URIC ACID DILEMMA AND GOUT

September 17th, 2017 - Brian Maguire

Uric acid is a normal by-product of metabolism, and like other compounds and systems in the body, needs to be in balance. Even though excessive uric acid is a MAJOR risk factor for the development of gouty arthritis, hypertension, insulin resistance, stones, arteriosclerosis, diabetes, cancer, and just about any adverse condition you can think of, this acid paradoxically acts as a powerful DNA protective antioxidant when in proper quantitative balance.

Uric acid is found mostly in its ionic form as urate. When urate circulates in the blood at ideal concentrations it has many health benefits, like scavenging microbes and excess free radicals. However, when alkaline mineral stores and buffering system capabilities are exhausted, and uric acid levels are allowed to get too high, the anti-oxidant benefits are lost, and body tissues are vulnerable to destruction. Like free radicals, uric acid is a great example of the old adage “it’s the dose that makes the poison”, because high concentrations in the blood, interstitial fluid, and tissues can lead to excessive free radical, chronic inflammatory, acidic conditions.

So, in proportionate blood levels, uric acid works as a powerful antioxidant helping to prevent damage to our blood vessel linings. At the same time, too much uric acid can LIMIT the production of nitric oxide from the endothelium lining of the vessels. Nitric oxide is a very important substance that helps protect arterial walls from damage, increase oxygen and blood flow, and regulate blood pressure. When uric acid is overproduced the blood becomes thick or viscous, blood pressure escalates, and acids are pushed out of the blood into fat cells, lower circulation in the extremities, joints, and other tissues, etc. These acids can also clog the capillaries that connect the arterial and the venous systems, decreasing the supply of oxygen to the body’s tissues.

These acid waste deposits often take YEARS to build-up, starting with mild acidosis, leading to low grade chronic acidosis, eventually leading to hyperuricemia, clinical pH imbalances, and disease when left unchecked. When acid levels are continuously disproportionate it is a serious warning sign that the body is under extreme stress and at a MUCH higher risk for disease promotion!

The body is fairly resistant, but it can only take so much abuse. If you have someone balance a 5lb weight on their head, they could do it effortlessly. However, if you keep adding 5 lb. weights to the load the physical stress will eventually be too overwhelming, and they will be forced to release the heavy load to avoid injury! The blood acts in a similar fashion. As it becomes saturated with uric and other acidic waste it has no choice but to release the acid burden into body tissues and joints as a protective mechanism, to avoid more serious, immediate life-threatening complications.

Uric acid is a major contributor, but certainly not the only culprit in this balancing act. Often times, normal uric acid elimination is hindered and accumulates appreciably due to the over-production of other acid waste. The more metabolic acids that build up, the less uric acid that can be excreted.

The acids (H+) that can build-up in the body are the resultant metabolic acid by-products like:

  • Sulfuric acid from eggs and meat
  • Purine rich foods
  • High phosphorus in meat and other animal products
  • Synthetic phosphoric acid in processed foods and beverages
  • Poor digestion
  • Lack of hydration
  • Toxic thoughts and emotions
  • Purine nucleic acid cellular waste from normal cell metabolism,
  • Lactic acid from low oxygen low pH muscle tissue, like with low grade chronic acidosis and fibromyalgia.
  • Cancer cells and escalated cell death from cancer treatments

A pH balanced whole food diet that includes eggs and meat is not the problem. Mostly, these accumulating acids are the result of acidogenic diets and inferior, unconscious lifestyle choices. ACIDOGENIC inflammatory diets are typically high in animal protein, oxidized vegetable oils, refined sugars and flours, alcohol, caffeine, prescription and over the counter drugs, processed foods, and iodized processed acid forming table salt, while at the same time low in alkaline forming fruits and vegetables!

Uric acid is also a byproduct of fructose metabolism, resulting mostly from LARGER amounts in the form of high fructose corn syrup, soft drinks like soda, and table sugar as opposed to fiber rich, alkaline forming fruits. This bleak scenario steers the body towards a sub-clinical or low-grade state of metabolic acidosis, leading to the buildup of acids in the fluids and tissues.

