Uric Acid and Joint Problems

Uric acid is a waste product created when the body breaks down chemicals called purines (the end product of purine nucleotide degradation). Occasionally, uric acid builds up in joints and tissues, causing a range of health issues. One such issue is gout, a form of arthritis.

To have some uric acid in the blood is normal but, when its level increases or decreases above or below a healthy range, this can result in health problems. Excessive uric acid can lead to gout. Low uric acid levels are rare, but it is possible if a person excretes too much uric acid as waste. In males, the normal level of uric acid is 2.5–7.0 mg/dl whereas in females the normal level of uric acid is 1.5–6.0 mg/dl. Too much uric acid in the blood can lead to crystals forming in the joints and tissues, which may cause inflammation and gout symptoms.

If too much uric acid accumulates in the body, it causes hyperuricemia. This condition can cause crystals of uric acid (or urate) to form. These crystals can settle in the joints and cause gout, a form of arthritis that can be very painful. They can also settle in the kidneys forming kidney stones.[2]

An attack of gout can occur suddenly, often waking you up in the middle of the night with the sensation that your big toe is on fire or a burning sensation. The affected joint can become hot, swollen and so tender that even the weight of the bedsheet on it may seem intolerable. Gout symptoms may come and go, but there are ways to manage symptoms and prevent flares. This occurs when urate crystals accumulate in your joint, causing the inflammation and intense pain of a gout attack.

• Intense pain in the affected joint
• Redness and inflammation in the affected joint
• A feeling of discomfort that tends to last for a while
• Limited range of motion of the affected joint

• Eating Habits: A diet high in red meat and shellfish and drinks sweetened with fruit sugar (fructose) increase uric acid levels, which increases gout risk.
• Alcohol consumption: Especially beer, increases the risk of gout.
• Weight: Being overweight/Obese can produce more uric acid and your kidneys may have a more difficult time eliminating uric acid.
• Medical conditions: Chronic diseases and conditions, such as obesity, diabetes, high blood pressure, and metabolic syndrome, can increase your risk of gout.
• Medications: Low-dose aspirin, thiazide diuretics, anti-rejection drugs prescribed for people who have undergone an organ transplant, angiotensin-converting enzyme (ACE) inhibitors and some beta-blockers — also can increase uric acid levels. 
• Family history: If other members of your family have had gout, you're more likely to develop the disease.
• Age and sex: Gout occurs more often in men, primarily because women tend to have lower uric acid levels. However, women's uric acid levels approach those of men after menopause.
• Recent surgery or trauma: Experiencing recent surgery or trauma can sometimes trigger a gout attack. Getting a vaccination can trigger a flare-up of gout in some people.
  

To determine the level of uric acid, a blood sample is taken and tested. Finding an elevated blood uric acid level is NOT the same as diagnosing gouty arthritis and to diagnose definite gout, the uric acid crystals must be seen in the fluid taken from a swollen joint or seen by special imaging of the bones and joints (Ultrasound, X-ray or CAT scan). The joint fluid method involves drawing fluid from the affected joint using a needle. If the fluid is examined under a microscope, urate crystals may be visible.

There are two types of medication for gout. The first type helps reduce the inflammation and pain associated with gout attacks. The second type prevents gout complications by lowering the amount of uric acid in your blood. The doctor may prescribe medicines either to reduce or prevent complications, depending on the frequency of the inflammation or the conditions.

The better way is to choose healthier beverages and limit alcoholic beverages and drinks sweetened with fructose. Avoid the intake of foods that are high in purines such as red meat and organ meats, such as liver, which are especially high in purines. Purine-rich seafood includes anchovies, sardines, mussels, scallops, trout and tuna. Some low-fat dairy products may be a better choice of protein for people prone to gout. Gout can be prevented by exercising regularly and maintaining a healthy weight. Walking, bicycling and swimming are low-impact exercises that are also easy on your joints.

A long-term disease management program can control and stop flare-ups of joint pain and high uric acid levels. Medications can be prescribed by your doctor to dissolve the deposits of uric acid crystals. Also having some good lifestyle modifications can improve the condition.