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Wednesday 13 September 2017

Gout and Uric Acid




Gout is a kind of arthritis due to the accumulation of uric acid crystals formation inside and around the joints, causing sudden and severe burning pain, stiffness, swelling in joints, usually resulting in a big toe. 

Uric Acid (C5H4N4O3) heterocyclic organic compound. Condition of high or excess uric acid is known as Hyperuricemia, which is the root cause of development of gout, kidney stones, renal dysfunction, hypertension, hyperlipidemia, diabetes and obesity. Multiple studies have also associated hyperuricemia with the precursors of stroke, cardiovascular and coronary artery disease.




Hyperuricemia occurs due to the (1) increased uric acid production (2) the impaired renal uric acid excretion, or a combination of the above.

In modern medicine, you will be asked not to eat red meat, egg, fish {(high protein food) high protein foods are rich in Purine} in order to reduce the uric acid formation and also treated with medications like anti-inflammatory, steroids.




Are meat, eggs and fish the real cause of uric acid formation? Or the Excess carbohydrates and Fructose (fruit sugar) are the cause ?

Before that, Why body produces Uric acid? 

Uric acid is the end product (waste) of an exogenous pool of purines metabolism. (Also, its byproduct of protein digestion) Later, Uric acid dissolves in the blood and is excreted by the kidneys. That’s why you are advised not to consume protein rich food such as meat, egg, fish.  We will see how far it’s valid? 

Purines are the primary genetic material of our cells (Building blocks for DNA) Hence, its vital for our survival and found in all foods and drinks that we consume. Only the amount may differ from one to another. Foods like red meat, egg, and fish have concentrated levels of purines. Hence, production of uric acid is unavoidable.




Purines (a type of chemical compound) are digested/broken down thru purine metabolism, and uric acid becomes the end product or as a waste. Though it’s a waste, it’s a good antioxidant, which prevents the oxidation on the arteries. Kidneys are responsible to maintain the uric acid level in our blood stream and excrete the excess uric acid thru urine to prevent the uric acid crystals around the joints. 

So, How to control the excess uric acid production and what prevents the excretion of the (excess) uric acid?




Apart from purine metabolism and Protein digestion, Uric acid also produced by breaking down of Adenosine Tri-Phosphate (ATP).our body cells rely on ATP to survive (ATP is a fuel for our body cells)




When, we eat the high carbohydrates, especially Fructose rich (refined sugar) food, our body (Liver) converts the excess sugar into fat (and stores) thru a chemical process, by breaking down ATP, end up with uric acid! Fructose (available in fruit juices, Ice cream, processed food, bakery, sweet and confectionary) is rapidly depletes ATP and increases the amounts of uric acid.




ATP also breaks down, during Insulin secretes from pancreas. After all, insulin is a growth hormone. We know, pancreases release the insulin in order to bring down the blood sugar. The only reason for blood sugar rise is high carb food. Hence, High carbohydrates and Fructose can produce more uric acid than purine and protein. The most effective way to control uric acid is restricting the carbohydrates, not by restricting purine or protein rich food.




Apart from ATP breakdown, high carb food keeps the blood sugar above the normal range. (refer normal vs abnormal) this significantly reduces the kidney filtration efficiency to excrete the uric acid from blood.

Last, but not the least, alcohol plays major role in uric acid production and also prevent the excretion process. In order to breakdown/digest alcohol, liver undergoes to a special and complex process called alcohol metabolism, where more number of ATP broken down (uric acid production) and alcohol interfere with kidney function (filtrations) which results very high uric acid level.

Until the 20th century, Gout was referred as "rich man's disease" because bread, sugar, alcohol were quite luxuries those days. Later, sugar, alsohol and refined carbohydrates were freely available to the common population and it becomes “common disease” in 21st century.

The best way to control the uric acid is to thru HFLC. By limiting the carbohydrate consumption and totally avoiding the fructose and  alcohol is the only and more biological way to control / reduce the uric acid production also improves the the kidneys filtration ability.  Definitely not by restricting red meat, egg, fish (high protein and purine rich food) 

Remember, unlike carbohydrates, protein and purines are the vital for survival. As protein and purine the building blocks of the body and DNA respectively. Hence, it’s wise to restrict the carb's to get rid of hyperuricemia, to lead healthy life.

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