Should Patients Who Develop Hyperuricemia With Hydrochlorothiazide Be Started On Allopurinol?

Content

• How Is Gout Diagnosed?
• Other Treatments
• Medicines That May Increase Uric Acid
• Health Solutions From Our Sponsors

They tend to be overweight and have high blood pressure and elevated cholesterol levels. Gout patients are more likely to be diabetic, have impaired kidney function and suffer from heart disease. Many experts have wondered whether the elevated blood levels of uric acid seen in gout sufferers is at the root of these other medical problems. Among the 18 studies analyzed, there was data from 55,607 participants, including 13,025 participants with high blood pressure. The researchers noted that participants with hyperuricemia were more than 40 percent more likely to later develop high blood pressure than participants without hyperuricemia.

How Is Gout Diagnosed?

Uric acid is a normal waste product in the blood resulting from the breakdown of certain foods. Uric acid usually passes through the kidneys and is eliminated from the body in urine. But it can build up in the blood and form painful, spiky crystals in your joints. This may happen if the body is making too much uric acid or if the kidneys are having a hard time filtering it out. Sometimes an acute gouty arthritis attack has a sudden onset at nighttime.

If you are not overweight, watch your diet carefully so you don't become overweight. Your doctor may check for other types of arthritis such as CPPD deposition disease and infectious arthritis. These conditions resemble gout but are not caused by uric acid crystals. To determine which type of arthritis you might have, your doctor may have to remove fluid from an affected joint and examine it for crystals.

Other Treatments

If diet is the cause (e.g. eating too much fatty food, liver, kidneys, shrimp, and even such vegetables as Brussels sprouts), it must be addressed. In addition to an injection, doctors often prescribe an aspirin-type medication after the injection, such as ibuprofen/Advil which can help with any residual pain that the injection may not help control. Creating your list of questions in advance can help you make the most of your time with your doctor. Write down your symptoms, including when they started and how often they occur. Joint X-rays can be helpful to rule out other causes of joint inflammation.

In some people, receiving a vaccination can trigger a gout flare. Purines are also found in certain foods, including red meat and organ meats, such as liver. Purine-rich seafood includes anchovies, sardines, mussels, scallops, trout and tuna. Alcoholic beverages, especially beer, and drinks sweetened with fruit sugar promote higher levels of uric acid. If you experience sudden, intense pain in a joint, call your doctor. Gout that goes untreated can lead to worsening pain and joint damage.

Learn about the four most common warning signs.Article Gout Gout is an inflammatory type of arthritis that more commonly affects men. Although it’s unclear why gout might increase the risk of cardiovascular disease, she said possible reasons include increased oxidative stress and inflammation. Patients who had gout at any point during the study had a twofold increased risk of heart failure death compared to people who never developed gout. Animal studies indicate that early in the disease, the extra uric acid activates the renin angiotensin system of the body, shrinking key blood vessels and causing high blood pressure. Eventually, however, the small vessels in the kidney are permanently affected, making the blood pressure sensitive to salt or sodium.

Usually, hypertension has no signs or symptoms, but you can check your blood pressure yourself or have it checked by your physician to know if you have hypertension. If an attack seems to be coming on in the lower extremity, patients are well-advised to try to get off their feet, since impact seems to worsen gout attacks. Clues to an attack of gout coming on include local swelling, heat, redness, and tenderness in a joint, especially in the foot, ankle, or knee. Some patients have fever and chills as the first warning that an attack of gout is coming on. A third type of crystal-induced arthritis, hydroxyapatite deposition disease, has a type of crystal that needs special studies for identification.

You may be referred to a rheumatologist, who specializes in diseases of the joints, muscles and bones. Gout is treatable and can be managed before permanent joint damage or deformities happen. If you have large tophi that are draining, infected or are interfering with the movement of your joints, you and your doctor may decide to have them surgically removed. There are several kinds of operations that can be done to relieve pain and improve the function of the affected joints.

What is the fastest way to get rid of uric acid crystals?

Too much alcohol may raise your uric acid level and bring on a gout episode. Drink at least 10-12 eight-ounce glasses of non-alcoholic fluids daily, especially if you have had kidney stones. This will help flush the uric acid crystals out of your body.

Merola JF, Wu S, Han J, Choi HK, Qureshi AA. Psoriasis, psoriatic arthritis and risk of gout in US men and women. The contents of this website are for informational purposes only and do not constitute medical advice.CreakyJoints.org is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a physician or other qualified health provider with any questions you may have regarding a medical condition. This medication is typically given every two weeks for six months until gout build-up is gone or your doctor decides you can stop treatment. “Obesity is more common in gout patients than in the general population. There is evidence that obesity is also a risk factor for having more complications of COVID-19,” says Dr. Fields.

About 20% of people with gout have family histories of this condition. Several genes are linked to uric acid metabolism and gout. Some people have a defective protein that interferes with the way the body breaks down purines. Before menopause, women have a much lower risk of developing gout than men. This may be because estrogen causes more uric acid to be excreted by the kidneys. Only about 15% of gout cases in women occur before menopause.

The diagnosis of gout is usually confirmed when uric acid crystals are identified in a sample of a tophus or in joint fluid removed with a needle and viewed under a special microscope with polarized light. Over time, joint motion becomes progressively restricted by damage caused by deposits of uric acid crystals in the joints and tendons. Doctors remove fluid from the joint and check it for uric acid crystals to confirm the diagnosis of gouty arthritis.

How do you check uric acid levels?

A uric acid test can be done as a blood test or a urine test. During a blood test, a health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial.

Most often, pain begins suddenly in one or more joints, usually at night. Often the joint swells, feels warm, becomes painful, and the skin over the joint may look red, tight, and shiny. Pain and swelling usually peaks within 12 to 24 hours, and gets better within a few days to several weeks.