What should be avoided with hyperuricemia?

Written by Li Hui Zhi
Endocrinology
Updated on September 26, 2024
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Foods to avoid for hyperuricemia include those high in purines. Here is a list of foods that are high in purines: 1. Seafood, such as some shellfish, shrimp, crab, and certain fishes. 2. Broths that have been simmered for a long time, as they tend to contain higher levels of purines. 3. Certain mushrooms should be consumed less, such as shiitake and straw mushrooms. 4. Animal organs should be avoided as much as possible. 5. Alcohol, especially strong spirits and beer, should be avoided; instead, it's important to drink plenty of water, ensuring to consume 1500 to 2000 milliliters daily.

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Written by Luo Juan
Endocrinology
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What fruits to eat for hyperuricemia?

For patients with hyperuricemia, we generally need to limit the intake of high-purine foods, such as crab and animal offal. Moderate consumption of medium-purine foods, such as meats and fish, is acceptable. Low-purine foods like vegetables, fruits, milk, and eggs can be safely consumed. For example, fruits like grapes, pears, grapefruits, kiwis, and dragon fruits are all acceptable to eat. However, many patients with hyperuricemia also have other metabolic abnormalities, such as high blood sugar. In such cases, it is important to monitor the quantity of fruit intake because excessive consumption can lead to fluctuations in blood sugar levels. Therefore, fruits can be safely consumed by those with hyperuricemia, but attention must be paid to any additional metabolic abnormalities that may be present.

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Written by Liang Yin
Endocrinology
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How to reduce high uric acid in hyperuricemia?

The treatment of hyperuricemia includes lifestyle intervention and medication. Lifestyle intervention involves controlling the total caloric intake of the diet, limiting the intake of high-purine foods, avoiding animal offal, shellfish, hot pots, and not consuming tofu, bean sprouts, and other soy products. Smoking and drinking alcohol should be prohibited. It is advocated to eat alkaline foods and choose melon-type vegetables. Appropriate exercise, such as brisk walking, jogging, and aerobic dancing, should be performed. Weight control is necessary, and obese patients should lose weight. Secondly, medication should be used to lower uric acid levels. Options include drugs that promote the excretion of uric acid and drugs that inhibit the production of uric acid, while also alkalizing the urine.

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Written by Luo Juan
Endocrinology
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Hyperuricemia treatment agent

Currently, the main treatments for hyperuricemia in clinical practice include the following types. One category is drugs that inhibit uric acid synthesis, primarily allopurinol and febuxostat. Allopurinol is a xanthine oxidase inhibitor, which mainly works by preventing the conversion of hypoxanthine and xanthine into uric acid through the inhibition of xanthine oxidase. Febuxostat, on the other hand, is a newer xanthine oxidase inhibitor and may be more effective than allopurinol in lowering blood uric acid levels. Another category includes drugs that promote the excretion of uric acid, suitable for patients with normal renal function and hyperuricemia. These mainly include probenecid, benzbromarone, and some use of thiazide diuretics, though their effectiveness for hyperuricemia is somewhat controversial. (Specific medications should be taken under the guidance of a physician.)

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Written by Luo Juan
Endocrinology
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The causes of hyperuricemia

The causes of hyperuricemia can currently be divided into two categories: primary and secondary. The cause of most primary hyperuricemia is not yet clear. A few cases are due to enzyme deficiencies, which are related to either excessive production or reduced excretion of uric acid. There is also idiopathic hyperuricemia, such as familial kidney diseases that are associated with hyperuricemia, among others. Some secondary hyperuricemias, for example, are secondary to some congenital metabolic diseases, such as glycogen storage disease. It can also be due to certain systemic diseases, such as leukemia, multiple myeloma, lymphoma, polycythemia vera, hemolytic anemia, etc. Some cases are physiological increases, such as the intake of foods rich in purines, long-term eating and fasting states can also cause increased blood uric acid. Some medications can also lead to hyperuricemia, such as thiazide diuretics, furosemide, ethanol, immunosuppressants, aspirin, etc., which can also cause hyperuricemia. Therefore, the causes of hyperuricemia are diverse, and some causes are still unclear.

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Written by Chen Xie
Endocrinology
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How is hyperuricemia treated?

The treatment of hyperuricemia mainly includes: First, improving lifestyle, including healthy eating with a low-purine diet, quitting smoking, drinking more water, exercising regularly, and controlling weight. Second, alkalinizing the urine using sodium bicarbonate to maintain urine pH between 6.2 and 6.9, which facilitates the excretion of uric acid. Third, avoiding medications that increase blood uric acid levels, such as diuretics, corticosteroids, and insulin, among others. Fourth, using medications that lower uric acid, including drugs that increase uric acid excretion, mainly benzbromarone and probenecid, and drugs that inhibit uric acid synthesis, such as allopurinol and febuxostat. The choice of medication has specific indications, contraindications, and side effects, and it is advised to use these medications under the guidance of a specialist and not to self-medicate.