SO, WHAT ARE PURINES, AND WHY ARE THEY IMPLICATED IN THE PRODUCTION AND BUILDUP OF URIC ACID? 

Purines are naturally found in all cells in the body. They are part of the building blocks of nucleic acids, found in the nucleus of the cell. When cells die and get recycled, purines are broken down into uric acid. The body then utilizes these nitrogen-containing compounds for cellular energy. Besides being an end-product of normal metabolism, purines (although not proteins themselves), are somewhat present in all protein foods, with the highest concentrations found in animal proteins like organ and other meats.

While uric acid-producing purines are an important part of the body’s normal processes, like anything else, too much of a good thing can create imbalances adversely affecting your health. The uric acid resulting from the purines produced during normal cellular metabolism is not a problem. The real damage ensues when the uric acid concentrates and collects in the body, directly resulting from a high protein, purine rich diet, in conjunction with a lack of hydrating alkaline mineral rich foods and beverages.

Visualize the uric acid metabolic process as a 16-ounce glass. Let’s assume that when you are young, your glass contains about 6oz. Let us consider that at a 16oz level, you would be a candidate for a gout attack. After years of overindulging in high purine, acidic food selections, and damaging stress, your glass gradually rises to 14oz. An average meal in purines may bring you up to 15.5, but luckily, within 4-6 hours your system can bring it back down to 14.1. This process is repeated several times, until one day you top the 16 ounces, and you are now in a gout attack! However, the damage that can be done to the body when acid levels are allowed to escalate prior to the gout can be DETRIMENTAL. Dangers of hyperuricemia and gout. 

Purine rich foods include, chicken, sardines, salmon, tuna, kidney beans, navy beans, lima beans, oatmeal, and peas. Cauliflower, asparagus, spinach, and mushrooms are also purine rich, but these foods are alkaline forming, lowering acidity. If you notice these purine rich foods are also among the healthiest foods, with a few of them being highly alkaline. While some of these foods can be avoided or limited temporarily when hyperuricemia is present, they do NOT by any means need to be excluded from the diet permanently.

The idea is to balance your pH levels. You do this by making healthier diet and lifestyle choices, at which time purines will no longer be an issue at all. Simply put, make sure that the greater percentage of your meals consist of more neutral, alkaline-forming foods, especially vegetables, to counteract the effect of acid producing proteins, purine rich foods, toxins, and emotional stress.

Purines are also found in LARGE quantities in fat cells. SO, BEWARE: any weight loss program should include a pH balancing protocol to offset the increase in uric acid waste, as these fat cells are burned up for energy.

Unlike other mammals, humans LACK the enzyme uricase needed to break down uric acid from purine containing foods. So, after the body utilizes the uric acid it needs for energy and anti-oxidant purposes, 30% of the leftover uric acid passes through the liver and is then broken down by bacteria and excreted through the intestines, while the remaining 70% is excreted in the urine via the kidney under normal conditions. However, when blood uric acid levels exceed blood saturation levels due to poor diet and lifestyle choices, blood buffers and elimination channels like the kidneys become overwhelmed.

Higher than normal uric acid levels in the blood is referred to as hyperuricemia. This can be caused by the over-production of uric acid in the body, and/or the inability of the kidneys to adequately remove enough uric acid from the body in a timely manner. Remember, the kidneys can ONLY eliminate accumulating acids every 24-48 hours, and they require a significant amount of water, alkaline forming minerals, and various buffer systems to do so. Besides the added stress placed on the liver and other organ systems as the kidneys are overworked, there is an additional price to pay. Uric acid passes through the kidneys at a very slow rate causing it to build in the bloodstream and stick in crystal form to veins and arteries and form stones in the kidneys along with the calcium used to buffer it.

URIC ACID & CRYSTAL SALTS

Normal uric acid levels are 2.4-6.0 mg/dL. (female) and 3.4-7.0 mg/dL. Higher levels would be considered hyperuricemia. Under so called “normal” non-clinical circumstances, when acid levels get too high the bloods buffers will revert serum pH back to normal or close to normal levels, even when these protective systems are not functioning optimally. However, if you keep adding more acid to the cup when its already FULL the excess has to spill somewhere, right?  So where does the acid waste go then?

