GOUT- CONVENTIONAL MEDICINE FAILS TO SEE BIG PICTURE

GOUT is a serious warning sign, not just a little acid buildup in the joints and extremities!

Conventional physicians may not be aware of the real dangers of accumulating acid waste, but ironically, they do recognize the condition known as gout. It is highly logical to assume that this acid buildup did not occur overnight by any means. You don’t just wake up one morning with a toe, finger, or knee full of inflammatory acid crystals with no prior acidic pre-disposition! The majority of people develop gout after years of poor diet and lifestyle choices. Despite this very obvious fact, conventional medicine still ignores, is very slow to recognize, or misses completely, the direct association between gout, other inflammatory acidic conditions, and the gradual buildup of damaging acid waste over time.

Conventional medicine mistakenly only recognizes hyperuricemia as a problem if gout is instituted, just like they only recognize acid/alkaline imbalances when clinically appropriate or near death! These physicians proclaim that not everyone with high blood urate levels or hyperuricemia develops gout (which is true), but it is also under-diagnosed for lack of proper testing. They also proclaim that up to two-thirds of individuals with hyperuricemia never develop gout symptoms and are thus considered asymptomatic and do not require treatment. Not surprising and shocking at the same time, MOST conventional doctors do not require or recommend any treatment at all for hyperuricemia until gout, other forms of arthritis, stones, or tophi (uric acid deposits under the skin) materialize. Better late than never, right? Scary stuff! Keep in mind it’s not the physician’s fault per say, it’s the broken pHARMa system they were taught (or indoctrinated to follow), based on symptom management, NOT root causes.

In fact, The National Institute of Arthritis and Musculoskeletal and Skin Diseases very fallaciously states, “Hyperuricemia is not a disease, and by itself it is not dangerous.” So even though these physicians are well aware that asymptomatic hyperuricemia precedes conditions like gout, they are basically insinuating that NO precautionary measures need to be taken in order to prevent the onset of these conditions, and high uric acid levels pose no problem to the body. Not only does this prognosis mislead the patient to a false sense of security, it is inaccurate, unfounded, and completely UNTRUE! The higher the blood serum acid levels, the LESS available oxygen to the organ systems. This simple fact alone should be a serious warning sign to err on the side of caution!

It’s like the little white elephant in the room, you may ignore it, or not see it at all, but it still exists nonetheless! Doctors take a Hippocratic oath to uphold specific ethical standards and do what’s in the BEST interest of the patient to the best of their knowledge and ability. Although they lack knowledge, IGNORING the little white elephant in the corner is far from in the patient’s best interest.

It becomes fairly obvious when you do the research and perform an empirical, mindful, unbiased investigation, that the severe negative impact of excess uric and other acids that buildup in the fluids and tissues are not just associated directly with acid buildup in the extremities, and the damage to the body’s tissues extends far beyond the joints. In actuality, the research on gout and hyperuricemia (high levels of uric acid in blood) shows an UNCANNY association between elevated blood and tissue acidity and risk factors like hypertension, high blood sugar, insulin resistance, stones, and major medical disorders like diabetes, chronic kidney disease, cardiovascular disease, obesity, and cancer.

Before you develop gout, you would first develop hyperuricemia, which is a sign that uric acid levels are quite high. From a holistic stand point, it is NOT rational or ethical to wait until a patient has symptoms of gout to treat them for the excessive acidity that likely caused or will cause a tremendous amount of damage prior to the symptoms of gout. The logical approach is to examine how these elevated acid levels are affecting the rest of the body, not just focusing on how the accumulating acids may affect one joint! The symptom that needs to be addressed promptly is the acid/alkaline imbalance even prior to the onset of hyperuricemia. Forget about waiting for gout to materialize.

Gout alone is proof that tissue acid saturation from low grade metabolic acidosis is a real phenomenon. After all, these acid levels didn’t just get to such high levels overnight!

DANGERS OF HYPERURICEMIA AND GOUT

The risk factors and disturbances that are present with gout sufferers are evidence enough of the destruction that coincides with excessive acidity in the blood and tissues. Studies show that gout sufferers have far more serious complications throughout the body than the actual gout itself!

