Uric acid is produced when the body breaks down purines, which are found in certain foods and drinks, as well as produced naturally by the body. Normally, the body filters out uric acid through the kidneys and urine. However, consuming too many purines or having inefficient elimination can cause a buildup of uric acid in the blood, leading to gout and making blood and urine too acidic. The acceptable uric acid level is below 6.8 mg/dL. Reducing uric acid levels can prevent gout and its flares. Maintaining optimal uric acid levels is important for overall health.
Why do uric acid levels increase?
Abnormal levels of uric acid, leading to hyperuricemia, can be caused by two primary etiologies: overproduction of uric acid and and decreased excretion. The following factors can lead to an increase in uric acid levels:
1. Dietary Factors:
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High Purine Diet:
This includes foods like red meats, seafood, beans and peas as well as a high-fructose diet from processed foods and drinks.
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Alcohol Consumption:
Excessive intake of alcohol prioritises its metabolism over uric acid due to the presence of ethanol, inhibiting the excretion of uric acid by the kidneys.
2. Medical Conditions:
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Metabolic Syndrome (Diabetes, High Blood Pressure and Obesity
- Kidney Inefficiency: Reduced kidney function impairs uric acid filtration.
- Hypothyroidism: Decreased plasma flow to kidneys affects glomerular filtration, increasing uric acid levels.
- Chemotherapy for cancer: Rapid death of cancer cells can lead to increased uric acid levels, as kidneys are unable to filter the excess load of uric acid, decreasing the excretion.
3. Medications:
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Diuretics:
Increased urination due to diuretics leads to a reduction in body fluid levels. Due to less fluid, uric acid concentration increases and there are chances of urate crystal formation which may lead to gout.
Symptoms of uric acid
Symptoms may vary both in conditions of hyperuricemia and hypouricemia.
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High Uric Acid Levels (Hyperuricemia)
High uric acid levels can cause various symptoms. In the case of gout, a common condition caused by elevated uric acid, symptoms include painful or swollen joints, joints that feel warm to touch, and discoloured skin around the joints. Other symptoms associated with gout are joint stiffness, difficulty moving the affected joints, and redness and swelling around the joints. Chronic hyperuricemia can also lead to the formation of tophi, which are hard lumps under the skin that can cause joint pain, damage, and possible nerve compression.
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Low Uric Acid Levels (Hypouricemia)
Low uric acid levels are less common and often do not cause direct symptoms. They can lead to oxidative stress and endothelial dysfunction. However, frequent urination is a possible symptom, which can lead to dehydration if fluid intake is not adequate. Low uric acid levels are sometimes associated with specific conditions. For instance, Fanconi syndrome, a disorder of the proximal tubules, can lead to symptoms such as weakness, fatigue, joint pain, and excessive urination.
Signs and symptoms for both low and high uric acid in the body:
- Swollen and stiff joints leading to mobility issues
- Skin discolouration and joints that feel warm to touch
- Urinary tract infection
- Lower back pain due to kidney stones
- Dehydration due to low uric acid levels
Natural Ways to reduce uric acid in the body
1. Limit Purine-Rich Foods
Purine-rich foods, such as certain meats, seafood, and vegetables, contribute to uric acid production. Limit or avoid purine-rich foods like red meat, organ meats, fish, shellfish, poultry, sugary foods and beverages, and certain kinds of alcohol (beer, liquor). Foods with moderate purine content include pork, ham, chicken, beef, duck, and some shellfish (oysters, shrimp, crab, lobster).
2. Manage Weight
Excess body fat can elevate uric acid levels by increasing the BMI, leading to an increased risk of gout due to obesity, which increases uric secretion. It also leads to less efficient kidney function due to glucose imbalance, increased uric acid production, and decreased excretion. You may refer to a dietitian to create a balanced eating plan and recommend an exercise plan or lifestyle changes. Maintaining a moderate weight through sustainable changes, such as increased physical activity, balanced diet, and nutrient-dense foods, can lower blood uric acid levels and improve overall health.
3. Eat fresh fruits
Eat cherries, avocado, citrus fruits, berries and banana.
A 2019 research study published by the National Library of Medicine found that consuming cherries and cherry juice can lower uric acid levels in people with gout. Cherries contain anthocyanins, antioxidants, and anti-inflammatory compounds, along with fibre and vitamin C. Consider snacking on cherries or drinking unsweetened cherry juice.