In the body’s attempt to protect itself from the life-threatening accumulation of liquid acids, solid crystal salts can develop in various more vulnerable areas of the body. Excess uric acid deposits show-up as monosodium urate (MSU) or calcium urate. When these crystals accumulate in the fluids and tissues it is considered gout. GOUT is in fact the resultant buildup of uric acid and urate crystals most commonly in areas like the synovial lining and fluid of the joints and extremities, often resulting in excruciating inflammatory pain. Many describe this pain as “the worst pain they ever felt in their life!”

Higher acid levels in general lead to the deposition of other crystal salts as well.  Although not common knowledge, studies show that these crystals are often involved in many forms of arthritis, pseudo gout, bursitis, tendonitis, and arteriosclerosis. Calcium oxalate crystals can form, but they involve oxalic acid instead of uric. Calcium pyrophosphate deposition (CPPD) crystals can also form, but they involve phosphate, not urate. Basic calcium phosphate is yet another type of crystal primarily composed of hydroxyapatite (bone). Cholesterol crystals can also form in the arteries, liver, and gallbladder. Crystals materialize along your arterial walls (coronary artery disease), in your kidneys or gallbladder (stones), in your joints, toes, and fingers (gout, pseudo gout, other forms of arthritis, bone spurs), and crystals can form under the skin (tophi) in certain areas on the body. Calcium deposits have also been found to form on the nerve endings when the blood, and in turn the interstitial fluids, become too acidic, which can lead to incessant pain!

What needs to be understood here is that soluble uric acid measured in the blood supply does NOT include interstitial fluid, lymph, or intracellular acid levels, nor what has become crystallized and is now hiding out in body tissues, joints, and arteries. For this reason, blood tests are often skewed and therefore not an accurate indication of uric acid saturation. Serum uric acid levels can test near normal while you can still have very high levels of acid in the tissues! remember, the blood buffers MUST clear excessive acids to prevent serious injury or death. For this reason, acids get pushed into the tissues, causing blood urate levels to fluctuate.

Authors of “Gout and Pseudo Gout Workup” proclaimed:

In gout, crystals of monosodium urate (MSU) appear as needle-shaped intracellular and extracellular crystals. If crystals are seen, their shape and appearance under polarized light are diagnostic. The ‘more damaging’ negatively birefringent urate crystals are seen on polarizing examination in 85% of specimens. Gouty attacks are not related to serum levels of uric acid. Thus, an elevated serum uric acid level does not prove the diagnosis of acute gout, although hyperuricemia is present in 95% of cases, and a normal level does not exclude the diagnosis.

If pain is not enough of an indication, and you want to be certain, you would need to test the joint fluid for urate or other crystal deposits. Synovial fluid analysis is not part of any routine examination for crystals, nor do doctors test the interstitial fluid.  So often times it’s a mere guessing game based on certain criteria. Better yet, just go on a pH balancing anti-inflammatory protocol to dissolve acid crystals, while eliminating any pain and additional damage. Most often the condition can heal and reverse with a pH balancing-anti-inflammatory diet and lifestyle, as the body goes into a state of homeostasis!

Any drug prescribed by an allopathic doctor may give you temporary relief from the condition but will NOT cure it and will most likely lead to other issues or side effects like ALL synthetic drugs. When body tissues and fluids are pH balanced, the acidic environment necessary for conditions like gout to develop will not be present!

Keep in mind, it’s not just purines that can create issues. In low pH conditions, bacteria, metals, and other toxins can settle in vulnerable joints, increase autoimmune activity, and augment inflammatory acidic conditions, causing damage and acid crystallization.

When blood acid levels are low enough some of the acid crystals can precipitate back into the blood for elimination, but without instituting dietary and lifestyle changes the overly acidic environment will continue to present a danger to your health. If you take a few scoops of highly alkaline greens mix regularly for instance, the blood will be capable of accepting some of the acid from the tissues, giving you pain relief as inflammatory acids migrate out of the tissues into the bloodstream for elimination!

 

 

http://2012books.lardbucket.org/books/an-introduction-to-nutrition/s12-01-generation-of-free-radicals-in.html

http://emedicine.medscape.com/article/329958-workup