With the improvement of living standards, more and more people find that they have high uric acid. Conservative estimates show that at present there are about 120 million hyperuricemia patients in our country, accounting for about 10% of the total population. The high incidence age is middle-aged and elderly men and postmenopausal women. However, in recent years, the trend of rising uric acid among young people is also increasing.
Many people have many questions about high uric acid. Therefore, Dr. Clove specially invited Dr. Liu Lei from the Department of Rheumatology of Huashan Hospital Affiliated to Fudan University to answer everyone’s doubts.
At present, the activity is over. Thank you for your active participation. The following is a wonderful question and answer. You can also click on the author’s avatar below the article to view all Dr. Liu’s articles and obtain more relevant knowledge.
Pay attention to the topic of [high uric acid], see you next time.
Selected Questions and Answers on Life and Diet
1. Can hyperuricemia patients eat tofu?
Dr. Liu Lei: You can eat it in an appropriate amount. Although dry soybeans have high purine content, after being made into tofu, the purine content is greatly diluted after soaking and grinding. When making tofu, some serous water must be squeezed out, and purine content is further reduced due to water loss.
Considering comprehensively, tofu, dried tofu, shredded tofu and other foods can be included in the diet of hyperuricemia patients on the premise of limited intake and replacing fish and meat as dietary protein supplement sources. However, considering that it will temporarily increase the level of blood uric acid after meals, it should still be avoided during the acute attack period.
2. Uric acid was 360 the year before last and 450 last year. The diet has been controlled all the time. Why does it still increase if you don’t eat mushrooms, seafood and beans? The age is 28 years old, male.
Dr. Liu Lei: Uric acid produced by diet is called exogenous uric acid, and its contribution to hyperuricemia is only about 20%. The remaining 80% is mainly endogenous, mainly due to problems in purine metabolism.
3. The body is relatively fat and uric acid is high. If you lose weight, will uric acid decrease?
Dr. Liu Lei: It helps. Bad living habits can lead to obesity, thus increasing the risk of gout. Therefore, in the prevention and treatment of gout, we should not only eat low purine, drink more water and not drink alcohol, but also pay attention to weight control.
4. Will high uric acid cause alopecia? Or are these all signs of renal function problems?
Dr. Liu Lei: There is no research on hyperuricemia and alopecia for the time being.
5. Hello! May I ask whether sex will aggravate the attack of gout? About once a week.
Dr. Liu Lei: There is no relevant research for the time being.
6. Would you like to ask the doctor, male, 31 years old, high uric acid, 471 (high triglyceride, low high density lipoprotein cholesterol), this kind of situation usually diet should pay attention to what? It is good to eat more what. Should what eat less and cannot eat? Ask too many questions at once, please the doctor!
Dr. Liu Lei: Pay attention to a balanced diet and reduce the intake of high purine and high fat diets. To learn more about diet, it is recommended to check the historical news in the gout doctor’s public number (micro signal: tfyisheng). If there is a gout attack, it is recommended to take medication.
7. Hello, Dr. Liu. Type 1 diabetes patients complicated with hyperuricemia, how much higher uric acid need drugs? There is also a strict control of diet, not to eat meat and rely on egg white, low-fat milk and a small amount of bean products to supplement protein?
Dr. Liu Lei: If there are complications, the blood uric acid is greater than 480. It is recommended to reduce uric acid. Strict diet control can only partially reduce uric acid.
8. My son is 18 years old. He found that uric acid exceeded the index by more than twice from junior high school. Last year, he examined uric acid 457 and the standard was 428. Doctors said that he did not need to take medicine, but paid attention to diet. Can it be no problem?
Dr. Liu Lei: Pay attention to diet. If you are overweight, it is recommended to control your weight. For the time being, there is no need for treatment and regular examination.
9. Is it generally the problem of uric acid metabolism that leads to high blood uric acid, or is it eaten? Can the loss of uric acid metabolism recover?
Dr. Liu Lei: Diet accounts for about 20%. Uric acid metabolism dysfunction still needs drug control.
10. When the weather freezes, the knee hurts. Is gout high in uric acid?
Dr. Liu Lei: Whether high uric acid requires blood test does not look like gout from the symptom description.
11. In the past three years, my uric acid has gradually increased, reaching 500 in October last year. I don’t smoke, and I don’t drink alcohol for nearly a year. I just like to eat meat. Now I have no symptoms of what. May I ask experts: What should I do? Thank you!
Dr. Liu Lei: Reduce the intake of meat, at the same time strengthen exercise, lose weight. According to China’s dietary guidelines, combined with the patient’s condition, gout acute attack period should not eat meat, remission period or hyperuricemia state, the average daily intake of red meat should be controlled within 50 grams. Animal viscera is best not to eat.
12. What about the high normal range of uric acid?
Dr. Liu Lei: Only for uric acid, there is no need to deal with it. Regular physical examination and follow-up are recommended.
