggravate the occurrence of those diseases. Therefore, whether it is to prevent gout or reduce the occurrence or impact of chronic diseases, high uric acid should be discovered as early as possible and proactive measures should be taken to reduce uric acid. More and more people know and realize the dangers of high uric acid and want to With "lowering uric acid".

However, all kinds of gods and so-called "miracle medicines" have appeared, claiming that they are all "masters and miracle medicines" in reducing uric acid, which has led many people to embark on the "wrong path" of reducing uric acid. Not only was time and money lost, but it was ineffective and complications occurred. So, today I will talk with you about how to "lower uric acid"? What is the best way to lower uric acid? To know what is happening, we must know why. We must first know what kind of uric acid is in our body? How did it come about?

Normally, we all have uric acid, because it is a substance metabolite of our people, and this substance is the purine that everyone often mentions now. When it comes to high uric acid, everyone knows to eat low purine. food.

However, this often leads to a misunderstanding: the belief is that uric acid comes from the food we eat. If we don’t eat high-purine foods, we will definitely have high uric acid!

In fact, about 80% of the uric acid in our body comes from endogenous purine metabolism, which means it is metabolized by our body itself and comes from nucleic acids and other purine compounds decomposed by our cells; And only 10%-20% is decomposed by the action of enzymes from the purine in the food we eat!

How to understand the above sentence? In fact, it is very simple. You only need to remember two points:

First, high uric acid may be a problem of your own body metabolism, or it may be caused by improper diet or poor living habits, or There are two reasons. Therefore, when you see a person with high uric acid, it is not right to say that he must have been eating blindly recently and not eating well;

The second point is that our normal body metabolizes and excretes uric acid every day. And under normal circumstances, 600mg is newly generated every day, and 600mg is excreted, maintaining such a dynamic balance. The production mainly comes from our liver. As mentioned just now, 80% comes from the metabolism of our cells, and only about 20% is metabolized by purine-rich foods (such as animal offal, seafood, fungi, etc.). At the same time, 2/3 of the uric acid excreted is metabolized by the kidneys, while less than 1/3 of the remaining uric acid is excreted through other excretion pathways such as the intestines.

So how come this wonderful dynamic balance of uric acid is broken? Why is uric acid so good?

Many times we people only know that high uric acid means that our bodies metabolize more uric acid and eat too much. But in fact, many people with high uric acid belong to the type of reduced uric acid excretion or a mixed type. is relatively common!

Why? In fact, I just introduced the source of uric acid to you in the first part. We metabolize, synthesize and excrete uric acid every day, which means that uric acid in the body goes in and out!

Then this is simple. If there is too much incoming or metabolized, the uric acid may be high. If it cannot be excreted or the excretion is reduced, will high uric acid also occur?

Therefore, in our clinical practice, hyperuricemia is actually divided into three categories:

The first type is the increased uric acid production type, which is mainly due to the metabolism of nucleic acid in cells in our body. Caused by a defect in the enzyme that processes uric acid. For example, the increased activity of xanthine oxidase (E6) in the picture will accelerate the conversion of hypoxanthine into xanthine and xanthine into uric acid. There are also problems with PRPP, PRPPAT and other enzymes in the picture, which may also cause us The production of uric acid in the body increases.

Of course, it is natural that if we eat a high-purine diet for a long time, it will also lead to an increase in purine in the body, which will lead to an increase in uric acid production.

The second type is the type with reduced uric acid excretion. A simple understanding is like there is a problem with the drainage pipe in our home, resulting in water outflow obstruction, and here it is caused by excretion disorders in the main uric acid excretion pathways such as the kidneys, such as reduced glomerular filtration, renal tubular filtration, etc. Excessive reabsorption, increased renal tubular secretion, decreased urate crystal deposition, etc. More than 80% of patients with hyperuricemia actually have this kind of uric acid excretion disorder, and the most important one is reduced renal tubular secretion! Therefore, as I have said before, many of us still regard dietary factors as the main factor causing high uric acid. In fact, this is wrong. Impaired uric acid excretion is sometimes the most fundamental cause.

The third type, which has both of the above, is mixed hyperuricemia.

Therefore, if we find that we have high uric acid in our daily physical examination, we must find out what is the cause. Is it a lack of excretion? Is it produced too much, or is it a combination of both? This is actually very important for lowering uric acid. Only by clarifying the cause can we find the champion choice for lowering uric acid. Finally, let’s talk about how to find the champion choice for lowering uric acid. What is the correct way to open it?

First of all, uric acid is high. It does not mean that it is high if we say it is high or that once a blood test is taken to measure uric acid, it must be high. We must first make a differential diagnosis because of the source of uric acid. I also tell everyone As I said, nearly 1/3 comes from exogenous sources, such as seafood, some meat, or drinking some wine. It is these exogenous purines that increase uric acid. Therefore, if some patients are found to have elevated uric acid all at once, our doctors will usually tell the patient not to worry first and ask about their recent diet, what they have eaten, whether they have drank alcohol, etc. If so, it will be recommended to check again after 2 weeks to see if uric acid is really high!

