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If there is hyperuricemia, you have to Lower uric acid. Otherwise, painful, inflammatory deposits of uric acid crystals in joints, tendon sheaths and subcutaneous tissue occur. The kidney can also be affected. Read here what role diet plays in lowering uric acid, which drugs are used for therapy and whether alternative remedies can lower uric acid.
Lower uric acid: diet
If you want to lower your uric acid level, the first step is usually to normalize your weight and change your diet.
The following Food are low in purine. You can eat these without hesitation if you have elevated uric acid:
- Vegetables (excluding purine-rich varieties such as cabbage, green beans, broccoli, spinach, and asparagus)
- Dairy products
Many foods contain so-called purines, the breakdown of which results in uric acid. Therefore it is important foods rich in purine to avoid. These are above all:
- Meat (especially offal)
- Fish (for example salmon, tuna, sardines)
- Shellfish and crustaceans
- Legumes (lentils, peas, soybeans, and others)
Unless otherwise prescribed, the patient should also ensure that they drink enough water (at least two liters per day). In the case of mild hyperuricemia, the uric acid can often be lowered naturally by changing the diet, without any medication.
Lower uric acid: tea and coffee allowed?
Tea, coffee and cocoa also contain purines, which are broken down into uric acid in the body. In the usual consumption quantities, however, this has no effect on the uric acid concentration in the blood. Patients do not have to go without their morning coffee or cup of tea. On the other hand, it is important to avoid alcoholic beverages, especially beer.
Lower uric acid with medication
An acute attack of gout is treated with commercially available non-steroidal anti-inflammatory drugs. These include, for example, ibuprofen, diclofenac, naproxen and indomethacin. Salicylates such as ASA, on the other hand, should be avoided: They inhibit the excretion of uric acid via the kidneys, so that even more uric acid remains in the body.
If there are occasional, mild attacks of gout, no long-term drug therapy is necessary. However, the following situations require the start of long-term therapy with drugs that reduce uric acid:
- more than two gout attacks per year
- Uric acid concentration in blood serum> 9 mg / dl
- known overproduction of uric acid (for example during chemotherapy)
- Uric acid stones in the urinary tract
- Build-up of crystals in the kidneys (urate nephropathy)
The drug of first choice is allopurinol: it is an inhibitor of xanthine oxidase. This is the enzyme that breaks down the purine breakdown products xanthine and hypoxynthin into uric acid.
Sometimes gout attacks increase after the start of allopurinol therapy because the uric acid crystals that are present are mobilized. In this case, the doctor may prescribe naproxen or colchicine.
If you want to permanently lower the uric acid levels, the medication usually has to be taken for a lifetime. The uric acid level is checked regularly.
Lower uric acid: reserve drugs
If the standard drug allopurinol in combination with a low-purine diet is not enough, there are so-called uricosurics as reserve drugs. These promote the excretion of uric acid with the urine. They can either be given in addition to or instead of allopurinol. The active substances probenecid and benzbromaron are representatives of the uricosuric agents.
A newer alternative is the genetically engineered rasburicase: this enzyme converts uric acid in the blood into a more water-soluble product, allantoin. This can be excreted more easily and does not form crystals. Rasburicase is only given in an emergency when uric acid levels are very high, such as those caused by tumor lysis syndrome (rapid disintegration of cancer cells).
Lowering uric acid: natural remedies and alternative approaches
Some patients want to lower their uric acid levels without taking medication. Some patients find homeopathic remedies (e.g. Belladonna) helpful.
The concept of homeopathy and its specific effectiveness have not yet been scientifically proven.
In herbal medicine, for example, birch or black poplar are used. Their effect has not been scientifically proven either. In addition, natural remedies can possibly alleviate the symptoms, but not cure the cause. Do you want that effectively Lower uric acid, a change in diet and, if necessary, the prescribed medication are essential.
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