In this 2005 study researchers from Boston University School of Medicine (BUSM) have found that the incidence of gout and hyperuricemia in the U.S. has risen SIGNIFICANTLY over the last 20 years and is associated with major medical disorders like hypertension and chronic kidney disease. The study is published in the American Journal of Medicine. This acidosis epidemic has gotten worse in recent years, not better.

Data was compiled from the latest U.S. National Health and Nutrition Examination Survey (NHANES) performed in 2007 and 2008. Out of 5,707 participants, the researchers found that gout now affects 8.3 million Americans, or four percent of the population. They also found that hyperuricemia affects 43.3 million U.S. adults, or 21 percent of the population! This is NOT including those with bicarbonate blood levels on the low side of normal which drives these numbers exponentially higher!

The study results demonstrated that participants with gout have remarkably high rates of hypertension (74 percent) and chronic kidney disease (71 percent). More than half of this patient population was obese (53 percent) and a significant number had diabetes (26 percent) and kidney stones (24 percent). These participants also showed high rates of heart attack (14 percent), heart failure (11 percent) and stroke (10 percent).

Additionally, study results showed that among individuals with the highest uric acid levels, rates of kidney disease were (86 percent), hypertension (66 percent) and obesity (65 percent). Approximately one third of the survey participants had heart failure and diabetes, and the prevalence of heart attack (23 percent) and stroke (12 percent) also were high. These numbers are staggering! (1)

Not everyone that has hyperuricemia will develop gout, but as you can see, a whole variety of FAR WORSE conditions are well established in the individuals that have hyperuricemia. It would seem to be far more logical to scrutinize the impact of hyperuricemia as opposed to waiting to see if it may progress to gout, don’t you think? Thinking outside the box and examining this scenario consciously, it is rather careless (to say the least) to dismiss the obvious ill effects of consistently elevated uric acid levels. The conventional ‘no concern, no treatment’ approach to hyperuricemia may NOT be the best idea after all!

In a 2006 study “Uric acid and inflammatory markers” authors made this statement: “Epidemiological studies have recently shown that UA may be a risk factor for cardiovascular diseases and a negative prognostic marker for mortality in subjects with pre-existing heart failure.” (2)

In a 2006 population-based cohort study “The association between serum uric acid level and long-term incidence of hypertension” researchers found increasing experimental evidence, supporting a causal role for uric acid in the development of hypertension. Even though this study did not prove that uric acid is independently associated with the long-term incidence of hypertension, it seems likely. When 2520 hypertension-free individuals were studied, 956 individuals developed hypertension over a 10-year follow-up period. Increasing quartiles of serum uric acid was associated with 10-year incidence of hypertension independent of smoking, alcohol intake and baseline kidney function, suggesting an independent positive association between serum uric acid levels and hypertension development among community-dwelling older adults. (3)

Researchers evaluated the relationship between UA levels and several inflammatory markers in 957 subjects, free of severe renal failure, from a representative Italian cohort of persons aged 65–95. After adjustment for age, sex, behavior, and disease-related confounders, results were virtually unchanged. The researchers concluded that a positive and significant association between UA and several pro-inflammatory markers was found in a large population-based sample of older persons and in a sub-sample of participants with normal UA as well. Accordingly, the prevalence of abnormally high levels of C-reactive protein and IL-6 increased significantly across UA quintiles (indicating acids paralleling high levels of inflammation as expected).

In a 2007 study ‘Relationship of Uric Acid with Progression of Kidney Disease’ authors tested the hypothesis that uric acid may be associated with kidney disease progression using 5,808 participants of the Cardiovascular Health Study. Uric acid levels were surely increased in patients with kidney dysfunction. Researchers then concluded that uric acid levels are associated strongly with prevalent CKD, and there was only a modest, but significant, association between uric acid levels and progression of abnormal kidney function. (4)

In a 2006 article ‘Serum Uric Acid as a Risk Factor for Cardiovascular and Renal Disease: An Old Controversy Revived’, published in The Journal of Clinical Hypertension, authors stated “Considerable experimental evidence suggests a causal role for Serum Uric Acid (SUA) in the pathogenesis of hypertension. Furthermore, the link between SUA levels and traditional metabolic risk factors is well known, and several large clinical studies have shown that asymptomatic hyperuricemia is associated with cardiovascular (CV) and renal complications.” (5)

STUDIES SHOW IT WOULD BE HIGHLY PRACTICAL TO EXAMINE SERUM URIC ACID LEVELS AS A HEALTH MARKER, JUST LIKE IS DONE WITH BLOOD PRESSURE AND CHOLESTEROL.

