uric-acid & gout

Source: TW

Uric acid is a compound of Carbon- Nitrogen- Hydrogen- Oxygen, that is a product of Metabolism (more later). It is largely excreted through Urine & some of it is broken down by Gut Bacteria.

Biological role

It is commonly believed that is a waste with no use. that is absolutely NOT true. Uric Acid is biologically active. Uric acid is an important antioxidant & also a marker of tissue injury that acts as one of the regulators of our immune system. It has the highest concentration of any water soluble antioxidants found in our blood(50x powerful thn VitC). When our body is under assault & confronted by an imbalance of free radicals & damaged cells, our body’s antioxidant defences & our immune system swing into action in order to put things right.

Excess

High levels of uric acid are a warning sign that things are going wrong. When Uric acid levels get too high, it becomes unstable & can crystallize, especially in the joints. This results in local inflammation that causes a painful arthritis known as GOUT. Most commonly seen in the big Toe on your Foot. But it can have an effect on all joints.

There are 2 reasons for excess Uric acid

  1. Excess Uric acid Production (10% cases)
  2. Under excretion (90% cases)

Or both.

Excretion

Uric acid is normally excreted by the kidneys into the urine & eliminated from the body. But Insulin Resistance messes this up! This Causes Uric acid concentration to build up in blood.

Generation

There are 3 sources of Uric Acid

  1. Purines
  2. Fructose
  3. Alcohol

Purines are organic molecules found in DNA and RNA. When cells are broken down & purines are processed, Uric acid is formed as a result. Around 70% of the Purine are endogenous & rest are from diet. Purines are mainly found in meat, some fish, organs etc. Note that exogenous purines are not much, compared to Endogenous.

More cell breakdown releases more purines & hence more uric acid is produced - Which is why Age effects Uric acid levels.

So the reduced efficiency of excretion due to IR & other reasons.

Purines, especially from Diet is really a small player in this Uric acid game. Cutting Meat is not the answer!

Fructose

Fructose or Fruit sugar is one of the simple sugar molecules (like glucose). It’s sweeter than Glucose. Your white sugar contains 50% Glucose & Fructose. HFCS or High fructose corn syrup is a processed form of Fructose created from corn. It’s Cheap & an industry Favorite. HFCS is 55% Fructose & 45% Glucose. Our ancestors used to consume very less fructose bcz Fruits, Honey etc were seasonal & very less in quantity (& less sweeter than modern day selectively bread fruits). Fructose & Glucose metabolism are totally different!

Glucose stimulates Insulin response from the pancreas, but fructose doesn’t. This doesn’t make it SAFE. Like Alcohol, Fructose is directly metabolized by the Liver. Within liver cells, the enzyme fructokinase begins its work, including the consumption of ATP (energy). The end product of this process is Uric Acid.

What is more problematic is that Uric acid further activates Fructokinase & cascade of other things. In evolutionary terms this mechanism is very useful in times of Food scarcity & perhaps human race wudnt have survived if it wasn’t for this. However in modern day, Food scarcity is no longer a thing, but our body is that of our ancestors. that mismatch causes all the problem. Fructose has no direct effect on Insulin, but Uric acid, the product of Fructose metabolism causes Oxidative stress on Pancreatic Islets that produce Insulin.+++(5)+++

Alcohol

Alcohol metabolism is similar to that of Fructose n causes similar problems. The issue with high Uric Acid isnt only GOUT. High BP, Fatty Liver, CKD, Obesity, Erectile dysfunction, T2D, Alzheimer’s etc are all interconnected with elevated Uric acid (maybe not the cause).

Solution

Just take Allopurinol & suppress Uric Acid? Hell No!

  1. Limit Carbs, especially those with Fructose. It helps in 2 ways. One it will cause less production of Uric Acid. Two it bring down Insulin resistance & hence improve its excretion through urine.
  2. Cut Alcohol
  3. Fasting
  4. Limit Organ meat if your uric acid levels are too high.
  5. Workout

Supplements that will Help

  1. Quercetin
  2. Luteolin
  3. DHA
  4. Vitamin C
  5. Chlorella

Get your Uric Acid levels tested! Keep it Under 5.5 mg/dL (don’t take it upto 7 or higher). It’s an inexpensive test.