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Uric Acid

Uric acid (C5H4N4O3) is a heterocyclic compound comprising carbon, hydrogen, nitrogen and oxygen. This compound develops salts as well as ions that are known as acid urate and urates respectively, for instance ammonium acid urate. In fact, uric acid is formed due to the metabolism of purine nucleotides. Elevated amounts of uric acid in the body may result in gout. In addition to gout, this compound is also responsible for several other health conditions, counting diabetes as well as development of kidney stones - which are basically solidified ammonium acid urate.

As mentioned earlier, uric acid forms in the human body in the form of a derivative of purine nucleotide metabolism. Uric acid formed in this way is excreted through urine. As far as purines are concerned, they are different nitrogen compounds found in a variety of foods, like wheat bran, green peas, mushroom, fish and meat products. From the chemical viewpoint, uric acid is basically a reducing compound comprising carbon, oxygen, nitrogen and hydrogen, having a chemical formula C5H4N4O3. Uric acid is extremely antioxidant and about 50 percent of blood plasma's antioxidant aptitude is attributed to this chemical compound.

Uric acid formed in the body following the metabolism of purines enters the bloodstream and circulate through the body before reaching the kidneys. Almost 75 percent of the uric acid deposited in the kidneys is excreted through urination. However, when the right amounts of the compound are not eliminated from the body, it often causes several physical aberrations, which may result in acute health problems. Keeping this aspect in view, it is extremely vital to be aware of the damages caused by surplus uric acid in the body and what should be the standard amount of this compound in our body. Since uric acid is present in our bloodstream as well as urine, you can take samples of any of these two for a medical examination. However, people generally undergo a blood test to ascertain the level of uric acid in their body.

Eating certain foods in excess may lead to too much uric acid in the body. For instance, consumption of excessive meat, red meat in particular, raises the level of uric acid in the body and when the uric acid goes beyond certain limits, it causes severe problems. The risk of severe health conditions owing to presence of excessive uric acid stems from the fact that this compound is practically insoluble in water and the human body does not have any mechanism to convert uric acid into a water soluble compound.

Presence of excessive uric acid in the body owing to its failure to excrete appropriate levels of the compound through urination may lead to kidney diseases because it retards the speed of blood circulation. Often the affected person may also develop a severe renal failure. In fact, inside the human body, uric acid is present in an ionized form - urate. The kidneys filter this ionized form of uric acid at the glomerulus. However, when the concentration of this compound is very high, the kidneys cannot tackle with the heavy burden.

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This results in an extremely excruciating health condition called gout. Precisely speaking, gout occurs when the serum build up of uric acid produces some crystals in the capillaries and the joints.

Presence of excessive uric acid in the body may even lead to cardiovascular disease, diabetes and several metabolic problems. However, till date no scientific studies have been undertaken to precisely determine whether uric acid is directly responsible for diabetes. On the other hand, although rare, it has been found that in a few instances, elevated levels of uric acid may lead to the Lesch-Nyhan syndrome - a condition that causes a person to develop inadvertent movement, spasticity and even cognitive retardation.

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Diseases associated with an elevated uric acid

When the uric acid levels in your body are very high (a condition known as hyperuricemia) it may result in gout, a type of arthritis. According to available records, this health condition troubled humans since the time of the early Greeks. This health condition develops following the accumulation of uric acid crystals in the joints leading to inflammation and acute pain. It is interesting to note that gout can occur to men at any age, it has been found that generally women do not develop this painful condition till they are already 10 years to 15 years after their menopause. However, gout is quite common in aged people.

Gout can be distinguished by occurrence of unexpected and acute arthritis (inflammation of the joints) that may continue for a couple of days to a week or even more. Usually, the condition afflicts the first toe. However, the condition may also involve other toes, ankle, mid-foot and knee. Precisely speaking, gout can affect virtually all joints, including those of the hands. Occasionally, when the accumulation of uric acid in the body is very high, it may form gout crystal swellings that may manifest as tiny white nodules beneath the skin. These are most commonly seen on the fingers, in the region of the joints in the feet and external ear. It has been found that majority of people suffering from gout also have an elevated level of uric acid in their body. However, at times the level of this compound in gout patients may even be normal - towards the higher limit. In fact, you will hardly find an individual who has gout, but his/ her uric acid level in the bloodstream is low.

Kidney stones formed due to accumulation of uric acid are known as nephrolithiasis. Such stones may form due to the deposit of uric acid in the kidneys, the ureters, or even the tubes that connect the kidneys with the urinary bladder. An individual with uric acid kidney stones will experience a number of symptoms, including acute pain in the lower or middle of the back, excruciating pain in the region of the groin, fever and also blood in his/ her urine.

Kidney problems: When your kidneys are unable to expel sufficient amounts of uric acid, the concentration of the compound increases in the bloodstream. Consequently, you may be afflicted by various problems including high blood pressure (hypertension) and/ or diabetes. There is a possibility of these diseases being related to high levels of uric acid in your body.