“Several reports indicate that SUA is independently associated with adverse events, especially in women. This finding has been confirmed by most of 11 studies among subjects at higher CV risk, such as those with hypertension and diabetes. Gueyffier et al. analyzed the Individual Data Analysis of Antihypertensive Intervention Trials (INDANA) database and found that the prevalence of CV events associated with increased SUA levels is similar to what is attributable to blood pressure (BP) and total cholesterol. The association of SUA with Stroke is even stronger in well-treated hypertensive patients and endures after successful BP control.” The list of studies for further review can be found here on table 1- http://onlinelibrary.wiley.com/doi/10.1111/j.1524-6175.2006.04755.x/full

More studies show high SUA levels are a promotor of CV and Renal Damage

Expanding on the previous article this question was answered by the same authors stating “The relationship between SUA and the development of sub-clinical CV and renal damage has been under investigation for several years. In several cross-sectional and prospective reports, SUA levels were found to be associated with carotid (artery) intima-media thickening and/or carotid (artery) plaque.” The list of studies can be found here on table 3- http://onlinelibrary.wiley.com/doi/10.1111/j.1524-6175.2006.04755.x/full

In another 2010 study ‘Metabolic Basis for Low Urine pH in Type 2 Diabetes’, researchers found that “patients with type 2 diabetes exhibited a significantly lower 24-hour urine pH and higher net acid excretion compared with control subjects.” This scenario greatly increases the risk for uric acid nephrolithiasis, or kidney stones. (6)

In yet ANOTHER 2015 study ‘Serum uric acid and the risk of cardiovascular and kidney disease’, researchers found SUBSTANTIAL EVIDENCE suggesting that chronic hyperuricemia is an independent risk factor for hypertension, metabolic syndrome, chronic kidney disease (CKD) and cardiovascular diseases. (7)

GOUT IS ON THE RISE!

In the U.S., gout has risen over the last twenty years, now affecting 8.3 million (4%) Americans. Prevalence of increased uric acid levels (hyperuricemia) also rose, affecting 43.3 million (21%) adults. As previously stated, gout is just one form of arthritis that involves the buildup of (MSU) acid crystals in the surrounding joint with excessive pain. As mentioned, there are many other forms of arthritis and other conditions that involve acid buildup and crystallization besides what is conventionally known as gout. Currently almost 23% of adults in US were diagnosed with some type of arthritis including gout, lupus, and fibromyalgia. This number climbs to almost 80% in individuals over the age of 50. ALL forms of arthritis involve excessive levels of inflammation/acidity at some point, in fact most all diseases do!

Additionally, most people do not take a definitive test for acid crystal deposition, nor does gout always produce symptoms, escalating those percentages further. At the same time, hyperuricemia only represents high blood levels of uric acid, not interstitial fluids and tissues, making blood tests inaccurate, raising percentages even higher. The number of people holding onto excessive amounts of acid is far more than estimations of gout and hyperuricemia would be indicative of.

It all starts with low grade chronic acidity/ inflammation, which according to statistics effects the majority of the US as well as many other Western nations. This is a direct result of poor diet and lifestyle choices and the resultant acid buildup takes years to accumulate. With all these factors considered, the direct link between excessive acid accumulation and disease is obvious and undeniable! You don’t need to develop gout symptoms or high blood urate levels to prove this fact.

However, if you do develop gout symptoms or hyperuricemia, consider yourself lucky and take it as a very serious warning sign indicative of other dangerous metabolic disturbances as studies STRONGLY suggest. Take action towards a heathier diet and lifestyle to prevent any irreparable organ issues and reverse the damage. Prevention is the cure! There are many solutions.

https://www.cdc.gov/arthritis/data_statistics/arthritis-related-stats.htm