Banana is high in potassium that prevents uric acid from forming uric acid crystals in the body.
Avocados are high in vitamin E, an anti-inflammatory, can help reduce gout flares.
4. Boost Vitamin C Intake
A 2021 study found that high vitamin C intake can lower uric acid levels. Increase vitamin C intake through fruits and vegetables, over-the-counter supplements, or as advised by a doctor to help prevent gout.
5. Add More Fibre to Your Diet
A high-fibre diet can help reduce uric acid levels and increase satiety. A study depicted that consuming 20–28 grams of fibre daily from whole grains, fruits, and vegetables reduces risks of hyperuricemia.
6. Avoid Alcohol
Alcohol consumption can cause dehydration and increase uric acid levels. Some types of alcohol, such as beer, have a higher purine content, but all alcohol types can raise purine production and affect uric acid secretion. Limiting alcohol intake can help manage uric acid levels.
7. Drink More Water
Drinking plenty of fluids helps the kidneys flush out uric acid, filtering about 70% of the uric acid in the body. Adequate water intake can support kidney function and reduce the risk of uric acid kidney stones. Keep a water bottle handy and set hourly reminders to take sips.
8. Avoid Sugar
Fructose, a natural sugar in fruit and honey, releases purines when broken down, increasing uric acid levels. Fructose in beverages is absorbed faster than in whole foods, spiking blood sugar and uric acid levels. Reduce sugar intake by eating whole foods, limiting processed foods, checking labels for added sugars, satisfying sugar cravings with fresh fruit, and replacing sugary drinks with water or unsweetened beverages.
9. Eat More Low Purine Foods
Include low purine foods in your diet to help lower uric acid levels. These include low-fat and fat-free dairy products, peanut butter, most nuts, most fruits and vegetables, rice, bread, potatoes, and pasta.
10. Try Supplements
Certain supplements may help lower blood uric acid levels. Potentially beneficial supplements include vitamin C tablets and turmeric capsules. Consult a doctor before taking supplements to ensure they do not interfere with any current medications.
When Should You Consult a Doctor for High Uric Acid Levels
High uric acid levels without symptoms typically do not require medical attention. However, if you experience symptoms such as kidney stones or gout flare-ups, it is important to contact your doctor. Uric acid can cause painful symptoms like back pain or joint inflammation, warranting a consultation with a healthcare provider. While a high uric acid level itself is not a disease and may not always cause symptoms, healthcare providers might monitor uric acid levels in individuals with gout attacks or specific types of kidney stones. If you suspect that your medication is contributing to high uric acid levels, talk to your healthcare provider, but continue taking your medicines unless advised otherwise.
Conclusion
To manage uric acid levels naturally, consider dietary changes, maintaining a moderate weight, and avoiding certain medications. Consult a doctor to discuss symptoms and receive advice on lifestyle changes and treatments for managing gout. It's important to follow prescribed medications and combine them with a balanced diet and regular exercise. Planning weekly meals and consulting a dietitian can help effectively limit foods that raise uric acid levels.
FAQs
1. Which Foods Lower Uric Acid?
Ans: To help regulate uric acid levels in the body, incorporate fibre-rich foods such as lentils, nuts, oats, quinoa, and brown rice into your diet. Additionally, consume vitamin C-rich foods like oranges, grapefruit, and kiwi. Avoid alcohol, processed foods, and drinks, and reduce the consumption of red meats.
2. Which is the Best Drink to Flush Out Uric Acid?
Ans: Drinking at least eight glasses of water daily is the most effective way to help your kidneys flush out uric acid. Increased water intake can also reduce the frequency and severity of acute gout attacks. During gout attacks, drinking more water can alleviate pain.
3. Does Lemon Water with Sodium Bicarbonate Remove Uric Acid?
Ans: Yes, lemon water, though acidic, becomes alkaline after digestion and metabolism in the body. The remaining substance, primarily sodium bicarbonate, is also alkaline. Adding the juice of two freshly squeezed lemons to 2 litres of water along with a pinch of sodium bicarbonate daily has been shown to reduce uric acid levels in people with gout. Researchers concluded that lemon water with sodium bicarbonate helps neutralise uric acid, thus lowering its levels. It helps detoxify the body, which also helps lower uric acid levels.