In this patient, the uric acid was not found to be very high. For example, under normal circumstances, we say that uric acid exceeds the normal value of 420?mol/L, which is hyperuricemia. At this time, you detect uric acid. If it does not exceed 500, we also recommend that you control your diet for a period of time and then review whether you need to take medicine to lower uric acid.

But if we find that uric acid is particularly high, over 500 or 600, our doctors often recommend taking drugs to lower uric acid. Note that this does not mean that febuxostat has good side effects. People say that benzbromarone can also be used for febuxostat. So just go to the pharmacy and buy benzbromarone. We need to find out what is the specific reason for our high uric acid? Is the excretion of uric acid reduced or the production of uric acid increased?

So how to judge whether you have a uric acid excretion problem or a uric acid production problem?

Here are a few simple methods:

The first one is to measure the 24-hour urine uric acid volume, which is to collect our urine volume for a day and then check how much uric acid is contained in it.

If the final measured uric acid excretion is 800mg/d (normal diet) or 600mmol (low purine diet), then this is an excretion problem; otherwise, it is a type of excessive uric acid production; of course, some people cannot be ruled out It is a mixed type.

The second is to look at the uric acid/creatinine ratio in random urine: if it is greater than 1.0, it is a generation problem; if it is less than 0.5, it is an excretion problem;

The third, like us In outpatient clinics, sometimes the patient's urine routine pH test can be used to make a simple judgment. Under normal circumstances, the normal reference value of our human body's urine pH is 5.0-7.0, but when the urine pH is 5.0, it is more common to indicate increased uric acid production; when the pH is normal or high, it is more common to indicate uric acid excretion problems.

After judging the specific type, we can more accurately choose uric acid-lowering drugs, such as:

At the same time, no matter which type of drug is chosen, people with hyperuricemia You must also do the following:

First, control the total energy in your diet, quit smoking and limit alcohol, and limit the large intake of high-purine foods (such as heart, liver, kidney, etc.);

Second, drink more than 2000ml of water every day to increase uric acid excretion;

Third, use drugs that inhibit uric acid excretion with caution, such as the thiazide diuretics we often use;

Fourth, you can choose sodium bicarbonate to alkalize the urine and reduce the deposition of uric acid in the urine, but it should not be taken in large amounts for a long time, otherwise metabolic alkalosis is likely to occur!

Therefore, the so-called "champion" for lowering uric acid is not a choice or a drug, but a normal uric acid-lowering drug based on the specific reasons for high uric acid, as well as other treatments and preventive measures. Comprehensive treatment strategy!

Putting aside all other factors, purely in terms of the speed of reducing uric acid, the "champion" is undoubtedly the uric acid-lowering drug. Traditional Chinese medicine treatment, drinking more water, dietary adjustments, exercise therapy, etc. can definitely not reduce uric acid as fast as uric acid-lowering drugs.

Among the many urate-lowering drugs, we have selected the two most commonly used and effective ones: febuxostat and benzbromarone. Research shows that: Simply speaking, febuxostat is superior to benzbromarone in terms of the speed of lowering uric acid. Summary:

The dangers of high uric acid are self-evident, and I want to tell you that if you develop gout with high uric acid, it will accompany you throughout your life and it will be impossible to return to normal. If gout only causes you pain, tophi, and joint deformity. Its greater harm is to cause kidney failure, which is the most terrible thing.

Furthermore, 80% of uric acid is produced by the body, and only 20% of uric acid is obtained from food. Therefore, there is no shortcut to lowering uric acid. If you want to simply eat some food and find a "champion" for lowering uric acid, you will reach a dead end.

The control of uric acid is a comprehensive conditioning process. Even the champion of reducing uric acid is not as fast as drugs. Although diet therapy has a certain effect, it requires long-term persistence. But the problem comes again. People have various problems. Disease, if you eat this kind of food for a long time, it will lead to nutritional imbalance and other diseases, so it is unrealistic to do so. So how should uric acid be reduced or maintained stable?

The first is, of course, diet control: don’t eat foods with high purine content or eat less of them. Eat less here means it’s okay to eat a little bit for a month. As long as you don’t overdo it and don’t eat too frequently, you can’t eat it too often. It’s okay to be addicted once. Don’t touch animal offal, broth, and seafood products unless you touch them. There are no special taboos for other fresh vegetables, fruits, and whole grains.

The second, of course, is exercise. Exercise can increase uric acid excretion. It should be pointed out that aerobic exercise is required and not strenuous exercise. Strenuous exercise will affect uric acid excretion.

The third is the prohibition on alcohol and beverages. Of course, it is not absolute. It is okay to drink once or twice a month and control the amount. Because they can easily lead to elevated uric acid.

The fourth is good sleep, which can promote uric acid excretion.

The fifth is to maintain psychological balance. Bad emotions will cause uric acid to rise and affect metabolism. Although we will encounter a lot of unhappiness and anger in life, we should not indulge in it. We should actively find ways to deal with it. If we can't find it, put it aside for the time being. You must learn to vent bad emotions, such as singing, exercising, etc., and quickly get rid of bad emotions.

