Why do some people suffer from severe pain due to high uric acid levels while others have no symptoms?

Expert of this article: Zhu Hongjian, Chief Physician, Beijing Jiangong Hospital

In most people's impressions, high uric acid is always related to gout, especially joint pain, which makes gout patients and people with relatively high uric acid levels miserable. They dare not eat various foods that will cause high uric acid levels, for fear that pain will suddenly come one day.

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But some people, who clearly have no symptoms of discomfort, are found to have elevated uric acid levels during examinations. What is going on? Doesn’t all high uric acid levels cause symptoms? In addition to the well-known joint pain, what other symptoms may occur?

What is uric acid?

Uric acid is a metabolic product that exists in the human body. Under normal circumstances, the human body produces 600 mg of uric acid every day and excretes 600 mg, maintaining a balance.

Normal blood uric acid levels: 149-416μmol/L for adult males; 89-357μmol/L for females. 250-476μmol/L for males over 60 years old; 190-434μmol/L for females. Generally, hyperuricemia is defined as blood uric acid levels exceeding 420μmol/L.

The normal reference value for women is about 60-70 μmol/L lower than that for men. Usually, the uric acid value will gradually approach the value of adult men after menopause.

What are the dangers of high uric acid?

When we talk about high uric acid in life, everyone will think of gout. In fact, gout is the most common complication of high uric acid. Kidney damage, diabetes, cardiovascular and cerebrovascular diseases also have a certain relationship with high blood uric acid levels.

The existence of uric acid in the human body is like putting salt in a glass of water. If there is too much salt in the water, it will be difficult to dissolve and will precipitate into crystals. The same is true for uric acid. When there is too much uric acid in our body and it cannot be dissolved, urate crystals will precipitate and settle in various parts of our body, such as joints, soft tissues, blood vessel walls, etc. Long-term high uric acid state is likely to bring about problems in many aspects such as the endocrine metabolic system and urinary system.

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What are the symptoms of elevated uric acid?

Not all patients with high uric acid levels have symptoms such as gout. It is normal for uric acid to be elevated but the body has no symptoms. These patients simply have elevated uric acid levels and will not experience any discomfort or obvious symptoms clinically. However, it is also necessary to lower uric acid levels by controlling diet and regularly monitor uric acid levels. If uric acid control is not ideal, you need to actively seek medical attention and, if necessary, follow the doctor's advice to use uric acid-lowering drugs for treatment.

In some patients, when uric acid levels rise to a certain level, the following symptoms will occur:

gout

Fingers and toes are prone to redness, swelling, heat and pain (symptoms of a gout attack), and the pain usually feels like a knife cut.

Joint pain

When there is too much uric acid in the body, urate crystals will deposit in the joints and may cause joint pain.

Abnormal urination

The urine excreted by normal people is light yellow, and the urination process is smooth and painless. If the uric acid level in the body is too high, the color of the urine we excrete will become darker and appear turbid. This phenomenon is because uric acid damages the human kidneys and other organs, leading to problems with human metabolism.

Body edema

Excessive uric acid will irritate the kidneys, obstructing the excretion of water from the kidneys and causing edema in the body (due to the influence of gravity, edema is generally more obvious in the lower limbs).

Dry mouth

If the uric acid level in the human body cannot be well controlled and continues to rise, it will easily cause dehydration in the body. Because the uric acid level in the body is high, water is needed to dilute the uric acid, and symptoms of dry mouth will appear.

Should I draw blood or test urine to check uric acid?

Uric acid is usually checked by testing blood uric acid, which requires collecting venous blood. If you already have hyperuricemia or gout, it is recommended to check both blood uric acid and urine uric acid.

Blood uric acid can clearly show the condition of elevated uric acid. Things to note during the examination:

1. You need to fast for 8 hours before collecting venous blood. It is recommended to collect blood in the morning.

2. It is recommended to avoid eating high-purine foods and drinks before blood collection.

3. Avoid strenuous exercise before blood collection.

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Uric acid in urine can tell whether uric acid excretion is reduced or uric acid production is increased. Things to note when checking:

1. Avoid eating high-purine foods, smoking and drinking, and stop taking medications that affect uric acid excretion before the examination.

2. Avoid strenuous exercise before collecting urine.

3. This test is not recommended if you have a urinary tract infection.

How to maintain normal uric acid?

diet

Improper diet is a common cause of increased uric acid. It is recommended that you eat regularly, refuse to overeat, properly combine meat and vegetables, eat less animal offal (such as liver and kidney), and eat less greasy and salty food.

Drinking water

It is recommended that everyone drink 2000-3000 ml of water every day. It is recommended to drink boiled water and avoid alcohol and high-sugar drinks.

rest

Get regular rest and avoid staying up late for long periods of time to prevent the nervous system from becoming overly excited and causing more uric acid to be produced.

weight

Keep normal body weight (BMI) between 18.5 and 23.9. Obesity can also lead to increased uric acid.

sports

In daily life, we should move reasonably, avoid strenuous exercise, and do moderate-intensity aerobic exercise. This can not only control our own weight, but also enhance the body's metabolic capacity and promote the excretion of uric acid.

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