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Gout And Hyperuricemia

The Difference Between Gout & Hyperuricemia

Gout and hyperuricemia, while having much in common, do vary from each other. Gout is a medical condition that is characterized by abnormally high levels of uric acid in the blood, recurring attacks of joint inflammation (arthritis), deposits of tophi (hard lumps of uric acid crystals) on and around joints, a decrease in kidney function and a presence of kidney stones.

Hyperuricemia is a high level of uric acid in the blood, caused by either overproduction of uric acid in the body or under elimination of uric acid from the body. Nearly two thirds of the total body urate is produced within the body while only one third comes from dietary purine sources. The kidneys excrete about 70 percent of the urate produced daily and the intestines eliminate the rest.

Under excretion of uric acid from the body is the primary cause of hyperuricemia and even though hyperuricemia may indicate a risk for gout, the relationship between the two conditions is unclear. Many people with hyperuricemia never develop gout and, conversely, many people who suffer with gout have low blood uric acid levels.

If I Have Hyperuricemia, Will I Have Gout?

There is ongoing active research in several fields of gout and hyperuricemia as they relate to each other. Certainly, the connection is there. High levels of uric acid in the blood cause crystal deposits in joint tissue resulting in attacks of gout. However, only a small portion of people with hyperuricemia actually develops gout. This means that the condition of gout can exist in a person without their blood uric acid levels being elevated.

What this translates into is the fact that high uric acid levels may not be the cause of a gout attack. Frequently, drastic changes of uric acid levels-either up or down-precede acute gout attacks. In addition, metabolism (which is inherited) seems to affect the tendency toward developing gout significantly.

Factors In Gout Treatment

Several factors are being studied as they relate to the treatment of gout, its management, and the relationship of improving blood pressure and kidney function to gout management. It has been reported that intake of large amounts of animal protein only slightly increase the risk for gout. In times past, animal protein was considered a prime cause of gout. Adequate intake of dietary calcium has been shown to help protect against gout attacks.

Trial Medications And Aspirin Use

There are new medications being developed to increase the elimination of uric acid in the urine (benzbromarone) and lower uric acid blood levels (PEG-uricase). These drugs are currently being evaluated in clinical trials. Another medication that is being considered for gout is aspirin. It has been noted that aspirin increases the level of uric acid in the blood (important in gout), but many people are prescribed aspirin as a means of preventing heart attack and stroke. While it is true that small doses of aspirin can increase blood uric acid levels because it can impede excretion of uric acid from the kidneys, that factor only applies when the aspirin is taken in the method prescribed in OTC doses. Taken in very low dosages, aspirin has little effect upon blood uric acid levels. However, because moderate to high doses of aspirin can affect blood uric levels, people known to have gout should avoid it.