Only in this way can uric acid be well controlled, and teaching others to find "champions" for lowering uric acid will harm patients with high uric acid! Remember, you are the “champion” in lowering uric acid!

We all know that the "four-piece set" that raises uric acid is seafood, beer, broth, and offal. These types of things make our gout patients get sick as soon as they eat them, and they say it every time they eat. I don’t know how to eat it, but when summer comes, how can I completely resist the temptation of beer crayfish? Therefore, we need our acid-lowering "champions". Dr. Lin here still advocates using drugs to control uric acid first. Don't imagine that diet therapy alone can control 500 or tophi. Who is the “champion” in lowering uric acid?

That must be the drug "Febuxostat". It is now the most recommended drug in our uric acid-lowering guide. It has the most significant effect and has the lowest side effects among all acid-lowering drugs. At this stage, There should be no one. Both domestic and imported products are acceptable, but you have to go through formal channels.

The runner-up for lowering uric acid is benzbromarone, which can even induce gouty arthritis if used improperly.

It is suitable for mild and moderate hyperuricemia and should be used starting from a small dose to avoid urate crystal deposition in the urinary tract or obstruction of renal tubules leading to renal colic, kidney stones and kidney function. Exhaustion.

If the blood uric acid level is very high, or there is a history of gouty arthritis attacks, although there is currently no attack, in order to prevent the blood uric acid from falling too fast and the blood uric acid level fluctuating too much, which may trigger an acute attack of gouty arthritis, It should not be applied too early.

The third runner-up of acid-lowering drugs is allopurinol, but it has high side effects, including liver function damage leading to elevated transaminases. Nausea, vomiting, indigestion, etc., gastrointestinal reactions, allopurinol is prone to symptoms such as rash, drug fever, skin itching, etc.

Note on medication: The formation of gout is more complex, so you must first consult a doctor before taking medication. For example, if you like to eat the "four-piece set for gout", it is a typical case of excessive purine intake, which leads to more uric acid production. This type is also The majority of people with high uric acid have a very obvious effect of Febu. However, a small number of people have impaired renal function or have difficulty excreting uric acid. This problem cannot be solved by current mainstream acid-lowering drugs (such as febubu or allopurinol) and requires other treatments. This point It’s important to remember that there is no foolproof, universal champion treatment for gout.

My name is DU Yuefeng from the Department of Urology. Let me answer your questions.

Because you are asking about the champion, I want to tell you that the fastest-acting drug is definitely medicine. Although diet, exercise, living habits, etc. are very important for controlling uric acid, they mainly play a role in controlling uric acid. Auxiliary role.

To quickly and clearly reduce uric acid levels, you still need to rely on medicine. Not only the reduction of uric acid, but also the rapid and obvious changes in other body indicators must be achieved through drugs.

After all, most drugs are designed to directly block certain biological and chemical reactions in the body to achieve therapeutic purposes. Most of them are highly concentrated and highly purified ingredients, which have faster and better effects.

Among uric acid-lowering drugs, febuxostat performs better. Febuxostat is essentially a selective inhibitor of xanthine oxidase (XO). As you can tell from the name, it It can inhibit the function of xanthine oxidase, and the main function of this enzyme is to help purine be converted into uric acid in the human body.

Febuxostat "fixes" xanthine oxidase, which can quickly cut off the formation of uric acid. Without a source, uric acid in the blood will naturally decrease, achieving the effect of quickly lowering uric acid.

I have a side dish that lowers uric acid very quickly. We eat this dish often, but we don’t usually eat enough.

The summer before last, a few of our good friends enjoyed a seafood meal at the beach. After having a feast with ice beer, the next day I was shocked to hear that one of my friends had joint pain all over his body, which was so severe that he could not walk. His family helped him and rushed to the hospital for medical treatment. Upon examination, his body was normal except for uric acid, which was 1300umol/L (the normal value of uric acid is 150- 420umol/L), the doctor diagnosed hyperuricemia and gave him uric acid-lowering drugs. He recovered in ten and a half months. Later, he followed the doctor’s instructions and paid attention to replenishing water, maintaining exercise, and avoiding animal offal, seafood, and alcohol. My friend still has no high uric acid levels.

Later, the remaining few of us went to the hospital for examination. Basically, the uric acid was high. The doctor told us that we didn’t need to take medicine, as long as we just pay attention to diet adjustment, exercise more, and drink more water. Check again after a period of time, and the uric acid will be normal.

Therefore, if uric acid surges and clinical symptoms appear, taking uric acid-lowering drugs will have the best effect. The rest of the time is just normal attention.

In short, high uric acid is easy to treat, and you can rest easy if you pay attention to it in daily life. However, it should be noted that high uric acid can easily induce gout, kidney stones, kidney disease, etc. It is necessary to have a physical examination once a year.

Replenish water

I don’t believe that drinking water can reduce uric acid. Even eating a vegetarian diet can’t reduce it. The effect of drinking water is minimal. I can only say that it does not make things worse. The only way is to take medicine and lose weight, except for people who are thin, because they are born with it.