Psoriasis and leukemia: Apart from kidney diseases, elevated levels of uric acid in the bloodstream may also cause psoriasis and leukemia. Then again, chemotherapy for treating certain cancer forms results in the discharge of uric acid in significant amounts into the bloodstream. When this occurs, it can damage the kidneys. Therefore, prior to chemotherapy, the patients are administered a medication that would keep the uric acid levels lower.

Obesity and alcohol consumption: Drinking lots of alcoholic beverages as well as obesity are related with elevated levels of uric acid in the bloodstream. In fact, these two are risk factors for gout and kidney stones. Especially binge drinking augments the risk of developing these conditions.

While elevated levels of uric acid in the bloodstream are nothing new in people suffering from gout or kidney stones, it has been found that most people who have high concentration of uric acid in their blood often do not develop either gout or kidney stones. Similarly, it is very rare for people with low levels of uric acid to develop gout. Since there is no evidence that having an elevated level of uric acid always leads to gout, ideally the diagnosis for gout should involve removing a small amount or sample of the fluid present in the joints or any other affected areas like a suspected uric acid crystal (gout) lump beneath the skin or bursa and study the sample under a particular microscope, which is known as a polarizing microscope. Likewise, if any individual is suffering from kidney stones, it is best to catch the stone and submit it to a pathological laboratory for chemical examination to ascertain whether the condition can be attributed to uric acid.

How to test uric acid levels

Physicians often recommend patients to undergo a blood test or urine examination with the view to determine the levels of uric acid, which is vital for ascertaining certain health conditions in them. For instance, a physician may ask the patients with kidney disorder or joint pain to take the test for measuring the uric acid levels in their body. Patients, who need to undergo an uric acid test, should not drink or eat anything for several hours before their blood sample is collected. In addition, your physician may also ask you to keep off from specific medications prior to your blood sample collection for an uric acid test. To examine the presence of uric acid in your body, blood sample is usually taken either from the back of your palm or near the elbow. Subsequently, the blood sample is examined in the laboratory by expert pathologists to determine the uric acid levels in your body.

What are the normal levels of uric acid

When we talk of normal levels of uric acid in the bloodstream, laboratory tests of blood should be anything between 3.0 and 7.0 mg/dL (milligram/ decilitre) of the compound in the blood, while the standard levels of uric acid in urine should be anything between 250 mg and 750 mg. In this case, it is important to bear in mind that the sample of the urine for uric acid analysis is for a day. Different laboratories may set different ranges for normal uric acid - however, this difference is very insignificant. Usually, it is rare to find any individual having a low blood uric acid concentration. On the other hand, high level of uric acid in the blood is quite common. However, some people may suffer from exceptionally low levels of uric acid in their blood and this may be attributed to a variety of conditions, including kidney diseases, malfunctioning of the liver, being exposed to toxic substances and chemicals too frequently as well as some hereditary imperfections.

In case the level of uric acid in the bloodstream or urine is higher compared to its normal range, your physician will ask you to undergo additional medical tests and also conduct some tests in the laboratory with a view to diagnose the problem. Generally, there are two basic reasons of elevated levels of uric acid in the bloodstream. First, it is possible that your body is not excreting appropriate amounts of uric acid through urine. Second, there may be excessive uric acid production in your body. High levels of uric acid (a condition called hyperuricemia) may also be related to other health disorders such as renal problems, gout, hyperparathyroidism, diabetes, and even lead poisoning. Apart from these, elevated levels of uric acid in the blood may also be a side effect of either chemotherapy or radiation therapy undertaken to treat certain forms of cancer.

There are a number of casual causes for hyperuricemia or gout directly associated with excessive synthesis or production of uric acid in our body. In this case, uric acid crystals deposit in the joints over a period of time causing extreme painful symptoms. As chemotherapy also leads to high production of uric acid, physicians conduct a test to find out the levels of uric acid in the bloodstream of the patient before administering chemotherapy drugs to the cancer patients. In addition, tests are also conducted in the intervals between two chemotherapy sessions to determine the uric acid levels, as chemotherapy releases a profuse amount of this compound in the body. Such tests are a part of the regular medical check-ups for the cancer patients.

Consumption of excessive foods that are rich in purine also add to the problem, as it results in high concentration of uric acid in the bloodstream. Therefore, it is advisable that people who are suffering from conditions like gout, hyperuricemia and related health conditions should be careful to stay away from foods as well as drinks containing high amounts of purines. Findings of some medical researches have shown that there is a direct relation between the concentration of uric acid in the bloodstream and rise and fall of one's blood pressure. Findings of a recent research revealed that lowering the levels of uric acid in the body directly brings down high blood pressure considerably. In fact, this particular finding is considered to be a significant achievement in keeping the blood pressure of people suffering from hypertension under control.

Irrespective of whether a patient is suffering from hyperuricemia or hypouricemia, the physician will recommend prescription drugs and, at the same time, suggest changes in the patient's lifestyle, particularly making modifications in his/ her eating and drinking patterns with a view to ensure that the uric acid levels in the blood remain normal. Following the physician's advice and taking an appropriate and planned diet that is low in purine content will help one to combat hyperuricemia more effectively.

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