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Lower uric acid: how it works!

by Josephine Andrews
Published: Last Updated on 444 views

If there is hyperuricemia, the uric acid level must be lowered . Otherwise, painful, inflammatory deposits of uric acid crystals in joints, tendon sheaths and subcutis occur. The kidneys can also be affected. Read here about the role of diet in lowering uric acid, which medications are used for therapy and whether alternative remedies can lower uric acid.

Lower uric acid: diet

If you want to lower the uric acid value, the first step is usually weight normalization and a change in diet.

The following foods are low in purines . You can eat these without hesitation if you have high uric acid :

  • pasta
  • Vegetables (excluding high-purine varieties like kale, green beans, broccoli, spinach, and asparagus)
  • fruit
  • potatoes
  • Dairy products

Many foods contain so-called purines, the breakdown of which produces uric acid. It is therefore important to avoid purine-rich foods . These are above all:

  • Meat (especially offal)
  • Fish (e.g. salmon, tuna, sardines)
  • shellfish and crustaceans
  • Legumes (lentils, peas, soybeans and others)

Unless otherwise prescribed, the patient should also ensure that they drink enough (at least two liters per day). In the case of mild hyperuricemia, uric acid can often be reduced naturally by changing your diet, without any medication.

Lower uric acid: tea and coffee allowed?

Tea, coffee and cocoa also contain purines, which are broken down into uric acid in the body. In the usual consumption amounts, however, this has no influence on the uric acid concentration in the blood . Patients don’t have to do without their morning coffee or cup of tea. On the other hand, it is important to avoid alcoholic beverages, especially beer.

Lower uric acid with medication

An acute attack of gout is treated with commercially available non-steroidal anti-inflammatory drugs. These include, for example , ibuprofen , diclofenac , naproxen and indomethacin . Salicylates such as ASA, on the other hand, should be avoided: They inhibit the excretion of uric acid via the kidneys, so that even more uric acid remains in the body.

If there are occasional, mild gout attacks, no long-term drug therapy is necessary. The following situations, on the other hand, require the start of long-term therapy with drugs that reduce uric acid:

  • more than two gout attacks per year
  • Blood serum uric acid concentration > 9 mg/dl
  • already known overproduction of uric acid (e.g. during chemotherapy )
  • Uric acid stones in the urinary tract
  • Deposition of the crystals in the kidneys (urate nephropathy)

Drug of first choice is allopurinol : It is an inhibitor of xanthine oxidase. This is the enzyme that breaks down the purine breakdown products xanthine and hypoxynthine into uric acid.

Sometimes gout attacks increase after the start of allopurinol therapy because the existing uric acid crystals are mobilized. In this case, the doctor may prescribe naproxen or colchicine.

If you want to lower your uric acid levels permanently, you usually have to take the medication for a lifetime. The uric acid level is checked regularly.

Lowering uric acid: reserve drugs

If the standard drug allopurinol is not sufficient in combination with a low-purine diet, there are so-called uricosurics as reserve drugs. These promote the excretion of uric acid in the urine. They can be given either in addition to allopurinol or instead of it. Representative of the uricosurics are the active ingredients probenecid and benzbromarone.

A more recent alternative is the genetically engineered rasburicase: This enzyme converts the uric acid in the blood into a more water-soluble product, allantoin. This can be excreted more easily and does not form crystals. However, Rasburicase is only given in emergencies in the event of very high uric acid levels, such as those that occur as part of tumor lysis syndrome (rapid decay of cancer cells).

Lowering Uric Acid: Natural Remedies and Alternative Approaches

Some patients want to lower uric acid levels without having to take medication. Some patients find homeopathic remedies (e.g. Belladonna ) helpful.

The concept of homeopathy and its specific effectiveness have not yet been scientifically proven.

In herbal medicine, for example, birch or black poplar are used. Their effect has not been scientifically proven either. In addition, natural remedies may alleviate the symptoms, but not cure the cause. If you want to effectively reduce uric acid , a change in diet and, if necessary, the prescribed medication are essential. 

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