Selected Questions and Answers
1. Is it better to take what’s uric acid lowering drugs?
Dr. Liu Lei: It varies from person to person, mainly depending on whether there are contraindications.
2. Take one tablet at a time and colchicine once a day to prevent gout attacks. Is it a big side effect to take it for a long time?
Dr. Liu Lei: 0.5 ~ 1 mg colchicine per day is used to prevent acute attack of gout at the same time as uric acid reduction therapy. The dose is small and the patient’s tolerance is generally better. Side effects vary from person to person. As long as liver and kidney functions are regularly tested, if there is discomfort and timely treatment, the side effects caused by drugs on human body can be well avoided.
3. My gout often attacks during this period of time. My diet is also controlled. The attack time interval is getting shorter and shorter. What should I do?
Dr. Liu Lei: Uric acid reduction treatment needs to be started.
4. Listen to people say that uric acid is high, is it true that eating soda tablets will relieve it? If it is true, will long-term administration have side effects?
Dr. Liu Lei: Soda tablets are adjuvant drugs in uric acid reduction treatment. Taking soda tablets only has limited effect on uric acid reduction.
5. May I ask the doctor whether uric acid lowering drugs and uric acid inhibiting drugs can be taken at the same time?
Dr. Liu Lei: The clinical effect of the current uric acid-reducing therapeutic drugs is still very positive. The vast majority of patients can effectively reduce uric acid by using one type alone. U.S. Guidelines believe that drugs that promote excretion can be combined with drugs that inhibit uric acid production.
6. Can uric acid lowering drugs cause stomachache?
Dr. Liu Lei: There may be gastrointestinal reactions.
7. I am a 36-year-old male with gout for nine years. I am satisfied with controlling uric acid with benzbromarone and sodium bicarbonate at ordinary times. Now I want to have children. The examination shows that sperm motility is insufficient. The doctor said it may be related to benzbromarone. May I ask if there are other methods to control uric acid in what during pregnancy preparation?
Dr. Liu Lei: During pregnancy preparation, it is recommended to stop using uric acid lowering drugs and strengthen lifestyle improvement. If gout is acute, non-steroidal anti-inflammatory drugs or hormones can be used for a short period of time. After your lover is pregnant, you can resume uric acid lowering treatment.
8. Good doctor! May I ask whether the normal gout attack without gout stones is the same as the pain of taking acid-lowering drugs to dissolve stones?
Dr. Liu Lei: The manifestations are redness, swelling and pain. There may be differences in personal feelings.
9. Hello, doctor! Uric acid is normal, and the feet are still suffering from repeated pain. Is this the manifestation of dissolving stones? Do you insist on taking medicine, tophus will become less and the frequency of attacks will become lower and lower? Can people with liver function damage take benzbromarone for a long time?
Dr. Liu Lei: Yes. Uric acid reduction treatment should be accompanied by gout prevention treatment. Small doses of colchicine are recommended. Liver function damage is recommended to the relevant departments for treatment and liver protection treatment.
10. Can Ligali Xian be taken for a long time and what is the daily dosage?
Dr. Liu Lei: It can be taken for a long time, starting with 50 mg, and monitoring liver and kidney functions.
11. I have kidney atrophy and gout. I should take what medicine at ordinary times. Thank you?
Dr. Liu Lei: At present, among the uric acid lowering drugs, febustat has the least effect on the kidney, but your situation needs to be decided by going to the hospital.
12. The gout knot of the big toe joint of the right foot has been operated on. Now there is a lump as big as jujube pit on the heel of both feet. It has been about 5 months. The surgeon said that the skin in that place is thin and cannot be operated on. Let the medicine be taken. Can the gout knot be eliminated by taking medicine?
Dr. Liu Lei: Uric acid reaches the standard for a long time, and tophus has the hope of subsiding.
13. Physical examination uric acid 607, how many times should baking soda tablets be taken every day? How many tablets at a time? Thank you
Dr. Liu Lei: The blood uric acid of 607 cannot be reduced by baking soda tablets. It is recommended to choose benzbromarone, allopurinol or febustat after perfect examination.
14. My uric acid 434, do you want to treat, I have kidney stones 5 mm is there a reason for high uric acid! The doctor asked me to drink more water. I now drink 4 litres of water every day. Will it cause too much burden on the kidney?
Dr. Liu Lei: 434 Just need to improve the lifestyle. There are many reasons for kidney stones, not necessarily related to uric acid. It is recommended to drink more than 2L of water per day, 4L should not cause too heavy a burden on the kidney.
Position Statement
- The answer only represents the personal opinion, not the position of the organization I work for. The answer is only aimed at the content provided by the question and should not be used as the only basis for diagnosis and medication. Please respect the comprehensive judgment of clinicians when seeking medical treatment.